Fosaprepitant Dimeglumine
Pronunciation: (foe-sa-PREP-i-tant).
- Generic name
- fosaprepitant dimeglumine
- Brand names
- Fosaprim, Fosaprepitant Accord, Fosalon, Fosawin, Fosaprepitant for Injection, Fosaprepitant Sandoz
- Drug class
- Antiemetic (Neurokinin-1 Receptor Antagonist)
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What fosaprepitant dimeglumine is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how fosaprepitant dimeglumine works
Fosaprepitant is a prodrug of aprepitant and acts as a selective, high-affinity antagonist of human substance P/neurokinin 1 (NK1) receptors. By blocking NK1 receptors in the central nervous system, it inhibits the action of substance P, a key mediator in the vomiting reflex pathway, thereby preventing both acute and delayed phases of chemotherapy-induced nausea and vomiting.
What fosaprepitant dimeglumine is used for
Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cancer chemotherapy (HEC)
Approved, in combination with other antiemetic agents, for adults and pediatric patients 6 months of age and older, for initial and repeat courses of highly emetogenic chemotherapy including high-dose cisplatin. (2)
Prevention of acute and delayed nausea and vomiting associated with moderately emetogenic cancer chemotherapy (MEC)
Approved, in combination with other antiemetic agents, for the prevention of delayed nausea and vomiting associated with moderately emetogenic chemotherapy; not studied for treating nausea or vomiting that has already started. (2)
Before taking fosaprepitant dimeglumine
Do not take / not appropriate for
- known hypersensitivity to any component of the product, and concurrent use with pimozide. (Contraindication) (2)
Tell your clinician about
(2)How to take fosaprepitant dimeglumine
- General Instructions: Fosaprepitant is administered as a single intravenous infusion, typically given 30 minutes before the start of chemotherapy. It is used in combination with other antiemetic agents.. Adult Dosing: The usual adult dose is 150 mg administered intravenously over 20-30 minutes on Day 1 of chemotherapy.. Pediatric Dosing: For children and adolescents (6 months to 17 years), dosing is weight-based and should be determined by a healthcare professional.. Administration: Given by a healthcare professional as an IV infusion. Do not self-administer.. When To Stop: Fosaprepitant is usually given as a single dose per chemotherapy cycle. Do not continue or repeat without medical advice.. Storage: Unopened vials must be REFRIGERATED at 2°C to 8°C (36°F to 46°F), protected from light. Once reconstituted and diluted for infusion, the prepared solution is stable at room temperature (up to 25°C/77°F) for up to 24 hours.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a scheduled dose, contact your healthcare provider immediately. Do not attempt to administer the medication yourself.
Overdose
In case of suspected overdose, seek emergency medical attention. Supportive care and monitoring of vital signs are recommended, as there is no specific antidote. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Fatigue
Incidence: Reported in the clinician-authored database; frequency not established
Diarrhea
Incidence: Reported in the clinician-authored database; frequency not established
Constipation
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Hiccups
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Neutropenia
Incidence: >=2% (per FDA label)
Asthenia (weakness), anemia, peripheral neuropathy, leukopenia, dyspepsia, urinary tract infection, pain in extremity
Incidence: >=2% (per FDA label)
Infusion-site reactions
Incidence: About 2.2% in patients receiving a moderately emetogenic chemotherapy (MEC) regimen (per FDA label)
Signs of a severe allergic reaction (swelling, difficulty breathing, hives) or a severe infusion-site reaction (significant pain, redness, or swelling at the IV site)
Incidence: Uncommon but serious; managed immediately by the infusion team
Serious warnings
May cause serious allergic reactions, including anaphylaxis — serious
Symptoms: May cause serious allergic reactions, including anaphylaxis. Use with caution in patients with moderate to severe hepatic impairment. May interact with warfarin, hormonal contraceptives, and certain chemotherapy agents. Not for use in the treatment of established nausea or vomiting. Monitor for infusion site reactions and signs of hypersensitivity.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Infusion-site reactions can occur — serious
Symptoms: Infusion-site reactions can occur; the infusion team avoids giving fosaprepitant into small veins or through a butterfly catheter, and pediatric patients receive it through a central venous catheter. If a severe infusion-site reaction develops, the infusion is stopped and appropriate treatment is given by the care team.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications — serious
Symptoms: Contraindications: hypersensitivity to fosaprepitant, aprepitant, or any excipient; and concurrent use with pimozide, because fosaprepitant/aprepitant can raise pimozide blood levels and increase the risk of dangerous QT-interval prolongation. Clinicians also use added caution in moderate-to-severe hepatic impairment and with other medications metabolized by CYP3A4, such as warfarin, hormonal contraceptives, and certain chemotherapeutic agents.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Fosaprepitant can interact with several medications, including warfarin (may decrease INR), hormonal contraceptives (may reduce effectiveness), and certain chemotherapy drugs. It is a moderate inhibitor of CYP3A4 and may affect the metabolism of drugs processed by this enzyme. Always inform your healthcare provider about all medicines you are taking. |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Available human data are insufficient to assess fosaprepitant's drug-associated risk in pregnancy. Animal studies did not show adverse developmental effects at exposures similar to the recommended human dose. Any use in pregnancy should be discussed with the treating oncology and obstetric team. (2)
Breastfeeding
It is not known whether aprepitant (fosaprepitant's active form) passes into human breast milk. The developmental and health benefits of breastfeeding should be weighed against the mother's clinical need for fosaprepitant and any potential infant risk, in discussion with the treating clinician. (2)
Children
Fosaprepitant IS approved, in combination with other antiemetic agents, for pediatric patients 6 months of age and older, for the same highly and moderately emetogenic chemotherapy indications as adults. Dosing is weight-based and determined by the treating clinician. Pediatric infusions are given through a central venous catheter, over 30 minutes (ages 12-17) or 60 minutes (ages 6 months to under 12 years). (2)
Renal_impairment
Hepatic impairment: no dose adjustment is needed for mild-to-moderate hepatic impairment (Child-Pugh score 5-9). Data are not available for severe hepatic impairment, so additional monitoring is warranted in that group. Renal impairment: no dose adjustment is required; aprepitant (the active moiety) is not eliminated by the kidneys, and hemodialysis removes only a minimal amount. (2)
Hepatic_impairment
Hepatic impairment: no dose adjustment is needed for mild-to-moderate hepatic impairment (Child-Pugh score 5-9). Data are not available for severe hepatic impairment, so additional monitoring is warranted in that group. Renal impairment: no dose adjustment is required; aprepitant (the active moiety) is not eliminated by the kidneys, and hemodialysis removes only a minimal amount. (2)
Monitoring
(2)Storage
Unopened vials must be REFRIGERATED at 2°C to 8°C (36°F to 46°F), protected from light and moisture, and kept out of reach of children. After a pharmacy reconstitutes and dilutes the medicine for infusion, the prepared solution is stable at room temperature (up to 25°C/77°F) for up to 24 hours.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cancer chemotherapy (HEC)
Dose summary: Fosaprepitant 150 mg administered intravenously as a single dose on Day 1 of chemotherapy.
Renal context: No dose adjustment is required for renal impairment; aprepitant is not renally excreted and hemodialysis removes only a minimal amount. (2)
Frequently asked questions
What is fosaprepitant used for?
Fosaprepitant is used to prevent nausea and vomiting caused by certain types of cancer chemotherapy. It is not used to treat nausea or vomiting that has already started.
How is fosaprepitant administered?
Fosaprepitant is given as an intravenous infusion by a healthcare professional, usually 30 minutes before chemotherapy begins.
Can I use fosaprepitant if I have liver disease?
Caution is advised in patients with liver disease. Dose adjustments may be necessary, and your doctor will monitor your liver function closely.
Are there any serious side effects I should watch for?
Yes. Serious side effects include severe allergic reactions, liver problems, and severe infusion site reactions. Seek immediate medical attention if you experience symptoms such as swelling, difficulty breathing, or yellowing of the skin or eyes.
Can I take fosaprepitant with other medications?
Fosaprepitant can interact with several medications, including warfarin and hormonal contraceptives. Always inform your healthcare provider about all medicines you are taking.
Is fosaprepitant safe during pregnancy or breastfeeding?
The safety of fosaprepitant in pregnancy and breastfeeding is not well established. Use only if clearly needed and prescribed by your doctor.
What should I do if I miss a dose?
Contact your healthcare provider immediately if you miss a scheduled dose. Do not attempt to administer the medication yourself.
What happens if I take too much Fosaprepitant?
If you suspect an overdose of Fosaprepitant, seek emergency medical attention immediately. While specific overdose symptoms for Fosaprepitant are not well-documented, general signs of an overdose can include severe nausea, vomiting, dizziness, or unusual fatigue. Always adhere to your prescribed dosage and consult your healthcare provider if you have concerns about your medication or experience any adverse reactions.
Can I drink alcohol while taking Fosaprepitant?
It is generally advisable to avoid or limit alcohol consumption while taking Fosaprepitant. Alcohol can exacerbate common side effects such as dizziness, drowsiness, and fatigue, which may already be present due to the underlying condition or other medications. Discuss alcohol use with your healthcare provider, as they can provide personalized advice based on your specific health status and treatment plan to ensure your safety and the medication's effectiveness.
Is Fosaprepitant safe during pregnancy?
Fosaprepitant's safety during pregnancy has not been definitively established, and it is categorized as a medication where the risks cannot be ruled out. Therefore, it is crucial to consult your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using Fosaprepitant. Your healthcare provider will weigh the potential benefits against any risks to you and your baby and determine the most appropriate course of action.
What is the mechanism of action of fosaprepitant dimeglumine?
Fosaprepitant is a prodrug of aprepitant and acts as a selective, high-affinity antagonist of human substance P/neurokinin 1 (NK1) receptors. By blocking NK1 receptors in the central nervous system, it inhibits the action of substance P, a key mediator in the vomiting reflex pathway, thereby preventing both acute and delayed phases of chemotherapy-induced nausea and vomiting.
What is the generic name of Fosaprepitant Dimeglumine?
The generic name is fosaprepitant dimeglumine. It is sold under brand names including Fosaprim, Fosaprepitant Accord, Fosalon, Fosawin, Fosaprepitant for Injection, Fosaprepitant Sandoz.
What class of drug is fosaprepitant dimeglumine?
Fosaprepitant Dimeglumine is classed as: Antiemetic (Neurokinin-1 Receptor Antagonist).
References
- MedGuideGlobal Fosaprepitant Clinician-Authored Medicine RecordMedGuideGlobal · Global (internal clinical reference) · accessed 2026-08-06 · source 1
- EMEND for injection (fosaprepitant dimeglumine) - prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- FOSAPREPITANT (FOSAPREPITANT DIMEGLUMINE) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [BAXTER HEALTHCARE CORPORATION] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- FOCINVEZ — FDA approval record (Drugs@FDA NDA216686)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- fosaprepitant dimeglumine — RxNorm normalized drug concept (RXCUI 754763)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient fosaprepitant dimeglumine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- FOCINVEZ150 mg/50mL · amneal pharmaceuticals llc
- EMEND150 mg/5mL · merck sharp & dohme llc
- NAVITRUX150 mg/5mL · avyxa pharma, llc