aprepitant 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
neurokinin NK1 (substance P) receptor antagonist	230	170729-80-3

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: emend aprepitant L-754030	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 chemotherapy-induced nausea and vomiting (CINV). Aprepitant has been shown in animal models to inhibit emesis induced by cytotoxic chemotherapeutic agents, such as cisplatin, via central actions. Molecular weight: 534.44 Formula: C23H21F7N4O3 CLOGP: 4.40 LIPINSKI: 1 HAC: 7 HDO: 2 TPSA: 75.19 ALOGS: -4.44 ROTB: 8 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

emend
aprepitant
L-754030

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 chemotherapy-induced nausea and vomiting (CINV). Aprepitant has been shown in animal models to inhibit emesis induced by cytotoxic chemotherapeutic agents, such as cisplatin, via central actions.

Molecular weight: 534.44
Formula: C23H21F7N4O3
CLOGP: 4.40
LIPINSKI: 1
HAC: 7
HDO: 2
TPSA: 75.19
ALOGS: -4.44
ROTB: 8

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
165	mg	O
150	mg	P

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	2	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	0 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	3.34 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability)	62.50 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
Vd (Volume of distribution)	0.94 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	1 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.05 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	13 hours	Lombardo F, Berellini G, Obach RS
S (Water solubility)	0.02 mg/mL	Bocci G, Oprea TI, Benet LZ

Approvals:

Date	Agency	Company	Orphan
March 27, 2003	FDA	MERCK

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Febrile neutropenia	496.24	16.75	439	31779	118010	63338794
Mucosal inflammation	168.89	16.75	160	32058	46768	63410036
Computerised tomogram thorax abnormal	156.13	16.75	51	32167	1712	63455092
Neutropenia	139.07	16.75	287	31931	174718	63282086
Gastrointestinal disorder	138.62	16.75	243	31975	130996	63325808
Pyrexia	133.54	16.75	531	31687	469947	62986857
Drug ineffective	133.01	16.75	204	32014	1044561	62412243
Atelectasis	132.65	16.75	100	32118	21383	63435421
Nausea	130.74	16.75	808	31410	853663	62603141
Febrile bone marrow aplasia	113.44	16.75	61	32157	7264	63449540
Computerised tomogram thorax	111.79	16.75	29	32189	420	63456384
Encephalopathy	110.01	16.75	116	32102	38504	63418300
Erythema	109.99	16.75	262	31956	175489	63281315
Medication error	100.12	16.75	128	32090	52156	63404648
Fall	96.91	16.75	39	32179	392295	63064509
Stomatitis	96.89	16.75	216	32002	138509	63318295
Hypoxia	95.54	16.75	134	32084	59658	63397146
Flushing	93.85	16.75	150	32068	74937	63381867
Muscle injury	85.05	16.75	133	32085	65212	63391592
Neutrophil count decreased	82.19	16.75	121	32097	56285	63400519
Folliculitis	80.47	16.75	135	32083	70182	63386622
Aplasia	73.12	16.75	38	32180	4221	63452583
Irritable bowel syndrome	65.16	16.75	135	32083	82277	63374527
Sleep disorder due to general medical condition, insomnia type	63.43	16.75	103	32115	52114	63404690
Duodenal ulcer perforation	62.20	16.75	137	32081	87072	63369732
Dyspnoea	60.05	16.75	554	31664	660759	62796045
Inappropriate antidiuretic hormone secretion	59.98	16.75	55	32163	15407	63441397
Hepatocellular injury	58.76	16.75	71	32147	27310	63429494
Anaphylactic shock	58.59	16.75	66	32152	23567	63433237
Hyponatraemia	56.58	16.75	154	32064	111746	63345058
Bone marrow failure	56.51	16.75	72	32146	29218	63427586
Injection site phlebitis	56.06	16.75	13	32205	114	63456690
Alveolitis	55.83	16.75	28	32190	2887	63453917
Helicobacter infection	53.35	16.75	134	32084	92651	63364153
Decreased appetite	52.43	16.75	259	31959	250793	63206011
Impaired healing	51.71	16.75	141	32077	102401	63354403
Feeling hot	51.48	16.75	92	32126	50262	63406542
Toxicity to various agents	48.53	16.75	33	32185	247217	63209587
Infusion related reaction	48.24	16.75	249	31969	245272	63211532
Vascular pain	47.24	16.75	17	32201	767	63456037
Lower respiratory tract infection	46.22	16.75	160	32058	132147	63324657
Palmar-plantar erythrodysaesthesia syndrome	45.07	16.75	57	32161	22958	63433846
Sense of oppression	42.95	16.75	17	32201	999	63455805
Hypersensitivity	42.56	16.75	274	31944	292411	63164393
Chemotherapy	41.96	16.75	19	32199	1560	63455244
Infusion site streaking	41.73	16.75	14	32204	511	63456293
Injection site vasculitis	41.26	16.75	7	32211	7	63456797
Therapeutic product effect incomplete	41.08	16.75	7	32211	125049	63331755
Product dose omission issue	40.00	16.75	36	32182	234277	63222527
Ill-defined disorder	38.82	16.75	110	32108	81645	63375159
Hiccups	38.57	16.75	20	32198	2211	63454593
Pneumonia	38.55	16.75	112	32106	456655	63000149
Sleep disorder	38.01	16.75	109	32109	81457	63375347
Blister	37.78	16.75	148	32070	129666	63327138
Tonsillar haemorrhage	37.75	16.75	11	32207	250	63456554
Respiratory syncytial virus infection	37.50	16.75	30	32188	6988	63449816
Arthritis	36.97	16.75	7	32211	115914	63340890
Oral pain	35.82	16.75	57	32161	28337	63428467
Bronchitis	34.98	16.75	10	32208	124925	63331879
Facet joint syndrome	33.73	16.75	36	32182	12102	63444702
Vomiting	32.71	16.75	430	31788	559187	62897617
Anti-cyclic citrullinated peptide antibody positive	31.81	16.75	130	32088	116082	63340722
Neuropathy peripheral	31.79	16.75	128	32090	113539	63343265
Interstitial lung disease	31.07	16.75	85	32133	61823	63394981
Deep vein thrombosis postoperative	30.33	16.75	33	32185	11336	63445468
Constipation	29.31	16.75	205	32013	224738	63232066
Nail infection	28.25	16.75	17	32201	2506	63454298
Peripheral venous disease	28.21	16.75	37	32181	15440	63441364
Influenza	28.13	16.75	10	32208	108712	63348092
Myocardial infarction	27.95	16.75	8	32210	99885	63356919
Intestinal strangulation	27.82	16.75	7	32211	89	63456715
Cerebellar syndrome	27.62	16.75	19	32199	3520	63453284
Pericarditis	27.59	16.75	136	32082	131443	63325361
Lip dry	26.69	16.75	36	32182	15434	63441370
Depression	26.09	16.75	37	32181	196455	63260349
Arteriospasm coronary	25.66	16.75	19	32199	3949	63452855
Maternal exposure timing unspecified	25.16	16.75	24	32194	7063	63449741
Cardiac failure congestive	24.78	16.75	8	32210	92425	63364379
Thrombocytopenia	24.75	16.75	146	32072	151011	63305793
Paraesthesia	24.67	16.75	150	32068	156816	63299988
Pain	23.35	16.75	252	31966	740376	62716428
Confusional state	23.33	16.75	202	32016	236178	63220626
Balance disorder	23.18	16.75	7	32211	84415	63372389
Colony stimulating factor therapy	23.17	16.75	8	32210	319	63456485
Overdose	23.04	16.75	15	32203	115063	63341741
Neutropenic colitis	22.71	16.75	16	32202	3079	63453725
Contusion	22.71	16.75	142	32076	149902	63306902
Gait disturbance	21.92	16.75	37	32181	183141	63273663
Chronic obstructive pulmonary disease	21.74	16.75	3	32215	62683	63394121
Stress	21.53	16.75	4	32214	67163	63389641
Dental fistula	21.22	16.75	9	32209	631	63456173
Injury	20.88	16.75	83	32135	73164	63383640
Diarrhoea	20.55	16.75	491	31727	714875	62741929
Hypomagnesaemia	20.30	16.75	45	32173	28692	63428112
Anorectal disorder	20.14	16.75	12	32206	1737	63455067
Capillary leak syndrome	20.03	16.75	13	32205	2187	63454617
Thrombocytopenic purpura	19.92	16.75	11	32207	1380	63455424
Injection site pain	19.77	16.75	22	32196	129778	63327026
Autoimmune disorder	19.66	16.75	33	32185	17144	63439660
Antinuclear antibody	19.47	16.75	8	32210	518	63456286
Suicidal ideation	19.41	16.75	4	32214	62417	63394387
Laryngeal discomfort	19.40	16.75	7	32211	318	63456486
Chest discomfort	19.16	16.75	108	32110	109861	63346943
Herpes zoster	19.03	16.75	9	32209	82453	63374351
Gastrointestinal scarring	18.82	16.75	7	32211	347	63456457
Hypokalaemia	18.78	16.75	103	32115	103701	63353103
Swollen joint count	18.71	16.75	10	32208	1176	63455628
Cognitive disorder	18.60	16.75	3	32215	55812	63400992
Leukopenia	17.73	16.75	82	32136	77208	63379596
Injection site reaction	17.69	16.75	4	32214	58520	63398284
Administration site oedema	17.69	16.75	4	32214	31	63456773
Influenza like illness	17.53	16.75	6	32212	66818	63389986
Hypermagnesaemia	17.51	16.75	9	32209	977	63455827
Alopecia	17.47	16.75	254	31964	337282	63119522
COVID-19	17.41	16.75	19	32199	113084	63343720
Vascular device infection	17.41	16.75	20	32198	7292	63449512
Osteoporosis	17.17	16.75	4	32214	57334	63399470
Oropharyngeal discomfort	17.15	16.75	17	32201	5243	63451561
Periorbital cellulitis	17.13	16.75	8	32210	705	63456099
Condition aggravated	16.94	16.75	127	32091	402090	63054714
Tumour pain	16.91	16.75	10	32208	1427	63455377
Sputum abnormal	16.89	16.75	8	32210	728	63456076
Abdominal pain	16.87	16.75	225	31993	293231	63163573

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Febrile neutropenia	249.18	18.86	288	13560	136561	34806522
Hiccups	112.14	18.86	62	13786	10020	34933063
Neutropenia	109.97	18.86	211	13637	156567	34786516
Erythema	98.87	18.86	147	13701	88633	34854450
Hypersensitivity	96.75	18.86	120	13728	60915	34882168
Neutrophil count decreased	95.03	18.86	109	13739	50995	34892088
Drug ineffective	84.38	18.86	38	13810	456713	34486370
Stomatitis	71.24	18.86	86	13762	42428	34900655
Nausea	70.37	18.86	293	13555	339615	34603468
Thrombocytopenia	70.29	18.86	176	13672	156071	34787012
Decreased appetite	63.21	18.86	176	13672	166216	34776867
Anaphylactic reaction	53.54	18.86	65	13783	32236	34910847
Vomiting	51.52	18.86	214	13634	247407	34695676
Encephalopathy	48.92	18.86	65	13783	35254	34907829
Toxicity to various agents	48.83	18.86	10	13838	200352	34742731
White blood cell count decreased	48.73	18.86	113	13735	95332	34847751
Intestinal ischaemia	48.30	18.86	33	13815	7761	34935322
Hepatocellular injury	47.48	18.86	51	13797	22160	34920923
Febrile bone marrow aplasia	46.75	18.86	33	13815	8176	34934907
Diarrhoea	45.91	18.86	287	13561	389625	34553458
Platelet count decreased	45.75	18.86	127	13721	119590	34823493
Fixed eruption	45.14	18.86	19	13829	1681	34941402
Testicular germ cell cancer metastatic	43.60	18.86	9	13839	57	34943026
Aplasia	42.37	18.86	25	13823	4563	34938520
Bone marrow failure	42.31	18.86	55	13793	29198	34913885
Oesophagitis	40.52	18.86	37	13811	13224	34929859
Mouth ulceration	39.89	18.86	35	13813	11875	34931208
Interstitial lung disease	39.77	18.86	83	13765	65199	34877884
Hepatic cytolysis	39.59	18.86	38	13810	14458	34928625
Mucosal inflammation	38.74	18.86	61	13787	38561	34904522
Anaphylactic shock	36.55	18.86	38	13810	15903	34927180
Flushing	35.03	18.86	53	13795	32367	34910716
Leukopenia	34.93	18.86	77	13771	62779	34880304
Stoma site pain	33.76	18.86	12	13836	672	34942411
Sense of oppression	32.38	18.86	11	13837	538	34942545
Change of bowel habit	32.25	18.86	13	13835	1030	34942053
Seminoma	32.16	18.86	9	13839	228	34942855
Toxic encephalopathy	31.99	18.86	22	13826	5227	34937856
Enteritis	31.51	18.86	26	13822	8116	34934967
Acute kidney injury	31.23	18.86	217	13631	304771	34638312
Oral pain	30.74	18.86	29	13819	10798	34932285
Pyrexia	30.69	18.86	231	13617	332782	34610301
Peritonitis	30.53	18.86	35	13813	16330	34926753
Emotional disorder	30.30	18.86	22	13826	5694	34937389
Neuropathy peripheral	29.50	18.86	86	13762	83177	34859906
Hypokalaemia	28.67	18.86	68	13780	58146	34884937
Constipation	28.08	18.86	118	13730	136864	34806219
Product dose omission issue	27.09	18.86	7	13841	119704	34823379
Large intestine perforation	24.57	18.86	23	13825	8480	34934603
Rash maculo-papular	24.55	18.86	42	13806	28409	34914674
Septic shock	24.30	18.86	73	13775	71761	34871322
Chemotherapeutic drug level increased	23.85	18.86	7	13841	211	34942872
Alopecia	23.77	18.86	38	13810	24317	34918766
Paraesthesia	23.41	18.86	67	13781	64105	34878978
Regurgitation	23.25	18.86	12	13836	1687	34941396
Platelet count increased	22.36	18.86	23	13825	9503	34933580
Jaundice	22.34	18.86	43	13805	31839	34911244
Dehydration	22.14	18.86	106	13742	129863	34813220
Bicytopenia	22.04	18.86	13	13835	2371	34940712
Atrioventricular block second degree	21.04	18.86	15	13833	3773	34939310
Necrotising ulcerative gingivostomatitis	20.66	18.86	5	13843	70	34943013
Cardiac failure congestive	20.58	18.86	4	13844	83266	34859817
Incorrect drug administration rate	20.37	18.86	11	13837	1694	34941389
Blood alkaline phosphatase increased	19.39	18.86	40	13808	31135	34911948
Infusion related reaction	18.97	18.86	55	13793	53002	34890081

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Febrile neutropenia	637.71	15.76	688	40714	230311	79472675
Neutropenia	187.92	15.76	442	40960	287268	79415718
Erythema	187.91	15.76	380	41022	222910	79480076
Nausea	173.02	15.76	962	40440	956234	78746752
Stomatitis	155.92	15.76	276	41126	146481	79556505
Drug ineffective	151.30	15.76	205	41197	1080708	78622278
Mucosal inflammation	147.63	15.76	189	41213	75391	79627595
Neutrophil count decreased	144.18	15.76	209	41193	93750	79609236
Febrile bone marrow aplasia	139.56	15.76	86	41316	12934	79690052
Computerised tomogram thorax abnormal	139.19	15.76	51	41351	2368	79700618
Gastrointestinal disorder	136.51	15.76	235	41167	121970	79581016
Encephalopathy	135.52	15.76	171	41231	67226	79635760
Hypersensitivity	133.72	15.76	367	41035	261872	79441114
Pyrexia	124.74	15.76	686	40716	678023	79024963
Hiccups	119.75	15.76	71	41331	9960	79693026
Toxicity to various agents	116.49	15.76	37	41365	421503	79281483
Flushing	112.30	15.76	180	41222	88088	79614898
Aplasia	111.11	15.76	62	41340	7758	79695228
Computerised tomogram thorax	111.06	15.76	29	41373	421	79702565
Atelectasis	106.44	15.76	106	41296	32151	79670835
Fall	102.98	15.76	63	41339	487566	79215420
Muscle injury	94.11	15.76	121	41281	48440	79654546
Hepatocellular injury	91.31	15.76	118	41284	47475	79655511
Decreased appetite	88.47	15.76	382	41020	342036	79360950
Folliculitis	87.56	15.76	125	41277	55255	79647731
Bone marrow failure	84.72	15.76	118	41284	50989	79651997
Anaphylactic shock	81.50	15.76	97	41305	35899	79667087
Infusion related reaction	74.79	15.76	276	41126	229961	79473025
Irritable bowel syndrome	73.82	15.76	123	41279	62118	79640868
Duodenal ulcer perforation	73.45	15.76	127	41275	66084	79636902
Sense of oppression	71.92	15.76	28	41374	1538	79701448
Neuropathy peripheral	66.25	15.76	192	41210	141113	79561873
Thrombocytopenia	66.22	15.76	293	41109	264966	79438020
Product dose omission issue	64.38	15.76	24	41378	247513	79455473
Helicobacter infection	62.54	15.76	122	41280	69582	79633404
Medication error	61.41	15.76	120	41282	68522	79634464
Hypoxia	61.20	15.76	153	41249	103090	79599896
Alopecia	60.36	15.76	259	41143	231096	79471890
Vascular pain	59.05	15.76	21	41381	894	79702092
Sleep disorder due to general medical condition, insomnia type	58.37	15.76	91	41311	43465	79659521
Interstitial lung disease	57.67	15.76	158	41244	112442	79590544
Therapeutic product effect incomplete	55.16	15.76	5	41397	141640	79561346
Palmar-plantar erythrodysaesthesia syndrome	52.68	15.76	75	41327	33059	79669927
Vomiting	52.08	15.76	551	40851	665277	79037709
Impaired healing	51.00	15.76	129	41273	87526	79615460
Anaphylactic reaction	50.57	15.76	125	41277	83618	79619368
Ill-defined disorder	50.45	15.76	108	41294	65767	79637219
Oral pain	49.12	15.76	71	41331	31727	79671259
Inappropriate antidiuretic hormone secretion	48.53	15.76	64	41338	26249	79676737
Hyponatraemia	47.83	15.76	201	41201	177647	79525339
Overdose	46.00	15.76	19	41383	184187	79518799
Alveolitis	45.79	15.76	28	41374	4152	79698834
Leukopenia	45.00	15.76	148	41254	116365	79586621
Paraesthesia	44.89	15.76	196	41206	176127	79526859
Cardiac failure congestive	43.98	15.76	10	41392	142392	79560594
Anti-cyclic citrullinated peptide antibody positive	43.90	15.76	118	41284	83025	79619961
Feeling hot	43.54	15.76	96	41306	59638	79643348
Diarrhoea	42.67	15.76	667	40735	879822	78823164
Sleep disorder	41.67	15.76	118	41284	85559	79617427
Oesophagitis	41.62	15.76	57	41345	24232	79678754
Glossodynia	41.47	15.76	133	41269	103204	79599782
Infusion site streaking	41.34	15.76	14	41388	514	79702472
Testicular germ cell cancer metastatic	41.31	15.76	9	41393	56	79702930
Chemotherapy	39.61	15.76	19	41383	1738	79701248
Intestinal ischaemia	39.03	15.76	41	41361	13229	79689757
Constipation	38.96	15.76	266	41136	282784	79420202
Lower respiratory tract infection	38.68	15.76	151	41251	129069	79573917
Blister	38.55	15.76	143	41259	119333	79583653
Toxic encephalopathy	38.48	15.76	38	41364	11402	79691584
Injection site vasculitis	38.26	15.76	7	41395	14	79702972
Pericarditis	37.24	15.76	129	41273	104107	79598879
White blood cell count decreased	36.83	15.76	194	41208	188094	79514892
Oropharyngeal discomfort	36.35	15.76	30	41372	7136	79695850
Myocardial infarction	35.80	15.76	26	41376	184103	79518883
Condition aggravated	35.49	15.76	137	41265	500987	79201999
Platelet count decreased	34.99	15.76	196	41206	194468	79508518
Dyspnoea	34.81	15.76	631	40771	856394	78846592
Enteritis	34.17	15.76	40	41362	14543	79688443
Pemphigus	33.65	15.76	121	41281	99461	79603525
Facet joint syndrome	33.38	15.76	35	41367	11267	79691719
Hepatic cytolysis	31.31	15.76	53	41349	27098	79675888
Neutropenic colitis	31.29	15.76	25	41377	5682	79697304
Respiratory syncytial virus infection	31.20	15.76	31	41371	9371	79693615
Seminoma	30.79	15.76	9	41393	202	79702784
Balance disorder	30.40	15.76	7	41395	98850	79604136
Fixed eruption	30.36	15.76	19	41383	2935	79700051
Arthritis	30.08	15.76	11	41391	114869	79588117
Colony stimulating factor therapy	29.97	15.76	11	41391	513	79702473
COVID-19	29.70	15.76	23	41379	157651	79545335
Deep vein thrombosis postoperative	29.47	15.76	32	41370	10720	79692266
Hypokalaemia	29.26	15.76	150	41252	143890	79559096
Depression	29.21	15.76	42	41360	216748	79486238
Hand deformity	28.35	15.76	118	41284	103801	79599185
Influenza	28.34	15.76	16	41386	129590	79573396
Chest discomfort	28.21	15.76	144	41258	137900	79565086
Injection site phlebitis	27.96	15.76	8	41394	166	79702820
Lip dry	27.66	15.76	37	41365	15381	79687605
Peripheral venous disease	26.75	15.76	37	41365	15872	79687114
Rash	26.73	15.76	435	40967	577923	79125063
Suicidal ideation	26.48	15.76	4	41398	76336	79626650
Chronic obstructive pulmonary disease	26.36	15.76	6	41396	85413	79617573
Nail infection	26.10	15.76	16	41386	2383	79700603
Rash maculo-papular	26.06	15.76	76	41326	56002	79646984
Heart rate decreased	26.02	15.76	3	41399	70313	79632673
Bronchitis	25.98	15.76	18	41384	130626	79572360
Wrong technique in product usage process	25.33	15.76	4	41398	73871	79629115
Intentional product misuse	25.10	15.76	9	41393	95156	79607830
Maternal exposure timing unspecified	24.79	15.76	22	41380	5770	79697216
Dermatitis acneiform	24.40	15.76	28	41374	9965	79693021
Chronic kidney disease	24.04	15.76	3	41399	66151	79636835
Tonsillar haemorrhage	23.72	15.76	8	41394	290	79702696
Dental fistula	22.63	15.76	9	41393	523	79702463
Death	22.57	15.76	187	41215	566327	79136659
Influenza like illness	22.20	15.76	5	41397	71702	79631284
Blood pressure systolic increased	22.14	15.76	4	41398	66982	79636004
Septic shock	21.62	15.76	123	41279	122678	79580308
Cardiac disorder	21.57	15.76	4	41398	65753	79637233
Cognitive disorder	21.40	15.76	5	41397	69921	79633065
Disseminated intravascular coagulation	21.10	15.76	53	41349	35789	79667197
Herpes zoster	21.06	15.76	11	41391	93072	79609914
Periorbital cellulitis	20.74	15.76	10	41392	925	79702061
Nasal congestion	20.60	15.76	7	41395	76545	79626441
Discomfort	20.30	15.76	123	41279	125494	79577492
Antinuclear antibody	20.21	15.76	8	41394	459	79702527
Hypoglycaemia	20.19	15.76	14	41388	101580	79601406
Cerebrovascular accident	20.02	15.76	31	41371	155261	79547725
Chills	19.93	15.76	147	41255	160087	79542899
Autoimmune disorder	19.91	15.76	33	41369	16579	79686407
Cardiotoxicity	19.89	15.76	28	41374	12211	79690775
Dysgeusia	19.75	15.76	70	41332	57107	79645879
Injection site pain	19.70	15.76	23	41379	129815	79573171
Blood pressure increased	19.70	15.76	51	41351	211309	79491677
Transposition of the great vessels	19.66	15.76	5	41397	65	79702921
Rhabdomyolysis	19.48	15.76	15	41387	103116	79599870
Anorectal disorder	19.27	15.76	13	41389	2280	79700706
Hyperthermia	19.21	15.76	34	41368	18003	79684983
Pneumonia	19.21	15.76	235	41167	660011	79042975
Systemic lupus erythematosus	19.18	15.76	118	41284	121031	79581955
Drug clearance decreased	19.15	15.76	15	41387	3312	79699674
Incorrect dose administered	18.97	15.76	8	41394	76622	79626364
Ileus	18.95	15.76	42	41360	26169	79676817
Upper respiratory tract infection	18.88	15.76	12	41390	91156	79611830
Injection site reaction	18.70	15.76	3	41399	54782	79648204
Chemotherapeutic drug level increased	18.61	15.76	7	41395	350	79702636
Arteriospasm coronary	18.43	15.76	20	41382	6696	79696290
Osteoporosis	18.39	15.76	3	41399	54109	79648877
Asthma	18.36	15.76	26	41376	135069	79567917
Therapeutic response decreased	18.19	15.76	6	41396	66847	79636139
Cholestasis	18.18	15.76	64	41338	52045	79650941
Blood glucose increased	17.84	15.76	20	41382	114955	79588031
Administration site oedema	17.71	15.76	4	41398	30	79702956
Hyperkalaemia	17.64	15.76	20	41382	114378	79588608
Hypomagnesaemia	17.57	15.76	59	41343	46852	79656134
Contusion	17.10	15.76	134	41268	148642	79554344
Peritonitis	17.07	15.76	42	41360	27994	79674992
Thrombocytopenic purpura	16.12	15.76	12	41390	2457	79700529
Infusion site vesicles	16.03	15.76	7	41395	515	79702471
Poor peripheral circulation	15.79	15.76	14	41388	3669	79699317

FDA Adverse Event Reporting System (Pediatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Small for dates baby	12.13	12.06	5	3	2804	86980

Pharmacologic Action:

Source	Code	Description
ATC	A04AD12	ALIMENTARY TRACT AND METABOLISM ANTIEMETICS AND ANTINAUSEANTS ANTIEMETICS AND ANTINAUSEANTS Other antiemetics
FDA MoA	N0000010262	Neurokinin 1 Antagonists
MeSH PA	D000932	Antiemetics
MeSH PA	D002491	Central Nervous System Agents
MeSH PA	D005765	Gastrointestinal Agents
MeSH PA	D064729	Neurokinin-1 Receptor Antagonists
MeSH PA	D018377	Neurotransmitter Agents
MeSH PA	D018373	Peripheral Nervous System Agents
FDA EPC	N0000175786	Substance P/Neurokinin-1 Receptor Antagonist
FDA MoA	N0000182141	Cytochrome P450 3A4 Inhibitors
FDA MoA	N0000185506	Cytochrome P450 3A4 Inducers
FDA MoA	N0000185507	Cytochrome P450 2C9 Inducers
CHEBI has role	CHEBI:35469	antidepressants
CHEBI has role	CHEBI:49110	peripheral nervous system drugs
CHEBI has role	CHEBI:50919	antiemetico
CHEBI has role	CHEBI:55350	neurokinin-1 receptor antagonists
CHEBI has role	CHEBI:55351	substance P receptor antagonists

Drug Use | Suggest Off label Use Form| |View source of the data|

Disease	Relation	SNOMED_ID
Chemotherapy-induced nausea and vomiting	indication	236084000
Prevention of Post-Operative Nausea and Vomiting	indication
Hepatic failure	contraindication	59927004

🐶 Veterinary Drug Use

None

🐶 Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	8.8	acidic
pKa2	13.0	acidic
pKa3	3.22	Basic
pKa4	2.56	Basic

Orange Book patent data (new drug applications)

Formulation strength	Trade name	Applicant	Application number	Approval date	Type	Dose form	Route	Patent number	Patent expiration date	Patent use
125MG	EMEND	MERCK	N021549	March 26, 2003	RX	CAPSULE	ORAL	8258132	Sept. 26, 2027	FOR THE PREVENTION OF NAUSEA AND VOMITING ASSOCIATED WITH CHEMOTHERAPY
125MG	EMEND	MERCK	N021549	March 26, 2003	RX	CAPSULE	ORAL	8258132	Sept. 26, 2027	PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING
40MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMEND	MERCK	N021549	June 30, 2006	DISCN	CAPSULE	ORAL	8258132	Sept. 26, 2027	FOR THE PREVENTION OF NAUSEA AND VOMITING ASSOCIATED WITH CHEMOTHERAPY
40MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMEND	MERCK	N021549	June 30, 2006	DISCN	CAPSULE	ORAL	8258132	Sept. 26, 2027	PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING
80MG	EMEND	MERCK	N021549	March 26, 2003	RX	CAPSULE	ORAL	8258132	Sept. 26, 2027	FOR THE PREVENTION OF NAUSEA AND VOMITING ASSOCIATED WITH CHEMOTHERAPY
80MG	EMEND	MERCK	N021549	March 26, 2003	RX	CAPSULE	ORAL	8258132	Sept. 26, 2027	PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING
125MG/KIT	EMEND	MSD MERCK CO	N207865	Dec. 17, 2015	RX	FOR SUSPENSION	ORAL	8258132	Sept. 26, 2027	PREVENTION OF NAUSEA AND VOMITING ASSOCIATED WITH CHEMOTHERAPY (CINV)
130MG/18ML (7.2MG/ML)	CINVANTI	HERON THERAPS INC	N209296	Nov. 9, 2017	RX	EMULSION	INTRAVENOUS	10624850	Sept. 18, 2035	TREATMENT OF NAUSEA AND VOMITING, INCLUDING THE PREVENTION OF ACUTE AND DELAYED NAUSEA AND VOMITING ASSOCIATED WITH INITIAL AND REPEAT COURSES OF HIGHLY OR MODERATELY EMETOGENIC CANCER CHEMOTHERAPY
130MG/18ML (7.2MG/ML)	CINVANTI	HERON THERAPS INC	N209296	Nov. 9, 2017	RX	EMULSION	INTRAVENOUS	10953018	Sept. 18, 2035	TREATMENT OF NAUSEA AND VOMITING, INCLUDING THE PREVENTION OF ACUTE AND DELAYED NAUSEA AND VOMITING ASSOCIATED WITH INITIAL AND REPEAT COURSES OF HIGHLY OR MODERATELY EMETOGENIC CANCER CHEMOTHERAPY
130MG/18ML (7.2MG/ML)	CINVANTI	HERON THERAPS INC	N209296	Nov. 9, 2017	RX	EMULSION	INTRAVENOUS	9561229	Sept. 18, 2035	TREATMENT OF NAUSEA AND VOMITING, INCLUDING THE PREVENTION OF ACUTE AND DELAYED NAUSEA AND VOMITING ASSOCIATED WITH INITIAL AND REPEAT COURSES OF HIGHLY OR MODERATELY EMETOGENIC CANCER CHEMOTHERAPY
130MG/18ML (7.2MG/ML)	CINVANTI	HERON THERAPS INC	N209296	Nov. 9, 2017	RX	EMULSION	INTRAVENOUS	9808465	Sept. 18, 2035	TREATMENT OF NAUSEA AND VOMITING, INCLUDING THE PREVENTION OF ACUTE AND DELAYED NAUSEA AND VOMITING ASSOCIATED WITH INITIAL AND REPEAT COURSES OF HIGHLY OR MODERATELY EMETOGENIC CANCER CHEMOTHERAPY
130MG/18ML (7.2MG/ML)	CINVANTI	HERON THERAPS INC	N209296	Nov. 9, 2017	RX	EMULSION	INTRAVENOUS	9974794	Sept. 18, 2035	TREATMENT OF NAUSEA AND VOMITING, INCLUDING THE PREVENTION OF ACUTE AND DELAYED NAUSEA AND VOMITING ASSOCIATED WITH INITIAL AND REPEAT COURSES OF HIGHLY OR MODERATELY EMETOGENIC CANCER CHEMOTHERAPY
32MG/4.4ML (7.2MG/ML)	APONVIE	HERON THERAPS INC	N216457	Sept. 16, 2022	RX	EMULSION	INTRAVENOUS	10624850	Sept. 18, 2035	A METHOD OF ADMINISTERING APREPITANT FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING
32MG/4.4ML (7.2MG/ML)	APONVIE	HERON THERAPS INC	N216457	Sept. 16, 2022	RX	EMULSION	INTRAVENOUS	10953018	Sept. 18, 2035	A METHOD OF ADMINISTERING APREPITANT FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING
32MG/4.4ML (7.2MG/ML)	APONVIE	HERON THERAPS INC	N216457	Sept. 16, 2022	RX	EMULSION	INTRAVENOUS	9561229	Sept. 18, 2035	A METHOD OF ADMINISTERING APREPITANT FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING
32MG/4.4ML (7.2MG/ML)	APONVIE	HERON THERAPS INC	N216457	Sept. 16, 2022	RX	EMULSION	INTRAVENOUS	9808465	Sept. 18, 2035	A METHOD OF ADMINISTERING APREPITANT FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING
32MG/4.4ML (7.2MG/ML)	APONVIE	HERON THERAPS INC	N216457	Sept. 16, 2022	RX	EMULSION	INTRAVENOUS	9974794	Sept. 18, 2035	A METHOD OF ADMINISTERING APREPITANT FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Substance-P receptor	GPCR	P25103	NK1R_HUMAN	ANTAGONIST	Ki	10.70	CHEMBL	CHEMBL
Cytochrome P450 3A4	Enzyme	P08684	CP3A4_HUMAN				WOMBAT-PK
Neuromedin-K receptor	GPCR	P29371	NK3R_HUMAN		Ki	6.34	CHEMBL
Substance-P receptor	GPCR		NK1R_MERUN		IC50	10.05	CHEMBL

External reference:

ID	Source
D02968	KEGG_DRUG
357280	RXNORM
C1176306	UMLSCUI
CHEBI:499361	CHEBI
CHEMBL1471	ChEMBL_ID
CHEMBL1201782	ChEMBL_ID
D000077608	MESH_DESCRIPTOR_UI
DB00673	DRUGBANK_ID
3490	IUPHAR_LIGAND_ID
8050	INN_ID
1NF15YR6UY	UNII
135413536	PUBCHEM_CID
17180	MMSL
247683	MMSL
46392	MMSL
d04855	MMSL
398690007	SNOMEDCT_US
409205009	SNOMEDCT_US
4021391	VANDF
009926	NDDF

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0461	CAPSULE	80 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0461	CAPSULE	80 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0461	CAPSULE	80 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0462	CAPSULE	125 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0462	CAPSULE	125 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0462	CAPSULE	125 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0464	CAPSULE	40 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0464	CAPSULE	40 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-0464	CAPSULE	40 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-3066	POWDER, FOR SUSPENSION	125 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-3066	POWDER, FOR SUSPENSION	125 mg	ORAL	NDA	31 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	0006-3066	POWDER, FOR SUSPENSION	125 mg	ORAL	NDA	31 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2321	CAPSULE	40 mg	ORAL	ANDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2321	CAPSULE	40 mg	ORAL	ANDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2322	CAPSULE	80 mg	ORAL	ANDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2322	CAPSULE	80 mg	ORAL	ANDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2323	CAPSULE	125 mg	ORAL	ANDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	0781-2323	CAPSULE	125 mg	ORAL	ANDA	26 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-591	CAPSULE	40 mg	ORAL	ANDA	25 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-591	CAPSULE	40 mg	ORAL	ANDA	25 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-592	CAPSULE	80 mg	ORAL	ANDA	25 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-592	CAPSULE	80 mg	ORAL	ANDA	25 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-593	CAPSULE	125 mg	ORAL	ANDA	25 sections
APREPITANT	HUMAN PRESCRIPTION DRUG LABEL	1	13668-593	CAPSULE	125 mg	ORAL	ANDA	25 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	42254-160	CAPSULE	40 mg	ORAL	NDA	26 sections
CINVANTI	HUMAN PRESCRIPTION DRUG LABEL	1	47426-201	INJECTION, EMULSION	130 mg	INTRAVENOUS	NDA	33 sections
CINVANTI	HUMAN PRESCRIPTION DRUG LABEL	1	47426-201	INJECTION, EMULSION	130 mg	INTRAVENOUS	NDA	33 sections
APONVIE	HUMAN PRESCRIPTION DRUG LABEL	1	47426-401	EMULSION	32 mg	INTRAVENOUS	NDA	29 sections
EMEND	HUMAN PRESCRIPTION DRUG LABEL	1	54868-5231	CAPSULE	80 mg	ORAL	NDA	26 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	68462-583	CAPSULE	40 mg	ORAL	ANDA	25 sections