NK1 receptor antagonist
Fosaprepitant
Brand names: Ivemend
Adult dose
Dose: 150mg IV over 20–30 min on day 1 of chemotherapy (with dexamethasone + 5-HT3 antagonist)
Route: IV
Frequency: day 1 of cycle
Clinical pearls
- Highly/moderately emetogenic chemotherapy — prevention of CINV
- IV alternative to oral aprepitant
Contraindications
- Concurrent pimozide/cisapride/terfenadine
- Severe hepatic impairment
Side effects
- Constipation
- Asthenia
- Headache
- Hiccups
- Hypersensitivity
- ALT rise
Interactions
- CYP3A4 substrates — dexamethasone dose reduction
- Reduces hormonal contraceptive efficacy
- Warfarin
- Tolbutamide
Reference: BNF; NICE TA313; ESMO antiemetic guidelines; https://bnf.nice.org.uk/drugs/fosaprepitant/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015