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Fosaprepitant Dosage

Medically reviewed on April 25, 2018.

Applies to the following strengths: 150 mg; 115 mg

Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

150 mg IV over 20 to 30 minutes approximately 30 minutes before chemotherapy on Day 1

ADDITIONAL MEDICATIONS:
Highly Emetogenic Cancer Chemotherapy:
-Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy; 5-HT3 antagonist orally/IV per treatment guidelines
-Day 2: Dexamethasone 8 mg orally once a day in the morning
-Days 3 and 4: Dexamethasone 8 mg orally two times a day

Moderately Emetogenic Cancer Chemotherapy:
Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy; 5-HT3 antagonist orally/IV per treatment guidelines

Comment: The 5-HT3 antagonists studied with this drug include ondansetron, granisetron, and dolasetron. The dosage should be determined by accepted treatment guidelines.

Uses:
-In combination with other antiemetic drugs for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (including high-dose cisplatin)
-In combination with other antiemetic drugs for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

Usual Pediatric Dose for Nausea/Vomiting - Chemotherapy Induced

Single-Day Regimen:
At least 6 kg:
6 months to less than 2 years: 5 mg/kg IV over 60 minutes
-Maximum dose: 150 mg
2 to less than 12 years: 4 mg/kg IV over 60 minutes
-Maximum dose: 150 mg
12 to 17 years: 150 mg IV over 30 minutes

Multi-Day Regimen:
At least 6 kg:
6 months to less than 12 years: 3 mg/kg IV over 60 minutes
-Maximum dose: 115 mg
12 to 17 years: 115 mg IV over 30 minutes

ADDITIONAL MEDICATIONS:
Highly Emetogenic Cancer Chemotherapy:
-Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy; 5-HT3 antagonist orally/IV per treatment guidelines
-Day 2: Dexamethasone 8 mg orally once a day in the morning
-Days 3 and 4: Dexamethasone 8 mg orally two times a day

Moderately Emetogenic Cancer Chemotherapy:
Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy; 5-HT3 antagonist orally/IV per treatment guidelines

Comments:
-The infusion should be given via central venous catheter, and should be completed approximately 30 minutes before chemotherapy on Day 1.
-The multi-day regimen should be completed with oral (e.g., capsule or oral suspension) formulations on Days 2 and 3.
-The 5-HT3 antagonists studied with this drug include ondansetron, granisetron, and dolasetron. The dosage should be determined by accepted treatment guidelines.

Uses:
-In combination with other antiemetic drugs for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (including high-dose cisplatin)
-In combination with other antiemetic drugs for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Mild to moderate liver dysfunction (Child-Pugh score 5 to 9): No adjustment recommended.
Severe liver dysfunction (Child-Pugh score greater than 9): Frequent monitoring recommended.

Dose Adjustments

Geriatric Patients: Use with caution, as age-related hepatic, renal or cardiac function decreases and/or concomitant disease/other drug therapy may interact with therapy.

Precautions

CONTRAINDICATIONS:
-Hypersensitivity to the active component or any of the ingredients
-Patients taking pimozide

Safety and efficacy have not been established in patients younger than 6 months.

Consult WARNINGS section for additional precautions.

Dialysis

No adjustment recommended.

Other Comments

Administration advice:
-Always administer therapy as a diluted, slow IV infusion over at least 20 to 30 minutes.
-This drug should not be given as a bolus injection or via IM/subcutaneous routes.
-Pretreatment with a corticosteroid and antiemetic agent should begin at least 30 minutes prior to beginning chemotherapy.

Storage requirements:
-The manufacturer product information should be consulted.

Reconstitution/preparation techniques:
-The manufacturer product information should be consulted.

IV compatibility:
-The manufacturer product information should be consulted.

General:
-This drug has not been studied in the treatment of established nausea and vomiting.
-The AUC of dexamethasone increased by 100% when administered with this drug. Lower doses of dexamethasone are recommended for use in the treatment of highly emetogenic cancer chemotherapy on days 1 and 2 account for this interaction.

Monitoring:
-Injection site reactions, including irritation and thrombosis
-Hypersensitivity reactions at any time during treatment
-INR in patients taking warfarin, especially 7 to 10 days after beginning this drug at each cycle

Patient advice:
-Patients should be advised to report all concurrent prescription and nonprescription medications or herbal products they are taking.
-Instruct patients to immediately report any signs/symptoms of Stevens-Johnson syndrome, toxic epidermal necrolysis, or hypersensitivity reactions.
-Patients should be advised to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding; patients using hormonal contraception to prevent pregnancy will need to speak with their health care provider about using a non-hormonal back-up method of birth control for up to 2 months after completing therapy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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