Fosaprepitant
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-FOSAPREPITANT |
|---|---|
| Type | Drug |
| Aliases | Emend IVIvemendФосапрепітант |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-ESMO-DLBCL-2024 SRC-NCCN-BCELL-2025 |
Drug Facts
| Class | Substance P / neurokinin-1 (NK1) receptor antagonist (intravenous prodrug of aprepitant) |
|---|---|
| Mechanism | Phosphorylated water-soluble prodrug of aprepitant; rapidly converted by ubiquitous tissue phosphatases to active aprepitant within 30 minutes of IV administration. Active moiety blocks the substance P / NK1 receptor in CNS emetic centers (nucleus tractus solitarius, area postrema), preventing the delayed phase of chemotherapy-induced nausea and vomiting (CINV) that is incompletely controlled by 5-HT3 antagonists alone. A single 150 mg IV dose given on day 1 covers the full delayed phase (~5 days), eliminating need for oral days 2-3 capsules. Approved by FDA January 2008 (single-dose 150 mg formulation: October 2008) and EMA January 2008. |
| Typical dosing | Single 150 mg IV infusion over 20-30 minutes, administered 30 minutes before chemotherapy on day 1 only. Always combined with 5-HT3 antagonist (ondansetron 8-16 mg or palonosetron 0.25 mg IV) and dexamethasone (12 mg IV/PO day 1, then 8 mg PO days 2-4 — note dex dose REDUCTION when combined with fosaprepitant). No dose adjustment for renal impairment (including dialysis); no adjustment for mild-moderate hepatic impairment; not studied in severe hepatic impairment. Pediatric ≥6 months: weight-based 4 mg/kg (max 150 mg). Higher infusion-site reaction rate vs aprepitant — use a free-flowing larger vein, avoid extravasation. |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
IV alternative to oral aprepitant for HEC/MEC prophylaxis. Single 150 mg dose = full 3-day oral course in efficacy. Preferred when: patient cannot reliably swallow capsules (mucositis, dysphagia, active vomiting prior to chemo), inpatient setting where IV administration is convenient, or compliance concerns. Trade-off: ~5-10% infusion-site reactions vs <1% for oral. Same key DDI profile as aprepitant — especially the dexamethasone dose halving. In Ukrainian onco-day-units, fosaprepitant is increasingly used over oral aprepitant for inpatient HEC because of guaranteed administration timing relative to the chemo infusion.
Used By
No reverse references found in the YAML corpus.