Prevention of Acute and Delayed Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy
- PO (Adults and Children ≥12 yr): Capsules: 125 mg given 1 hr prior to chemotherapy (Day 1), then 80 mg once daily for 2 days (Days 2 and 3). Suspension (if unable to swallow capsules): 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1) , then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3).
- IV (Adults): Cinvanti: 130 mg given 30 min prior to chemotherapy on Day 1 only.
- PO (Children 6 mo–<12 yr and >6 kg): Suspension: 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1), then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3).
Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Chemotherapy
- PO (Adults and Children ≥12 yr): Capsules: 125 mg given 1 hr prior to chemotherapy (Day 1), then 80 mg once daily for 2 days (Days 2 and 3). Suspension (if unable to swallow capsules): 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1), then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3).
- IV (Adults): Cinvanti (single–dose regimen for delayed nausea/vomiting): 130 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Cinvanti (3–day regimen): 100 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Continue aprepitant 80 mg PO on Days 2 and 3.
- PO (Children 6 mo–<12 yr and >6 kg): Suspension: 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1), then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3).
Prevention of Postoperative Nausea and Vomiting
- IV (Adults): Aponvie: 32 mg as a single dose administered prior to induction of anesthesia.
Therapeutic Classification: antiemetics
Pharmacologic Classification: neurokinin antagonists
Absorption: 60–65% absorbed following oral administration. IV administration results in complete bioavailability.
Distribution: Crosses the blood brain barrier; remainder of distribution unknown.
Protein Binding: 95–99%.
Metabolism/Excretion: Mostly metabolized by the liver (CYP3A4 enzyme system); not renally excreted.
Half-life: 9–13 hr.
