Aprepitant

Abstract

An antagonist of neurokinine NK1 receptors, aprepitant is indicated for the prevention of acute and delayed nausea and vomiting in adults related to moderate or high emetic risk anti-cancer chemotherapy. Chemotherapy induces nausea and vomiting by the means of peripheral mechanisms that start in the course of day 1 and in which 5-HT3 receptors play the major role, as well as by the means of central mechanisms that are triggered in the course of following days and in which neurokinine receptors are crucial. In clinical studies, the combination of aprepitant, a corticosteroid, and a 5-HT3 antagonist proved to lead to better overall response than the mere combination of a corticosteroid and a 5-HT3 antagonist. Adverse effects of aprepitant are similar to other antiemetics used in this indication.