The Pharmaceutical Journal
Vol 272 No 7285 p147
7 February 2004

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Novel anti-emetic therapy launched by MSD

A new anti-emetic therapy has recently been launched by Merck Sharp & Dohme. Emend (aprepitant) will be used in combination with other therapies for the prevention of nausea and vomiting associated with cisplatin-based cancer chemotherapy.

Current anti-emetic therapies inhibit the vomiting reflex by blocking serotonin receptors in the gut and brain stem. They are not always effective, particularly in patients receiving highly emetogenic chemotherapy such as cisplatin. Emend is a selective antagonist of substance P at neurokinin 1 receptors.

Emend is metabolised by CYP3A4, so should be used with caution in patients receiving products that are metabolised by this enzyme. It is given for three days in a regimen that includes a corticosteroid and a 5-HT₃ antagonist. The recommended dose is 125mg orally on day one and 80mg once daily on days two and three.

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