Aprepitant Accord
Aprepitant Accord Uses, Dosage, Side Effects, Food Interaction and all others data.
Aprepitant Accord is a selective high affinity antagonist of human substance P neurokinin 1 (NK1) receptors. When substance P attaches to these receptors, it causes nausea and vomiting. Aprepitant Accord stops substance P from binding to the NK1 receptors. By blocking the receptors, Aprepitant Accord can prevent nausea and vomiting, which often happens after chemotherapy or as a complication of surgery.
Aprepitant Accord, an antiemetic, is a substance P/neurokinin 1 (NK1) receptor antagonist which, in combination with other antiemetic agents, is indicated for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy. Aprepitant Accord is a selective high-affinity antagonist of human substance P/neurokinin 1 (NK1) receptors. Aprepitant Accord has little or no affinity for serotonin (5-HT3), dopamine, and corticosteroid receptors, the targets of existing therapies for chemotherapy-induced nausea and vomiting (CI NV).
Trade Name | Aprepitant Accord |
Availability | Prescription only |
Generic | Aprepitant |
Aprepitant Other Names | Aprepitant, Aprépitant, Aprepitantum |
Related Drugs | lorazepam, ondansetron, Zofran, dexamethasone, Ativan, metoclopramide |
Type | |
Formula | C23H21F7N4O3 |
Weight | Average: 534.4267 Monoisotopic: 534.150187993 |
Protein binding | Protein binding is reported to be >95%. |
Groups | Approved, Investigational |
Therapeutic Class | Anti-emetic drugs |
Manufacturer | Accord Healthcare Limited |
Available Country | United Kingdom |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Aprepitant Accord is used for-
- Prevention of postoperative nausea and vomiting (PONV)
- Prevention of Chemotherapy Induced Nausea and Vomiting (CINV)
Aprepitant Accord is also used to associated treatment for these conditions: Nausea and vomiting
How Aprepitant Accord works
Aprepitant Accord has been shown in animal models to inhibit emesis induced by cytotoxic chemotherapeutic agents, such as cisplatin, via central actions. Animal and human Positron Emission Tomography (PET) studies with Aprepitant Accord have shown that it crosses the blood brain barrier and occupies brain NK1 receptors. Animal and human studies show that Aprepitant Accord augments the antiemetic activity of the 5-HT3-receptor antagonist ondansetron and the corticosteroid ethasone and inhibits both the acute and delayed phases of cisplatin induced emesis.
Dosage
Aprepitant Accord dosage
Post Operative Nausea and Vomiting
The recommended oral dosage of Aprepitant Accord is 40 mg within 3 hours prior to induction of anesthesia.
Chemotherapy Induced Nausea and Vomiting
The following regimen should be used for the prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy:
Day 1: Aprepitant Accord 125mg orally, Dexamethasone 12 mg orally, 5-HT3 antagonist (Ondansetron): 24 mg 30 minutes before the start of chemotherapy.
Day 2: Aprepitant Accord 80 mg orally, Dexamethasone 8 mg orally
Day 3: Aprepitant Accord 80 mg orally, Dexamethasone 8 mg orally
Day 4: Dexamethasone 8 mg orally
*Aprepitant Accord is administered orally 1 hour prior to chemotherapy treatment on Day 1 and in the morning on Days 2 and 3. **Dexamethasone is administered 30 minutes prior to chemotherapy treatment on Day 1 and in the morning on Days 2 through 4. The dose of dexamethasone accounts for drug interactions.
The following regimen should be used for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy:
Day 1: Aprepitant Accord 125mg orally, Dexamethasone 12 mg orally, 5-HT3 antagonist (Ondansetron): one 8 mg tablet 30 minutes before chemotherapy followed by an 8 mg dose 8 hours later.
Day 2: Aprepitant Accord 80 mg orally, 5-HT3 antagonist (Ondansetron): 8 mg tablet twice a day
Day 3: Aprepitant Accord 80 mg orally, 5-HT3 antagonist (Ondansetron): 8 mg tablet twice a day
*Aprepitant Accord is administered orally 1 hour prior to chemotherapy treatment on Day 1 and in the morning on Days 2 and 3. **Dexamethasone is administered 30 minutes prior to chemotherapy treatment on Day 1. The dose of dexamethasone accounts for drug interactions.
Aprepitant Accord may be taken with or without food. No dosage adjustment is necessary for the elderly patients.
Patients with Renal Impairment- No dosage adjustment is necessary for patients with renal impairment or for patients with end stage renal disease (ESRD) undergoing hemodialysis.
Patients with Hepatic Impairment-No dosage adjustment is necessary for patients with mild to moderate hepatic impairment. There are no clinical data in patients with severe hepatic impairment .
Side Effects
Constipation, Hypotension, Pruritus, Pyrexia
Interaction
Aprepitant Accord is a substrate, a weak-to-moderate (dose dependent) inhibitor, and an inducer of CYP3A4. Aprepitant Accord is also an inducer of CYP2C9. Precautions should be taken while coadministering Aprepitant Accord with drugs that use CYP3A4 or CYP2C9, for example- Warfarin, Tolbutamide, Phenytoin, Ketoconazole, Itraconazole, Nefazodone, Troleandomycin, Clarithromycin, Ritonavir, Nelfinavir, Diltiazem, Rifampin, Carbamazepine etc. Upon coadministration with Aprepitant Accord, the efficacy of hormonal contraceptives during and for 28 days following the last dose of Aprepitant Accord may be reduced. Alternative or back-up methods of contraception should be used during treatment with Aprepitant Accord and for 1 month following the last dose of Aprepitant Accord.
Food Interaction
- Take with or without food. The absorption is unaffected by food.
Aprepitant Accord Drug Interaction
Unknown: charcoal, charcoal, diphenhydramine, diphenhydramine, sulfamethoxazole / trimethoprim, sulfamethoxazole / trimethoprim, prochlorperazine, prochlorperazine, meperidine, meperidine, sodium iodide, sodium iodide, pregabalin, pregabalin, acetaminophen, acetaminophen, cholecalciferol, cholecalciferol, ondansetron, ondansetron
Aprepitant Accord Disease Interaction
Volume of Distribution
- 70 L
Elimination Route
The mean absolute oral bioavailability of aprepitant is approximately 60 to 65%.
Half Life
9-13 hours
Clearance
- Apparent plasma cl=62-90 mL/min
Elimination Route
Aprepitant Accord is eliminated primarily by metabolism; aprepitant is not renally excreted. Aprepitant Accord is excreted in the milk of rats. It is not known whether this drug is excreted in human milk.
Pregnancy & Breastfeeding use
Pregnancy Category B: This drug should be used during pregnancy only if clearly needed.
It is not known whether this drug is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug based on patient’s importance.
Contraindication
Aprepitant Accord is contraindicated in patients who are hypersensitive to any component of the product. Aprepitant Accord should not be used concurrently with Pimozide, Terfenadine, Astemizole & Cisapride.
Special Warning
Patients with Renal Impairment: No dosage adjustment is necessary for patients with renal impairment or for patients with end stage renal disease (ESRD) undergoing hemodialysis.
Patients with Hepatic Impairment: No dosage adjustment is necessary for patients with mild to moderate hepatic impairment. There are no clinical data in patients with severe hepatic impairment .
Acute Overdose
No specific information is available on the treatment of overdosage with Aprepitant Accord. Single doses up to 600 mg of Aprepitant Accord were generally well tolerated in healthy subjects. Drowsiness and headache can be seen due to overdose. In the event of overdose, Aprepitant Accord should be discontinued. General supportive treatment and monitoring should be provided. Because of the antiemetic activity of Aprepitant Accord, medicine-induced emesis may not be effective. Aprepitant Accord cannot be removed by hemodialysis.
Interaction with other Medicine
Aprepitant Accord is a substrate, a weak-to-moderate (dose-dependent) inhibitor, and an inducer of CYP3A4. Aprepitant Accord is also an inducer of CYP2C9. Precautions should be taken while coadministering Aprepitant Accord with drugs that use CYP3A4 or CYP2C9, for example.-Warfarin, Tolbutamide, Phenytoin, Ketoconazole, Itraconazole, Nefazodone, Troleandomycin, Clarithromycin, Ritonavir, Nelfinavir, Diltiazem, Rifampin, Carbamazepine etc.
Upon coadministration with Aprepitant Accord, the efficacy of hormonal contraceptives during and for 28 days following the last dose of Aprepitant Accord may be reduced. Alternative or back-up methods of contraception should be used during treatment with Aprepitant Accord and for 1 month following the last dose of Aprepitant Accord.
Innovators Monograph
You find simplified version here Aprepitant Accord
Aprepitant Accord contains Aprepitant see full prescribing information from innovator Aprepitant Accord Monograph, Aprepitant Accord MSDS, Aprepitant Accord FDA label