Effects of aprepitant: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Major Research Findings

Aprepitant is a neurokinin 1 receptor antagonist used to prevent chemotherapy-induced nausea and vomiting (CINV). Several studies have shown that aprepitant is effective in preventing CINV. 10 , 1 , 2 , 11 Additionally, aprepitant may inhibit osteosarcoma cell migration and metastasis. 5 Furthermore, aprepitant may suppress the growth of leukemia cells. 20 Aprepitant is an antagonist of the neurokinin 1 receptor (NK1R), which plays a role in pain and inflammation. 3 Therefore, aprepitant may be effective in treating neuropathic pain and inflammation.

Benefits and Risks

Benefit Summary

Aprepitant has been shown to be effective in preventing chemotherapy-induced nausea and vomiting (CINV). 10 , 1 , 2 , 11 Aprepitant may also inhibit osteosarcoma cell migration and metastasis. 5 Moreover, aprepitant may suppress the growth of leukemia cells. 20 Aprepitant is an antagonist of the neurokinin 1 receptor (NK1R), which plays a role in pain and inflammation. 3 Therefore, aprepitant may be effective in treating neuropathic pain and inflammation.

Risk Summary

Aprepitant can inhibit or induce CYP3A4, potentially affecting the pharmacokinetics of other drugs. 14 , 6 , 16 , 1 For example, aprepitant can accelerate the metabolism of warfarin, reducing its anticoagulant effect. 10 Aprepitant may also affect the pharmacokinetics of corticosteroids like dexamethasone and methylprednisolone. 1 Additionally, aprepitant may interact with other drugs like imatinib and ondansetron. 14 , 18 Aprepitant is a neurokinin 1 receptor (NK1R) antagonist, and NK1R is involved in pain and inflammation. 3 Therefore, aprepitant may cause neuropathic pain and inflammation.

Comparison between Studies

Commonalities among Studies

These studies suggest that aprepitant is effective in preventing CINV. They also suggest that aprepitant can interact with other drugs, so caution is needed when taking it.

Differences between Studies

These studies used different drugs and administration methods to investigate the effects of aprepitant on the pharmacokinetics of other drugs. Therefore, more research is needed to understand which drugs are most likely to interact with aprepitant and to what extent.

Consistency and Contradictions in Results

These studies consistently suggest that aprepitant is effective in preventing CINV. However, there are contradictory findings regarding the effects of aprepitant on the pharmacokinetics of other drugs. Therefore, more research is needed to understand which drugs are most likely to interact with aprepitant and to what extent.

Considerations for Real-Life Application

Caution is advised when taking aprepitant, particularly if you are also taking other drugs like warfarin or dexamethasone. Consult your doctor if you are taking any medications before starting aprepitant. Additionally, consult your doctor immediately if you experience any adverse effects or unusual sensations while taking aprepitant.

Limitations of Current Research

These studies were all relatively small, and more research is needed. Furthermore, the studies used different drugs and administration methods to investigate the effects of aprepitant on the pharmacokinetics of other drugs. Therefore, more research is needed to understand which drugs are most likely to interact with aprepitant and to what extent.

Future Directions for Research

More research is needed to understand which drugs are most likely to interact with aprepitant and to what extent. Additionally, more research is needed on the long-term safety of aprepitant.

Conclusion

Aprepitant is a medication effective in preventing chemotherapy-induced nausea and vomiting (CINV). However, since aprepitant may interact with other drugs, consult your doctor before taking it. Further research is needed to evaluate the safety and effectiveness of aprepitant.

Literature analysis of 20 papers
Positive Content
19
Neutral Content
0
Negative Content
1
Article Type
8
0
0
1
20
1.

Effects of the neurokinin1 receptor antagonist aprepitant on the pharmacokinetics of dexamethasone and methylprednisolone.

Author: McCreaJacqueline B, MajumdarAnup K, GoldbergMichael R, IwamotoMarian, GarganoCynthia, PanebiancoDeborah L, HesneyMichael, LinesChristopher R, PettyKevin J, DeutschPaul J, MurphyM Gail, GottesdienerKeith M, GoldwaterD Ronald, BlumRobert A

Prevents nausea and vomiting
Drug interaction

This study evaluated the effects of aprepitant on dexamethasone and methylprednisolone, two corticosteroids that are substrates of cytochrome P4503A4. Aprepitant was found to increase the levels of both dexamethasone and methylprednisolone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Automated analysis of delayed emesis in the telemetered ferret: detection of synergistic effects of aprepitant and ondansetron.

Author: GoineauSonia, GuillaumePhilippe, BarraisLaurence, CastagnéVincent

Reduced emesis

This study evaluated the sensitivity of an automated emesis model in ferrets for detecting the effects of antiemetics. The model effectively detected the synergistic effects of aprepitant and ondansetron in reducing cisplatin-induced delayed emesis, highlighting its potential for evaluating combination therapies for chemotherapy-induced nausea and vomiting.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

[Effects of aprepitant in daily administrations of low-dose cisplatin].

Author: KariyaMisato, TanakaKenta, MatsumotoKumiko, KumeManabu, MakimotoHiroo, HiranoTakeshi, MiyakeHideaki, FujisawaMasato, HiraiMidori

Reduced nausea
Reduced vomiting

This study evaluated the efficacy of aprepitant in preventing nausea and vomiting in patients receiving daily low-dose cisplatin.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

6.

Evaluation of potential inductive effects of aprepitant on cytochrome P450 3A4 and 2C9 activity.

Author: ShadleCraig R, LeeYih, MajumdarAnup K, PettyKevin J, GarganoCynthia, BradstreetThomas E, EvansJudith K, BlumRobert A

CINV prevention
CYP2C9 induction
CYP3A4 induction

Aprepitant is a drug used to prevent chemotherapy-induced nausea and vomiting. This study found that aprepitant had a modest, transient effect on the activity of certain enzymes involved in drug metabolism.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Antiinflammatory effects of aprepitant coadministration with cART regimen containing ritonavir in HIV-infected adults.

Author: SpitsinSergei, TebasPablo, BarrettJeffrey S, PappaVasiliki, KimDeborah, TaylorDeanne, EvansDwight L, DouglasSteven D

Anti-HIV effects
Antiinflammatory actions
Systemic inflammation

This study evaluates the safety, pharmacokinetics, and anti-inflammatory properties of aprepitant, an NK1R antagonist, in HIV-positive individuals receiving cART. Aprepitant is a potential therapeutic agent due to its anti-HIV and anti-inflammatory properties.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effects of the neurokinin1 receptor antagonist aprepitant on the pharmacokinetics of dexamethasone and methylprednisolone.

Author: McCreaJacqueline B, MajumdarAnup K, GoldbergMichael R, IwamotoMarian, GarganoCynthia, PanebiancoDeborah L, HesneyMichael, LinesChristopher R, PettyKevin J, DeutschPaul J, MurphyM Gail, GottesdienerKeith M, GoldwaterD Ronald, BlumRobert A

Prevents nausea and vomiting
Drug interaction

This study evaluated the effects of aprepitant on dexamethasone and methylprednisolone, two corticosteroids that are substrates of cytochrome P4503A4. Aprepitant was found to increase the levels of both dexamethasone and methylprednisolone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Pharmacokinetics of aprepitant and dexamethasone after administration of chemotherapeutic agents and effects of plasma substance P concentration on chemotherapy-induced nausea and vomiting in Japanese cancer patients.

Author: TakahashiToshiaki, NakamuraYukiko, TsuyaAsuka, MurakamiHaruyasu, EndoMasahiro, YamamotoNobuyuki

Reduced dexamethasone dose

This study found that the pharmacokinetics of aprepitant in Japanese cancer patients were similar to those in non-Japanese patients. The study also found that the clearance of dexamethasone was approximately one-half of that previously determined in the absence of aprepitant. The substance P concentration in plasma significantly increased only in patients with delayed nausea/vomiting.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Placebo- and amitriptyline-controlled evaluation of central nervous system effects of the NK1 receptor antagonist aprepitant and intravenous alcohol infusion at pseudo-steady state.

Author: te BeekErik T, TatosianDaniel, MajumdarAnup, SelverianDiana, KlaassenErica S, PettyKevin J, GarganoCynthia, van DyckKristien, McCreaJacqueline, MurphyGail, van GervenJoop M A

Aprepitant safety with alcohol

This study investigated the potential for interactions between the NK1 receptor antagonist aprepitant and alcohol. No significant additive CNS effects were observed when aprepitant was co-administered with alcohol, suggesting no clinically relevant interactions between the two drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Effects of aprepitant on the pharmacokinetics of imatinib and its main metabolite in rats.

Author: DarbalaeiSanaz, ZhangXinlin, WangNanxi, QinYanjie, HanXuemei, RangYing, ZhaiXuejia, LuYongning

Drug interaction

Aprepitant (APT), an antiemetic drug, decreases the bioavailability of imatinib (IMA) in rats. A study of rats found that pretreatment with APT significantly decreased the blood concentration of IMA, both orally and intravenously, due to modulation of P-gp and CYP3A1.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Aprepitant Has Mixed Effects on Nausea and Reduces Other Symptoms in Patients With Gastroparesis and Related Disorders.

Author: PasrichaPankaj J, YatesKatherine P, SarosiekIrene, McCallumRichard W, AbellThomas L, KochKenneth L, NguyenLinda Anh B, SnapeWilliam J, HaslerWilliam L, ClarkeJohn O, DhallaSameer, SteinEllen M, LeeLinda A, MirielLaura A, Van NattaMark L, GroverMadhusudan, FarrugiaGianrico, TonasciaJames, HamiltonFrank A, ParkmanHenry P,

Reduce nausea

A randomized trial evaluated the effectiveness of aprepitant, a neurokinin-1 receptor antagonist, in reducing nausea and vomiting in patients with gastroparesis or gastroparesis-like syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Effects of aprepitant on cytochrome P450 3A4 activity using midazolam as a probe.

Author: MajumdarAnup K, McCreaJacqueline B, PanebiancoDeborah L, HesneyMichael, DruJames, ConstanzerMarvin, GoldbergMichael R, MurphyGail, GottesdienerKeith M, LinesChristopher R, PettyKevin J, BlumRobert A

Nausea and vomiting prevention

Aprepitant is a medication used to prevent chemotherapy-induced nausea and vomiting. It blocks neurokinin(1) receptors, which are involved in the vomiting reflex. Aprepitant may interact with other medications that are metabolized by CYP3A4, an enzyme in the liver.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Effects of the NK1 antagonist, aprepitant, on response to oral and intranasal oxycodone in prescription opioid abusers.

Author: WalshSharon L, HeiligMarkus, NuzzoPaul A, HendersonPam, LofwallMichelle R

Increased opioid effects

Aprepitant, an NK1 receptor antagonist, significantly enhanced the subjective effects of oxycodone, including euphoria and liking, when administered as a pre-treatment. This effect was observed with both oral and intranasal routes of oxycodone administration. All dose combinations were safely tolerated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

18.

Effects of aprepitant on the pharmacokinetics of ondansetron and granisetron in healthy subjects.

Author: BlumRobert A, MajumdarAnup, McCreaJacqueline, BusilloJohn, OrlowskiLaura H, PanebiancoDeborah, HesneyMichael, PettyKevin J, GoldbergMichael R, MurphyM Gail, GottesdienerKevin M, HustadCarolyn M, LatesChristian, KraftWalter K, Van BurenSandi, WaldmanScott A, GreenbergHoward E

Effective CINV prevention

Aprepitant does not significantly alter the pharmacokinetic profiles of ondansetron or granisetron, two commonly used antiemetics for chemotherapy-induced nausea and vomiting (CINV).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Evaluation of the antileukemic effects of neurokinin-1 receptor antagonists, aprepitant, and L-733,060, in chronic and acute myeloid leukemic cells.

Author: DikmenMiriş, GökhanerGökhan, CantürkZerrin

Leukemia treatment

This study compared the antileukemic effects of aprepitant and L-733,060, two neurokinin-1 receptor (NK1R) antagonists, on acute and chronic myeloid leukemic cells. Both drugs exhibited significant antiproliferative effects, suggesting potential therapeutic value for these types of leukemia.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Antileukemic effects of neurokinin-1 receptor inhibition on hematologic malignant cells: a novel therapeutic potential for aprepitant.

Author: BayatiSamaneh, RazaniElham, BashashDavood, Safaroghli-AzarAva, SafaMajid, GhaffariSeyed H

Apoptosis induction
Leukemia treatment

Aprepitant, a nonpeptide antagonist of NK1R, is investigated for its antileukemic effects in a panel of hematological cell lines. The study finds that aprepitant decreases cell survival and sensitizes cells to other antileukemic agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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