Aprepitant efficacy

Keller, Martin, Stuart Montgomery, William Ball, Mary Morrison, Duane Snavely, Guanghan Liu, Richard Hargreaves, Jarmo Hietala, Christopher Lines, Katherine Beebe and Scott Reines, Lack of Efficacy of the Substance P (Neurokinini Receptor) Antagonist Aprepitant in the Treatment of Major Depressive Disorder , Biological Psychiatry 59 (2006) 216-23... 

Aprepitant, dexamethasone, or metoclopramide have demonstrated efficacy in preventing CINV, whereas the results with SSRIs are inconsistent. 

Children Safety and efficacy of aprepitant in children have not been established. 

Although the effects of these reduced contraceptive steroids levels on ovulation were not assessed, it is likely that they could result in reduced efficacy. The manufacturer therefore recoimnends that alternative or additional contraceptive methods should be used during, and for 2 months (UK advice) or one month (US advice) after, aprepitant use. This seems a sensible precaution. No studies have been done on the effect of a single 40-mg dose of aprepitant 40 mg, as licensed in the US for postoperative nausea and vomiting. However, the US manufacturer states that the timing of the dose may cause contraceptive failure and the same guidance, as stated above, should be used. ... 

Rifampicin markedly reduced the AUC of aprepitant, and reduced efficacy would be expected. In the UK, the manufacturer recommends that concurrent use of aprepitant and other strong inducers of CYP3A4 should be avoided. 

Paul B, Trovato JA, Thompson J, Badros AZ, Goloubeva O. Efficacy of aprepitant in patients receiving high-dose chemotherapy with hematopoietic stem cell support. J Oncol Pharm Pract 2010 16 45-51. 

Oral contraceptives the co-administration of aprepitant may reduce the efficacy of hormonal contraceptives during and for 28 days after administration of the last dose of aprepitant. Alternative or backup methods of contraception should be used during treatment with aprepitant and for 1 month following the last dose of aprepitant... 

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