Aprepitant (Emend®), the first neurokinin-1-receptor antagonist
(NK-1-RA), represents a new class of antiemetics.
Aprepitant has been approved for the prevention and
treatment of acute (0-24 h after chemotherapy) and delayed
(1-5 days after chemotherapy) emesis resulting
from cisplatin-based chemotherapy and moderately
emetogenic chemotherapy. The addition of aprepitant to
standard antiemetic therapy in cisplatin-based chemotherapy
significantly improves emesis protection in general
and, in particular, in the delayed phase by approximately
20%. Results from a recently published study in
patients receiving moderately emetogenic chemotherapy
suggest a benefit of aprepitant when combined with dexamethasone
and a 5-HT3 receptor antagonist for the prevention
of acute emesis, followed by aprepitant as a single
agent in the prevention of delayed emesis. Altogether,
the addition of aprepitant to the standard antiemetic
regimen (5-HT3 receptor antagonist and dexamethasone)
significantly improves the protection against vomiting in
the acute as well as in the delayed phase in highly and
moderately emetogenic chemotherapies. Therefore, the
combination of a 5-HT3 receptor antagonist, dexamethasone
and aprepitant should be considered as a new standard
Copyright / Drug Dosage
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