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

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	476.88	16.35	371	21712	97296	50485745
Nausea	194.94	16.35	710	21373	704688	49878353
Mucosal inflammation	192.19	16.35	151	21932	39991	50543050
Neutropenia	177.51	16.35	267	21816	147698	50435343
Erythema	158.50	16.35	252	21831	146162	50436879
Encephalopathy	132.32	16.35	113	21970	33598	50549443
Drug ineffective	120.48	16.35	109	21974	819224	49763817
Flushing	107.19	16.35	139	21944	66876	50516165
Atelectasis	105.70	16.35	77	22006	18193	50564848
Pyrexia	104.40	16.35	383	21700	379820	50203221
Febrile bone marrow aplasia	100.66	16.35	51	22032	6260	50576781
Computerised tomogram thorax abnormal	99.68	16.35	33	22050	1350	50581691
Aplasia	82.57	16.35	38	22045	3775	50579266
Neutrophil count decreased	79.15	16.35	99	21984	45927	50537114
Hypoxia	75.49	16.35	102	21981	51021	50532020
Bone marrow failure	68.82	16.35	72	22011	27552	50555489
Hyponatraemia	68.48	16.35	138	21945	96001	50487040
Gastrointestinal disorder	65.39	16.35	134	21949	94322	50488719
Decreased appetite	63.21	16.35	212	21871	200711	50382330
Dyspnoea	61.82	16.35	429	21654	547179	50035862
Fall	61.41	16.35	35	22048	334897	50248144
Hepatocellular injury	59.98	16.35	65	22018	25882	50557159
Injection site phlebitis	58.01	16.35	13	22070	114	50582927
Feeling hot	57.54	16.35	78	22005	39124	50543917
Palmar-plantar erythrodysaesthesia syndrome	54.80	16.35	55	22028	20043	50562998
Vascular pain	52.05	16.35	17	22066	666	50582375
Vomiting	51.34	16.35	360	21723	460398	50122643
Respiratory syncytial virus infection	50.27	16.35	30	22053	5072	50577969
Anaphylactic shock	49.24	16.35	52	22031	20103	50562938
Alveolitis	47.92	16.35	23	22060	2511	50580530
Constipation	47.34	16.35	183	21900	185525	50397516
Neuropathy peripheral	46.66	16.35	119	21964	96638	50486403
Sense of oppression	46.64	16.35	17	22066	928	50582113
Oral pain	46.50	16.35	56	22027	24977	50558064
Infusion site streaking	46.12	16.35	14	22069	430	50582611
Injection site vasculitis	42.31	16.35	7	22076	7	50583034
Computerised tomogram thorax	40.03	16.35	10	22073	145	50582896
Tonsillar haemorrhage	39.99	16.35	11	22072	236	50582805
Inappropriate antidiuretic hormone secretion	39.62	16.35	38	22045	13105	50569936
Stomatitis	39.24	16.35	115	21968	101229	50481812
Diarrhoea	39.16	16.35	410	21673	588066	49994975
Depression	35.30	16.35	14	22069	165409	50417632
Chemotherapy	33.95	16.35	15	22068	1354	50581687
Rheumatoid arthritis	31.91	16.35	25	22058	202525	50380516
Hypersensitivity	31.87	16.35	181	21902	214980	50368061
Gait disturbance	31.51	16.35	13	22070	149992	50433049
Cerebellar syndrome	31.40	16.35	19	22064	3292	50579749
Abdominal pain	31.31	16.35	193	21890	236035	50347006
Interstitial lung disease	30.54	16.35	70	22013	53106	50529935
Hiccups	30.52	16.35	15	22068	1724	50581317
Toxicity to various agents	30.11	16.35	29	22054	212470	50370571
Chest discomfort	29.23	16.35	98	21985	92624	50490417
Intestinal strangulation	28.95	16.35	7	22076	88	50582953
Joint swelling	28.77	16.35	39	22044	245247	50337794
Asthma	28.32	16.35	3	22080	89334	50493707
Thrombocytopenia	25.61	16.35	117	21966	127556	50455485
Leukopenia	24.58	16.35	75	22008	67453	50515588
Colony stimulating factor therapy	24.58	16.35	8	22075	310	50582731
Hypokalaemia	24.27	16.35	89	21994	87903	50495138
Intercepted product administration error	24.02	16.35	6	22077	87	50582954
Infusion related reaction	24.01	16.35	141	21942	169416	50413625
Hypomagnesaemia	23.80	16.35	39	22044	23117	50559924
Anorectal disorder	23.78	16.35	12	22071	1460	50581581
Bronchitis	23.59	16.35	8	22075	104151	50478890
Dental fistula	22.97	16.35	9	22074	600	50582441
Musculoskeletal stiffness	22.68	16.35	14	22069	128467	50454574
Gastrointestinal scarring	22.64	16.35	7	22076	229	50582812
Thrombocytopenic purpura	22.63	16.35	11	22072	1235	50581806
Pneumonia	22.52	16.35	87	21996	378314	50204727
Anaphylactic reaction	22.51	16.35	63	22020	53992	50529049
Mobility decreased	22.25	16.35	4	22079	79944	50503097
Condition aggravated	22.01	16.35	62	22021	296996	50286045
Oropharyngeal discomfort	21.72	16.35	16	22067	3842	50579199
Exposure during pregnancy	21.62	16.35	13	22070	121002	50462039
Laryngeal discomfort	21.36	16.35	7	22076	277	50582764
Sputum abnormal	21.32	16.35	8	22075	474	50582567
Pain	21.15	16.35	157	21926	578746	50004295
Antinuclear antibody	20.94	16.35	8	22075	498	50582543
Balance disorder	20.83	16.35	3	22080	70587	50512454
Nail infection	20.43	16.35	12	22071	1969	50581072
Phlebitis	20.06	16.35	18	22065	5702	50577339
Dysgeusia	19.93	16.35	49	22034	38867	50544174
Myocardial infarction	19.88	16.35	7	22076	89020	50494021
Periorbital cellulitis	19.87	16.35	8	22075	573	50582468
Product dose omission issue	19.80	16.35	31	22052	183807	50399234
Tumour pain	19.79	16.35	10	22073	1220	50581821
Chills	19.67	16.35	89	21994	96598	50486443
Hypermagnesaemia	19.64	16.35	9	22074	885	50582156
Body temperature abnormal	19.48	16.35	10	22073	1260	50581781
Infusion site vesicles	19.05	16.35	7	22076	391	50582650
Hallucination, tactile	18.80	16.35	6	22077	218	50582823
Influenza	18.41	16.35	8	22075	89530	50493511
Administration site oedema	18.29	16.35	4	22079	31	50583010
Cough	17.81	16.35	172	21911	241092	50341949
Injection site induration	17.61	16.35	20	22063	8377	50574664
Folliculitis	17.61	16.35	47	22036	39178	50543863
Onychalgia	17.45	16.35	8	22075	787	50582254
Drug hypersensitivity	17.41	16.35	54	22029	250956	50332085
Abdominal operation	17.27	16.35	7	22076	510	50582531
Muscle injury	17.20	16.35	45	22038	37066	50545975
Paraesthesia	17.01	16.35	100	21983	120143	50462898
Cardiotoxicity	16.93	16.35	18	22065	7009	50576032
Aortitis	16.75	16.35	8	22075	864	50582177
Toxic encephalopathy	16.72	16.35	16	22067	5499	50577542
Subacute cutaneous lupus erythematosus	16.72	16.35	11	22072	2204	50580837
Cardiac failure congestive	16.63	16.35	8	22075	84374	50498667
Loss of personal independence in daily activities	16.53	16.35	5	22078	70045	50512996

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	220.64	19.29	254	12288	111986	29449999
Hiccups	107.40	19.29	59	12483	8794	29553191
Neutropenia	102.92	19.29	193	12349	131518	29430467
Hypersensitivity	99.02	19.29	117	12425	52786	29509199
Erythema	93.01	19.29	136	12406	75470	29486515
Neutrophil count decreased	79.26	19.29	95	12447	43472	29518513
Drug ineffective	78.92	19.29	28	12514	363142	29198843
Nausea	77.29	19.29	283	12259	288972	29273013
Thrombocytopenia	65.39	19.29	163	12379	134660	29427325
Stomatitis	59.55	19.29	76	12466	37037	29524948
Vomiting	56.79	19.29	208	12334	212052	29349933
Decreased appetite	54.65	19.29	160	12382	145182	29416803
Fixed eruption	50.27	19.29	19	12523	1183	29560802
Intestinal ischaemia	48.40	19.29	32	12510	6660	29555325
Hepatocellular injury	46.49	19.29	51	12491	21192	29540793
Encephalopathy	44.26	19.29	60	12482	30983	29531002
Toxicity to various agents	43.84	19.29	10	12532	173651	29388334
Aplasia	43.61	19.29	25	12517	4038	29557947
Diarrhoea	43.11	19.29	264	12278	332434	29229551
Testicular germ cell cancer metastatic	42.99	19.29	9	12533	57	29561928
Oesophagitis	41.74	19.29	37	12505	11886	29550099
Mouth ulceration	40.02	19.29	34	12508	10321	29551664
Anaphylactic reaction	38.86	19.29	53	12489	27520	29534465
White blood cell count decreased	38.46	19.29	99	12443	83263	29478722
Stoma site pain	36.21	19.29	12	12530	507	29561478
Bone marrow failure	34.58	19.29	50	12492	27399	29534586
Platelet count decreased	34.39	19.29	110	12432	104562	29457423
Toxic encephalopathy	33.22	19.29	22	12520	4590	29557395
Sense of oppression	32.85	19.29	11	12531	480	29561505
Oral pain	32.81	19.29	29	12513	9278	29552707
Flushing	32.49	19.29	50	12492	28942	29533043
Febrile bone marrow aplasia	32.29	19.29	26	12516	7325	29554660
Seminoma	32.02	19.29	9	12533	216	29561769
Change of bowel habit	32.00	19.29	13	12529	981	29561004
Mucosal inflammation	31.97	19.29	52	12490	31543	29530442
Emotional disorder	31.88	19.29	22	12520	4909	29557076
Interstitial lung disease	31.34	19.29	73	12469	57645	29504340
Anaphylactic shock	30.89	19.29	33	12509	13303	29548682
Leukopenia	30.17	19.29	70	12472	55133	29506852
Enteritis	29.79	19.29	24	12518	6767	29555218
Peritonitis	29.71	19.29	34	12508	14790	29547195
Neuropathy peripheral	29.35	19.29	81	12461	70946	29491039
Pyrexia	28.05	19.29	213	12329	287409	29274576
Alopecia	27.36	19.29	37	12505	19047	29542938
Paraesthesia	25.90	19.29	65	12477	53780	29508205
Regurgitation	25.46	19.29	12	12530	1295	29560690
Rash maculo-papular	24.60	19.29	40	12502	24249	29537736
Hypokalaemia	24.56	19.29	61	12481	50142	29511843
Large intestine perforation	24.11	19.29	22	12520	7334	29554651
Dehydration	23.77	19.29	104	12438	114644	29447341
Chemotherapeutic drug level increased	23.64	19.29	7	12535	203	29561782
Septic shock	23.55	19.29	69	12473	62491	29499494
Incorrect drug administration rate	23.53	19.29	11	12531	1165	29560820
Product dose omission issue	23.41	19.29	6	12536	96377	29465608
Platelet count increased	23.33	19.29	23	12519	8440	29553545
Jaundice	22.85	19.29	43	12499	29253	29532732
Acute kidney injury	20.75	19.29	187	12355	265080	29296905
Oropharyngeal discomfort	20.39	19.29	13	12529	2543	29559442
Necrotising ulcerative gingivostomatitis	20.32	19.29	5	12537	70	29561915
Cardiac failure congestive	20.13	19.29	4	12538	76577	29485408
Hepatic cytolysis	19.94	19.29	21	12521	8326	29553659

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	610.87	15.29	588	30272	187069	64280803
Erythema	231.75	15.29	360	30500	186710	64281162
Nausea	231.41	15.29	860	30000	784940	63682932
Neutropenia	227.24	15.29	409	30451	239215	64228657
Mucosal inflammation	166.01	15.29	176	30684	62408	64405464
Encephalopathy	153.51	15.29	164	30696	58655	64409217
Drug ineffective	150.86	15.29	110	30750	840137	63627735
Neutrophil count decreased	129.83	15.29	172	30688	77024	64390848
Aplasia	122.74	15.29	62	30798	6891	64460981
Hypersensitivity	122.40	15.29	282	30578	196170	64271702
Flushing	118.27	15.29	166	30694	78482	64389390
Febrile bone marrow aplasia	114.99	15.29	70	30790	11185	64456687
Hiccups	114.63	15.29	63	30797	8313	64459559
Pyrexia	103.32	15.29	533	30327	558111	63909761
Hepatocellular injury	93.88	15.29	112	30748	45123	64422749
Decreased appetite	93.18	15.29	321	30539	280968	64186904
Bone marrow failure	90.24	15.29	113	30747	47839	64420033
Stomatitis	87.37	15.29	174	30686	109431	64358441
Toxicity to various agents	86.40	15.29	33	30827	363480	64104392
Computerised tomogram thorax abnormal	85.31	15.29	33	30827	1936	64465936
Neuropathy peripheral	83.58	15.29	178	30682	117347	64350525
Atelectasis	81.86	15.29	82	30778	27184	64440688
Sense of oppression	76.30	15.29	28	30832	1419	64466453
Thrombocytopenia	72.83	15.29	254	30606	223547	64244325
Fall	70.13	15.29	58	30802	416768	64051104
Vomiting	69.58	15.29	476	30384	550641	63917231
Anaphylactic shock	67.76	15.29	78	30782	30250	64437622
Gastrointestinal disorder	63.91	15.29	136	30724	89573	64378299
Diarrhoea	63.55	15.29	574	30286	722130	63745742
Vascular pain	62.83	15.29	21	30839	805	64467067
Oral pain	61.91	15.29	71	30789	27422	64440450
Hyponatraemia	58.68	15.29	180	30680	148159	64319713
Interstitial lung disease	53.96	15.29	134	30726	97598	64370274
Anaphylactic reaction	53.47	15.29	108	30752	68556	64399316
Leukopenia	50.91	15.29	134	30726	101108	64366764
Constipation	49.44	15.29	229	30631	229108	64238764
Feeling hot	48.36	15.29	82	30778	45581	64422291
Hypoxia	47.75	15.29	120	30740	88029	64379843
Palmar-plantar erythrodysaesthesia syndrome	46.54	15.29	63	30797	28756	64439116
Toxic encephalopathy	46.17	15.29	38	30822	9777	64458095
Oesophagitis	45.59	15.29	54	30806	21576	64446296
Infusion site streaking	44.76	15.29	14	30846	433	64467439
Intestinal ischaemia	44.72	15.29	40	30820	11509	64456363
Infusion related reaction	44.52	15.29	176	30684	164291	64303581
Oropharyngeal discomfort	44.04	15.29	29	30831	5306	64462566
Testicular germ cell cancer metastatic	42.04	15.29	9	30851	56	64467816
Product dose omission issue	40.97	15.29	21	30839	194726	64273146
Respiratory syncytial virus infection	40.31	15.29	31	30829	7237	64460635
Injection site vasculitis	39.91	15.29	7	30853	11	64467861
Computerised tomogram thorax	39.05	15.29	10	30850	146	64467726
Chest discomfort	38.76	15.29	133	30727	115973	64351899
Alopecia	38.33	15.29	169	30691	165521	64302351
Depression	38.21	15.29	20	30840	183271	64284601
White blood cell count decreased	38.05	15.29	163	30697	157674	64310198
Alveolitis	37.80	15.29	23	30837	3669	64464203
Fixed eruption	37.37	15.29	19	30841	2140	64465732
Paraesthesia	37.24	15.29	145	30715	134377	64333495
Platelet count decreased	35.77	15.29	167	30693	167544	64300328
Rash maculo-papular	35.46	15.29	73	30787	46953	64420919
Dyspnoea	35.35	15.29	510	30350	718164	63749708
Asthma	34.43	15.29	3	30857	95222	64372650
Condition aggravated	34.28	15.29	80	30780	372346	64095526
Cardiac failure congestive	34.20	15.29	10	30850	130570	64337302
Overdose	33.87	15.29	17	30843	159549	64308323
Inappropriate antidiuretic hormone secretion	33.40	15.29	47	30813	22242	64445630
Seminoma	32.22	15.29	9	30851	186	64467686
Hypokalaemia	31.80	15.29	129	30731	121774	64346098
Chemotherapy	31.25	15.29	15	30845	1492	64466380
Colony stimulating factor therapy	31.03	15.29	11	30849	504	64467368
Myocardial infarction	30.48	15.29	21	30839	165800	64302072
Dermatitis acneiform	30.26	15.29	28	30832	8415	64459457
Mobility decreased	30.24	15.29	3	30857	85837	64382035
Balance disorder	29.40	15.29	3	30857	83923	64383949
Injection site phlebitis	29.12	15.29	8	30852	155	64467717
Hepatic cytolysis	27.85	15.29	34	30826	14015	64453857
Rheumatoid arthritis	27.39	15.29	23	30837	164271	64303601
Abdominal pain	27.21	15.29	248	30612	312127	64155745
Enteritis	26.87	15.29	31	30829	12046	64455826
Chills	26.60	15.29	133	30727	137131	64330741
Tonsillar haemorrhage	25.59	15.29	8	30852	247	64467625
Septic shock	25.48	15.29	109	30751	105328	64362544
Cholestasis	25.25	15.29	62	30798	44810	64423062
Musculoskeletal stiffness	24.86	15.29	14	30846	123192	64344680
Arthritis	24.71	15.29	5	30855	83809	64384063
Dysgeusia	24.38	15.29	63	30797	46984	64420888
Intentional product misuse	24.27	15.29	3	30857	72292	64395580
Neutropenic colitis	24.23	15.29	19	30841	4562	64463310
Cardiotoxicity	23.92	15.29	27	30833	10247	64457625
Dental fistula	23.78	15.29	9	30851	497	64467375
Chronic obstructive pulmonary disease	23.73	15.29	3	30857	71045	64396827
Periorbital cellulitis	23.56	15.29	10	30850	746	64467126
Drug clearance decreased	23.49	15.29	15	30845	2604	64465268
Epistaxis	23.37	15.29	101	30759	98030	64369842
Dehydration	23.05	15.29	180	30680	216583	64251289
Folliculitis	23.04	15.29	47	30813	30030	64437842
Ileus	22.68	15.29	40	30820	22926	64444946
Muscle injury	22.28	15.29	43	30817	26394	64441478
Suicidal ideation	21.77	15.29	3	30857	66539	64401333
Joint swelling	21.66	15.29	44	30816	215338	64252534
Influenza	21.64	15.29	12	30848	106519	64361353
Antinuclear antibody	21.14	15.29	8	30852	442	64467430
Bronchitis	21.03	15.29	13	30847	108730	64359142
Hyperthermia	20.69	15.29	31	30829	15519	64452353
Hypomagnesaemia	20.35	15.29	51	30809	37325	64430547
Nail infection	20.19	15.29	12	30848	1835	64466037
Anorectal disorder	19.65	15.29	12	30848	1927	64465945
Intercepted product administration error	19.62	15.29	6	30854	172	64467700
Chemotherapeutic drug level increased	19.26	15.29	7	30853	345	64467527
Peritonitis	19.04	15.29	39	30821	24984	64442888
Malaise	18.90	15.29	280	30580	395967	64071905
Wrong technique in product usage process	18.90	15.29	4	30856	64970	64402902
Drug hypersensitivity	18.86	15.29	55	30805	237760	64230112
Regurgitation	18.72	15.29	12	30848	2097	64465775
Infusion site vesicles	18.51	15.29	7	30853	386	64467486
Thrombocytopenic purpura	18.45	15.29	12	30848	2150	64465722
Keratitis	18.37	15.29	14	30846	3223	64464649
Osteoarthritis	18.22	15.29	4	30856	63332	64404540
Loss of personal independence in daily activities	18.16	15.29	6	30854	72448	64395424
Chronic kidney disease	18.05	15.29	3	30857	57916	64409956
Administration site oedema	18.04	15.29	4	30856	30	64467842
Large intestine perforation	18.03	15.29	26	30834	12578	64455294
Sputum abnormal	18.00	15.29	9	30851	978	64466894
Disseminated intravascular coagulation	17.46	15.29	44	30816	32304	64435568
Gait disturbance	17.45	15.29	35	30825	172120	64295752
Hallucination, tactile	17.11	15.29	7	30853	476	64467396
Hypermagnesaemia	17.10	15.29	9	30851	1088	64466784
Aortitis	17.07	15.29	9	30851	1092	64466780
Hypoglycaemia	17.03	15.29	11	30849	89881	64377991
Skin reaction	16.97	15.29	25	30835	12327	64455545
Laryngeal discomfort	16.89	15.29	7	30853	492	64467380
Heart rate decreased	16.84	15.29	3	30857	55064	64412808
Cerebellar syndrome	16.76	15.29	16	30844	5000	64462872
Onychalgia	16.73	15.29	8	30852	789	64467083
Duodenal ulcer perforation	16.55	15.29	45	30815	34580	64433292
Body temperature abnormal	16.48	15.29	10	30850	1588	64466284
Pain	16.23	15.29	178	30682	553333	63914539
Coombs positive haemolytic anaemia	16.00	15.29	8	30852	870	64467002
Type III immune complex mediated reaction	15.92	15.29	7	30853	569	64467303
Palmar erythema	15.85	15.29	10	30850	1700	64466172
Seizure	15.79	15.29	135	30725	166757	64301115
Cerebrovascular accident	15.70	15.29	26	30834	137557	64330315
Influenza like illness	15.65	15.29	5	30855	61697	64406175
Therapeutic response decreased	15.62	15.29	3	30857	52185	64415687
Hyperammonaemic encephalopathy	15.60	15.29	14	30846	4044	64463828

FDA Adverse Event Reporting System (Pediatric)

None

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

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
009926	NDDF
4021391	VANDF
398690007	SNOMEDCT_US
409205009	SNOMEDCT_US

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	0006-0462	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	0006-3066	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	0781-2322	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	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	13668-593	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
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
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	68462-584	CAPSULE	80 mg	ORAL	ANDA	25 sections
Aprepitant	HUMAN PRESCRIPTION DRUG LABEL	1	68462-585	CAPSULE	125 mg	ORAL	ANDA	25 sections