General Information

Aponvie (aprepitant) is a substance P/neurokinin-1 (NK1) receptor antagonist, an antiemetic agent.

Aponvie is specifically indicated for the prevention of postoperative nausea and vomiting (PONV) in adults.

Aponvie is supplied as an intravenous injection.

The recommended dose in adults is 32 mg administered as a 30 second intravenous injection prior to induction of anesthesia.

Mechanism of Action

Aponvie (aprepitant) is a selective high-affinity antagonist of human substance P/neurokinin 1 (NK1 ) receptors. Aprepitant has little or no affinity for serotonin (5-HT3 ), dopamine, and corticosteroid receptors, the targets of existing therapies for postoperative nausea and vomiting (PONV). Aprepitant has been shown in animal models to inhibit emesis via central actions. Animal and human Positron Emission Tomography (PET) studies with aprepitant have shown that it crosses the blood brain barrier and occupies brain NK1 receptors.

Side Effects

Adverse effects associated with the use of Aponvie may include, but are not limited to, the following:

• constipation
• fatigue
• headache

Clinical Trial Results

FDA approval was based on two multicenter, randomized, double-blind clinical studies comparing oral aprepitant to current standard of care, IV ondansetron, for the prevention of PONV in patients during the 48 hours following open abdominal surgery. Data demonstrated that aprepitant was more effective than ondansetron in preventing vomiting. Treatment with aprepitant resulted in approximately 50% fewer patients vomiting in the first 24 and 48 hours compared to ondansetron.