Aprepitant is available as an oil-in-water emulsion in single-dose vials containing 130 mg of aprepitant in 18 mL of emulsion.3436; 3437 Also present in each 130-mg vial are egg lecithin 2.6 g, ethanol 0.5 g, sodium oleate 0.1 g, soybean oil 1.7 g, sucrose 1 g, and water for injection.3436
Trade Name(s)
Cinvanti
Aprepitant is administered by direct intravenous injection over 2 minutes or by intravenous infusion over 30 minutes.3436
For direct intravenous injection, aprepitant emulsion is administered undiluted.3436 The infusion line should be flushed with sodium chloride 0.9% before and after administration of aprepitant.3436
For intravenous infusion, aprepitant emulsion should be diluted in a non-polyvinyl chloride (non-PVC) infusion bag containing 100 mL of sodium chloride 0.9% or dextrose 5%.3436
To prepare a 130-mg diluted solution for infusion, 18 mL of the emulsion should be withdrawn from the vial and transferred to a non-PVC infusion bag containing 100 mL of sodium chloride 0.9% or dextrose 5% (total volume of 118 mL).3436 To prepare a 100-mg diluted solution for infusion, 14 mL of the emulsion should be withdrawn from the vial and transferred to a non-PVC infusion bag containing 100 mL of sodium chloride 0.9% or dextrose 5% (total volume of 114 mL).3436 After addition of the emulsion to the infusion bag, the bag should be inverted gently 4 to 5 times; shaking should be avoided.3436 Infusion bags should be inspected for particulate matter and discoloration; if particulate matter is present or discoloration has occurred, the infusion bag should be discarded.3436
Aprepitant should be administered using only non-diethylhexyl phthalate (non-DEHP) tubing.3436
Aprepitant is an opaque, off-white to amber oil-in-water emulsion.3436; 3437 Intact vials should be stored at 2 to 8°C and should not be frozen.3436 Intact vials can be stored at room temperature for up to 60 days.3436 Aprepitant emulsion diluted as recommended in sodium chloride 0.9% is stable for up to 6 hours at ambient room temperature or 72 hours if stored under refrigeration.3436 Aprepitant emulsion diluted as recommended in dextrose 5% is stable for up to 12 hours at ambient room temperature or 72 hours if stored under refrigeration.3436
Aprepitant is incompatible with any solutions containing divalent cations (e.g., calcium, magnesium), including Ringer’s injection, lactated and Hartmann’s solution.3436
Sorption
The diluted emulsion should be prepared using only non-PVC infusion bags and administered using only non-DEHP tubing.3436
Plasticizer Leaching
The manufacturer recommends use of only non-DEHP tubing and non-PVC containers when preparing and administering aprepitant.3436
In a study evaluating aprepitant 0.485 and 1.102 mg/mL (18 mL diluted in 100 or 250 mL of sodium chloride 0.9% or dextrose 5%) stored in 150- and 250-mL PVC bags (Hospira) for up to 72 hours, the amount of of DEHP leached into the infusion admixture was time and concentration dependent.3714 For aprepitant 0.485 mg/mL in 250-mL PVC bags stored at 2-8°C, DEHP concentrations at 72 hours were 25.6 and 23.1 mcg/mL for sodium chloride 0.9% and dextrose 5%, respectively.3714 For aprepitant 1.102 mg/mL in 150-mL PVC bags stored at 2 to 8°C, DEHP concentrations at 72 hours were 84.9 and 82.2 mcg/mL, respectively, for sodium chloride 0.9% and dextrose 5%.3714
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