Aprepitant Capsules – Onco India International

What Are Aprepitant Capsules?

Aprepitant Capsules are oral medications that help prevent nausea and vomiting caused by chemotherapy or surgery. They work by blocking substance P, a neurotransmitter responsible for triggering the vomiting reflex.

Unlike many other antiemetics that target serotonin (5-HT3) or dopamine receptors, Aprepitant specifically acts on the neurokinin-1 (NK1) receptors in the brain. For maximum effectiveness, it is usually prescribed in combination with a serotonin receptor antagonist (e.g., ondansetron) and a corticosteroid (e.g., dexamethasone), forming a proven triple therapy regimen.

Uses of Aprepitant Capsules

Aprepitant is primarily used to prevent (not treat) nausea and vomiting in:

• Highly emetogenic chemotherapy (HEC) – e.g., cisplatin-based therapy.

• Moderately emetogenic chemotherapy (MEC) – e.g., anthracycline/cyclophosphamide combinations.

• Postoperative nausea and vomiting (PONV) – in patients at high risk after surgery.

Indications

• Chemotherapy-induced nausea and vomiting (CINV) – both acute (within 24 hours) and delayed (24–72 hours) phases.

• Postoperative nausea and vomiting (PONV) – especially in patients prone to severe nausea after anesthesia.

• Combination therapy – routinely used with dexamethasone and serotonin antagonists for improved antiemetic control.

Benefits of Aprepitant Capsules

• Effectively reduces chemotherapy-related nausea and vomiting.

• Prevents dehydration, malnutrition, and electrolyte imbalance caused by repeated vomiting.

• Helps patients adhere to chemotherapy regimens and improves overall quality of life.

• Provides extended protection beyond 24 hours, covering the delayed nausea phase.

How Do Aprepitant Capsules Work?

Aprepitant works by blocking NK1 receptors in the brain. These receptors respond to substance P, which triggers nausea and vomiting. By stopping this interaction, Aprepitant helps prevent both early (within 24 hours) and delayed (24–72 hours) phases of vomiting.

When combined with corticosteroids (like dexamethasone) and serotonin antagonists (like ondansetron), Aprepitant provides comprehensive antiemetic protection. It is also effective in managing post-surgical nausea and vomiting.

Dosage and Administration

• Chemotherapy-Induced Nausea and Vomiting (CINV):

  • Day 1: 125 mg orally, one hour before chemotherapy.

  • Days 2 & 3: 80 mg orally each morning.

• Postoperative Nausea and Vomiting (PONV):

  • A single 40 mg oral dose 1–3 hours before anesthesia.

Capsules should be swallowed whole with water, with or without meals. Dosage adjustments may be required in patients with liver conditions or those taking interacting medications.

When Not to Use Aprepitant

• Allergy to Aprepitant or its ingredients.

• Concurrent use with pimozide (risk of severe heart rhythm issues).

• Severe liver disease (use with caution or avoid).

• Children under 6 months or under 6 kg (safety not established).

• Pregnant or breastfeeding women (consult a doctor first).

• Not to be used for treating existing nausea/vomiting—only for prevention.

Drug Interactions

Aprepitant affects CYP3A4 liver enzymes, which may alter the effectiveness of certain medications.

• Increases levels of dexamethasone – dosage adjustment may be required.

• Reduces effectiveness of oral contraceptives – alternative birth control is advised.

• Modifies warfarin metabolism – requires closer monitoring of blood clotting parameters.

Avoid with:

• Pimozide

• Strong CYP3A4 inducers (rifampin, phenytoin, carbamazepine)

• Strong CYP3A4 inhibitors (ketoconazole, clarithromycin)

• Grapefruit juice (may alter drug metabolism)

Safety Advice

• Pregnancy & Breastfeeding: Use only if clearly needed, under medical supervision.

• Liver Disease: Caution advised; dose adjustments may be required.

• Driving & Machinery: May cause dizziness; avoid activities requiring alertness.

• Oral Contraceptives: Use non-hormonal methods of contraception.

Lifestyle & Dietary Recommendations

• Drink enough water to prevent dehydration.

• Eat small, frequent meals instead of large portions.

• Avoid greasy, spicy, or strongly flavored foods.

• Consume lean proteins, whole grains, fruits, and vegetables for strength.

• Avoid alcohol and excess caffeine.

• Practice stress-reducing techniques (deep breathing, meditation, light exercise).

• Ensure adequate rest and avoid nausea triggers (strong odors, heat, smoke).

Comparison with Other Treatments

• More effective than serotonin receptor blockers alone for delayed nausea.

• Better tolerated than dopamine antagonists (e.g., metoclopramide), which may cause movement disorders.

• Works best as part of triple therapy with ondansetron and dexamethasone.

Conclusion

Aprepitant Capsules, provided by Onco India International, are a proven solution for the prevention of chemotherapy- and surgery-induced nausea and vomiting. By targeting NK1 receptors, they provide both immediate and extended protection.

When used appropriately in combination therapy, Aprepitant enhances patient comfort, prevents treatment interruptions, and improves quality of life. Patients should follow medical advice carefully and be aware of possible interactions or precautions.