Cilostazole
Contraindicated
Textbook
Increased plasma levels and toxicity of cilostazole.
Should not be administered along with inhibitors of CYP3A4.
Source: KDT 7e · p555
Drug reference
Aprepitant
Antiemetic
Also known as Emend
AntiemeticATC A04AD12
CDSCO approvedSchedule HATC A04AD12
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 12 →
- CilostazoleContraindicatedTextbookKDT 7e · p555
- EbastineSevereTextbookKDT 7e
- AcalabrutinibSevereDatabaseDDInter
- AlfentanilSevereDatabaseDDInter
Mechanism
Aprepitant is a neurokinin 1-receptor antagonist. It prevents nausea and vomiting by blocking the substance P neurokinin 1 (NK1) receptor.
Indications
Prevention of nausea and vomiting associated with highly emetogenic chemotherapyPrevention of nausea and vomiting associated with moderately emetogenic chemotherapyAdjunct to dexamethasone and a 5HT3-receptor antagonist in preventing nausea and vomiting associated with moderately and highly emetogenic chemotherapyantiemeticPrevention of chemotherapy-induced nausea and vomiting (delayed phase, typically with a 5HT3 antagonist and dexamethasone)Prevention of postoperative nausea and vomiting (PONV)chemotherapy induced nausea and vomiting (CINV) (acute and delayed phases, especially with cisplatin and cyclophosphamide-based chemotherapy)postoperative nausea and vomiting (PONV)Prevention of chemotherapy-induced nausea and vomiting (severely emetogenic and moderately emetogenic regimens)
Dosing
- Adult
- Initially 125 mg orally, taken 1 hour before chemotherapy, then 80 mg orally once daily for 2 days. Consult product literature for dose of concomitant dexamethasone and 5HT3-antagonist.
Pharmacokinetics
Half-life
9 to 13 h
Protein binding
Extensively bound to plasma proteins (>95%)
Metabolism
Primarily by hepatic CYP3A4
Excretion
In the stools
Contraindications
- Acute porphyrias
- Patients receiving cisapride, terfenadine, astemizole, or pimozide (due to life-threatening QT prolongation)
- concomitant use with Q-T interval prolonging drugs like cisapride
Side effects
Common
Appetite decreasedastheniaconstipationgastrointestinal discomfortheadachehiccupsFatigueweaknessflatulence
Serious
- Anaemia
- febrile neutropenia
- anxiety
- dizziness
- drowsiness
- malaise
- palpitations
- skin reactions
- urinary disorders
- vomiting
- Bradycardia
- cardiovascular disorder
- chest discomfort
- cognitive disorder
- conjunctivitis
- cough
- disorientation
- euphoric mood
- gait abnormal
- hyperhidrosis
- increased risk of infection
- muscle spasms
- muscle weakness
- oedema
- oropharyngeal pain
- photosensitivity reaction
- polydipsia
- seborrhoea
- severe cutaneous adverse reactions (SCARs)
- sneezing
- stomatitis
- taste altered
- throat irritation
- Life-threatening QT prolongation (with contraindicated drugs)
- rarely rise in liver enzymes
Drug interactions
Ebastine
Severe
Textbook
Increased risk of arrhythmogenic potential.
Exercise caution with coadministration.
Source: KDT 7e
Acalabrutinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Alfentanil
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Astemizole
Severe
Database
Life-threatening QT prolongation.
Aprepitant is contraindicated in patients receiving astemizole.
Source: DDInter
Avanafil
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Avapritinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Bosutinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Brexpiprazole
Severe
Database
Increased AUC by 2-fold.
Reduce brexpiprazole dose by 50%.
Source: DDInter
Brigatinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Related guidelines
Other Antiemetic drugs
Ask House about Aprepitant
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-10 · House clinical team