Fosaprepitant dimeglumine (Merck) is available as a lyophilized powder in single-dose vials containing the equivalent of 150 mg of fosaprepitant.2998 Also present in each vial are edetate disodium 5.4 mg, polysorbate 80 75 mg, lactose anhydrous 375 mg, and sodium hydroxide and/or hydrochloric acid to adjust the pH.2998
Fosaprepitant dimeglumine (Teva) also is available as a lyophilized powder in single-dose vials containing the equivalent of 150 mg of fosaprepitant.3620 Also present in each vial are edetate disodium 18.8 mg, meglumine 75 mg, and povidone k12 600 mg.3620 Hydrochloric acid and/or meglumine may have been added to adjust the pH.3620
Each 150-mg vial should be reconstituted with 5 mL of sodium chloride 0.9%, directing the stream of diluent along the vial wall to prevent foaming.2998; 3620 The vial should be gently swirled to dissolve the powder; jetting of the diluent into the vial and shaking of the vial should be avoided.2998; 3620 After reconstitution, the solution should be further diluted to a concentration of 1 mg/mL by transferring the entire vial contents to an infusion bag containing 145 mL of sodium chloride 0.9% and gently inverting the bag 2 to 3 times.2998; 3620 For patients requiring doses less than 150 mg (e.g., certain pediatric patients), the entire volume of the infusion bag may not be required; in such patients, the appropriate dose of the fosaprepitant 1-mg/mL solution can be withdrawn from the infusion bag and transferred to an appropriately sized bag or syringe for administration by infusion.2998 The diluted solution should be inspected for particulate matter and discoloration prior to infusion.2998; 3620
Trade Name(s)
Emend
Fosaprepitant dimeglumine is administered by intravenous infusion over 20 to 30, 30, or 60 minutes (depending on patient age) after dilution in sodium chloride 0.9% to a concentration of 1 mg/mL.2998; 3620
The manufacturer recommends avoiding infusion of fosaprepitant dimeglumine into a small vein or through a butterfly catheter.2998; 3620 If a severe infusion-site reaction occurs, the infusion should be discontinued and appropriate medical treatment should be initiated.2998; 3620
Fosaprepitant dimeglumine is a white to off-white powder.2998; 3620 Intact vials should be stored under refrigeration at 2 to 8°C.2998; 3620
Fosaprepitant dimeglumine (Merck Sharpe & Dohme) reconstituted to a fosaprepitant concentration of 30 mg/mL in sodium chloride 0.9% was found to be visually compatible with little loss of drug in 7 days at 4.9°C.3621
Manufacturers state that the diluted solution for infusion is stable for 24 hours at or below 25°C.2998; 3620
Fosaprepitant is incompatible with any solutions containing divalent cations (e.g., calcium, magnesium), including Ringer’s injection, lactated, and Hartmann's solution.2998; 3620
For a list of references cited in the text of this monograph, search the monograph titled References.