Aprepitant (Emend®, Merck), a new neurokinin-1 (NK-1) antagonist, can help delay and prevent chemotherapy-related nausea and vomiting. Researchers from Medical University of South Carolina in Charleston observed that aprepitant significantly augmented the effects of corticosteroids and serotonin type 3 (5-HT3) antagonists when given before highly emetogenic chemotherapy, including cisplatin.
This agent seems to work better on vomiting than on nausea by blocking the emetic effects of substance P, a mediator of vomiting.
Aprepitant should not be used routinely as a first-line therapy in patients receiving moderately or mildly emetogenic chemotherapy, the researchers say. Although aprepitant is well tolerated with minimal adverse effects, there are many potential drug interactions. Patients should be carefully monitored.