Aprepitant does not alter prednisolone pharmacokinetics in patients treated with R-CHOP

Aprepitant in pediatric patients using moderate and highly emetogenic protocols: a systematic review and meta‐analyses of randomized controlled trials

“…Besides the need to explore the efficacy of aprepitant in combination with dexamethasone and ondansetron backbone in paediatric patients, safety features regarding aprepitant – a moderate inducer and inhibitor of cytochrome 3A4 – were left open by a previous multicenter trial . In that case, Gore and collaborators found an increased number of infections and febrile neutropenia in the triple therapy‐based group, which promoted several discussions throughout the scientific community .…”

Aprepitant and fosaprepitant drug interactions: a systematic review

“…Study authors did not report a GMR for AUC or C max when describing the co‐administration of the following drugs with aprepitant: alcohol IV , dexamethasone IV , prednisolone PO , quetiapine PO , tacrolimus IV and paroxetine PO . However, significant differences in other pharmacokinetic parameters were reported when aprepitant was co‐administered with several of these drugs.…”

“…Of the 64 included publications, 34 evaluated pharmacokinetic interactions in adults (aprepitant/fosaprepitant and antineoplastic drug: 14 [21][22][23][24][25][26][27][28][29][30][31][32][33][34]; aprepitant/fosaprepitant and non-antineoplastic drug: 20 [9,11,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]). Thirty-eight described adverse events in adults potentially resulting from drug interactions with aprepitant or fosaprepitant, eight of which also evaluated for a pharmacokinetic aprepitant/ fosaprepitant drug interaction (aprepitant/fosaprepitant and antineoplastic drug: 24 [23,25,33,; aprepitant and non-antineoplastic drug: 14 [35,43,46,51,52,[74][75][76][77][78]<...>…”

“…Non-antineoplastic drugs. Twenty publications evaluated aprepitant or fosaprepitant interactions with 16 nonantineoplastic drugs [9,11,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]. Interactions between fosaprepitant and dexamethasone PO [11] or midazolam PO [11] and between aprepitant and dexamethasone PO [44], methylprednisolone IV [44], midazolam PO/IV [9,47,49], oxycodone PO [39] and tolbutamide PO [46] met criteria for clinical significance.…”

“…Similarly, when a lower aprepitant dose of 40 mg was administered with tolbutamide PO, the interaction did not meet criteria for significance (GMR AUC 0-inf 0.87, 90% CI: not reported on day 4) [46]. Study authors did not report a GMR for AUC or C max when describing the co-administration of the following drugs with aprepitant: alcohol IV [51], dexamethasone IV [45,50], prednisolone PO [42], quetiapine PO [52], tacrolimus IV [40] and paroxetine PO [35]. However, significant differences in other pharmacokinetic parameters were reported when aprepitant was co-administered with several of these drugs.…”