Drug Action
Fosaprepitant is a prodrug of aprepitant.
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Drug reference
Fosaprepitant is a prodrug of aprepitant.
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Adjunct to dexamethasone and a 5HT3-receptor antagonist in preventing nausea and vomiting associated with moderately and highly emetogenic chemotherapy ▶BY INTRAVENOUS INFUSION ▶Adult: 150 mg, dose to be administered over 20–30 minutes and given 30 minutes before chemotherapy on day 1 of cycle only, consult product literature for dose of concomitant corticosteroid and 5HT3-receptor antagonist
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Acute porphyrias p. 1120
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Scottish Medicines Consortium (SMC) decisions SMC No. 678/11 The Scottish Medicines Consortium has advised (March 2011) that fosaprepitant (Ivemend ®) is accepted for restricted use within NHS Scotland for the prevention of acute and delayed nausea and vomiting associated with Nervous system highly emetogenic cisplatin-based chemotherapy in adults.
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→Appendix 1: fosaprepitant
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▶Common or very common Appetite decreased. asthenia. constipation. gastrointestinal discomfort. headache. hiccups ▶Uncommon Anaemia. anxiety. burping. dizziness. drowsiness. dry mouth. febrile neutropenia. flushing. gastrointestinal disorders. malaise. nausea. palpitations. skin reactions. thrombophlebitis. urinary disorders. vomiting ▶Rare or very rare Bradycardia. cardiovascular disorder. chest discomfort. cognitive disorder. conjunctivitis. cough. disorientation. euphoric mood. gait abnormal. hyperhidrosis. increased risk of infection. muscle spasms. muscle weakness. oedema. oropharyngeal pain. photosensitivity reaction. polydipsia. seborrhoea. severe cutaneous adverse reactions (SCARs). sneezing. stomatitis. taste altered. throat irritation. tinnitus. weight decreased ▶Frequency not known Dysarthria. dyspnoea. insomnia. miosis. sensation abnormal. visual acuity decreased. wheezing
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Effectiveness of hormonal contraceptives reduced—effective non- hormonal methods of contraception necessary during treatment and for 2 months after stopping fosaprepitant.
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Avoid unless potential benefit outweighs risk—no information available.
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Avoid—present in milk in animal studies.
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Manufacturer advises caution in moderate to severe impairment—limited information available.
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For intravenous infusion (Ivemend ®), manufacturer advises give intermittently in Sodium chloride 0.9%; reconstitute each 150 mg vial with 5 mL sodium chloride 0.9% gently without shaking to avoid foaming, then dilute in 145 mL infusion fluid; give over 20–30 minutes.
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ▶Ivemend (Merck Sharp & Dohme Ltd) Fosaprepitant (as Fosaprepitant dimeglumine) 150 mg Ivemend 150mg powder for solution for infusion vials | 1 vial P £47.42
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150 mg, dose to be administered over
First-line fragment. Read the complete Indications and Dose section above.
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