Comparative Pharmacology
Head-to-head clinical analysis: ANTIVERT versus FOSAPREPITANT DIMEGLUMINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANTIVERT versus FOSAPREPITANT DIMEGLUMINE.
ANTIVERT vs FOSAPREPITANT DIMEGLUMINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Antivert (meclizine) is a piperazine H1 histamine receptor antagonist with central anticholinergic and sedative properties. It suppresses the chemoreceptor trigger zone and labyrinthine apparatus, reducing vestibular stimulation and vertigo.
Fosaprepitant dimeglumine is a prodrug of aprepitant, a selective high-affinity antagonist of human substance P/neurokinin 1 (NK1) receptors. It inhibits emesis by blocking NK1 receptors in the central nervous system, particularly in the area postrema and the nucleus tractus solitarius.
25-100 mg orally daily in divided doses 2-4 times daily; maximum 400 mg/day.
150 mg intravenous over 30 minutes on day 1, combined with dexamethasone and a 5-HT3 antagonist; alternatively, 115 mg IV on day 1 followed by 80 mg IV on day 2 and 80 mg IV on day 3, or 150 mg oral (as fosaprepitant dimeglumine or aprepitant) on day 1 and 80 mg oral on days 2 and 3.
None Documented
None Documented
Terminal elimination half-life is 35–50 hours in adults; prolonged in renal impairment.
Terminal elimination half-life of aprepitant is approximately 9 to 13 hours; clinical significance includes once-daily dosing for prevention of chemotherapy-induced nausea and vomiting.
Primarily renal (urine) as unchanged drug and metabolites; biliary excretion is minimal. Approximately 80% excreted unchanged in urine.
Fosaprepitant is rapidly converted to aprepitant. Aprepitant is eliminated primarily by metabolism; <5% of the dose is excreted unchanged in urine. Fecal excretion accounts for approximately 58% of the dose, and urinary excretion accounts for 43% (mostly as metabolites).
Category C
Category C
Antiemetic
Antiemetic