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Aprepitant

Aprepitant is an antiemetic medication primarily used to prevent nausea and vomiting caused by chemotherapy and surgery. It belongs to a class of drugs known as substance P/neurokinin-1 (NK1) receptor antagonists. Aprepitant works by blocking the action of substance P, a neuropeptide associated with the vomiting reflex, thus helping to control nausea and vomiting in patients undergoing treatment that can provoke these symptoms.



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Frequently Asked Questions

How long does it take for aprepitant to work?
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Aprepitant usually starts to work within a few hours of taking the dose, especially when used as part of a regimen for chemotherapy.

Can I take aprepitant with other medications?
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Yes, but it's important to inform your healthcare provider about all medications you are taking, as aprepitant can interact with various drugs.

What should I do if I miss a dose of aprepitant?
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If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.

Can I take aprepitant if I’m pregnant?
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Consult your healthcare provider if you are pregnant or planning to become pregnant, as the safety of aprepitant during pregnancy should be evaluated.

Are there any dietary restrictions while taking aprepitant?
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There are no specific dietary restrictions, but maintaining a healthy diet and staying hydrated can help manage nausea and vomiting more effectively.

Comprehensive Drug Guide

How Does Aprepitant Work?

Aprepitant works by selectively inhibiting the NK1 receptors in the brain that are responsible for mediating the emetic (vomiting) response. By blocking substance P from binding to these receptors, aprepitant effectively reduces the likelihood of nausea and vomiting, particularly in the context of chemotherapy or postoperative recovery.



Common Dosages

  • Capsules: 40 mg, 80 mg, and 125 mg

Typical Dosing

  • For chemotherapy-induced nausea and vomiting, the typical dose is 125 mg taken orally on the first day of chemotherapy, followed by 80 mg once daily on days 2 and 3.
  • For postoperative nausea and vomiting, a dose of 40 mg may be given orally before surgery.

Typical Dosing

FDA Approved Indications

  • Prevention of nausea and vomiting associated with highly and moderately emetogenic chemotherapy
  • Prevention of postoperative nausea and vomiting in adults


Who Shouldn't Take Aprepitant?

  • Known hypersensitivity to aprepitant or any components of the formulation
  • Concomitant use of pimozide or cisapride due to potential interactions


Advice From The Pharmacist

  • Aprepitant can be taken with or without food, but it is important to follow the prescribed dosing schedule for optimal effectiveness.
  • Inform your healthcare provider about all medications you are taking, as aprepitant can interact with various drugs, including hormonal contraceptives and anticoagulants.
  • Stay well-hydrated and discuss any persistent nausea or vomiting with your healthcare provider.


Side Effects of Aprepitant

Common Side Effects

  • Fatigue
  • Dizziness
  • Nausea
  • Hiccups


Uncommon/Severe Side Effects

  • Allergic reactions (rash, itching, swelling)
  • Liver enzyme elevations


Risks and Warnings of Aprepitant

  • Drug Interactions: Aprepitant can affect the metabolism of various medications, leading to increased or decreased blood levels of other drugs. Careful monitoring is required.
  • Liver Function: Patients with liver impairment may require dose adjustments and should be monitored closely for adverse effects.


Interactions with Aprepitant

Common Drug Interactions

  • Hormonal Contraceptives: Aprepitant may reduce the effectiveness of hormonal contraceptives; alternative forms of contraception should be considered during treatment.
  • Warfarin: Aprepitant may affect the metabolism of warfarin, requiring more frequent monitoring of INR levels.
  • CYP3A4 Inhibitors and Inducers: Aprepitant is a substrate of CYP3A4, and its levels may be influenced by other drugs that inhibit or induce this enzyme.


Alternatives to Aprepitant

  • Ondansetron: A commonly used serotonin receptor antagonist for preventing nausea and vomiting.
  • Granisetron: Another serotonin receptor antagonist effective in managing chemotherapy-induced nausea and vomiting.
  • Dexamethasone: A corticosteroid that can be used in combination with other antiemetics to improve control of nausea and vomiting.