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Tolerability of Fosaprepitant and Bioequivalency to Aprepitant in Healthy Subjects

From the Clinical Pharmacology Research Unit, Clinical Pharmacology of Miami, Inc, Hialeah, Florida (Dr Lasseter) and Merck Research Laboratories, West Point, Pennsylvania (Dr Gambale, Dr Jin, Dr Bergman, Mr Constanzer, Mr Dru, Dr Han, Dr Majumdar, Dr Evans, Dr Murphy).

Fosaprepitant is an intravenous formulation of aprepitant, an oral NK₁ antagonist used to prevent chemotherapy-induced nausea and vomiting. This randomized study was designed to evaluate fosaprepitant in polysorbate 80 vehicle for tolerability and bioequivalency to aprepitant. Tolerability was assessed by physical and laboratory examinations and adverse events. Plasma collected for 72 hours was assayed for aprepitant and fosaprepitant. Analysis of variance models were applied to natural log-transformed aprepitant area under the curve (AUC) data. Fosaprepitant up to 150 mg (1 mg/mL) was generally well tolerated. Fosaprepitant 115 mg was AUC bioequivalent to aprepitant 125 mg; the 90% confidence interval for the geometric mean ratio of aprepitant AUC for fosaprepitant 115 mg/aprepitant 125 mg fell within prespecified equivalence bounds of 0.80 to 1.25.

Key Words: Fosaprepitant • aprepitant • bioequivalency • tolerability

Address for correspondence: Kenneth C. Lasseter, MD, Vice President and Medical Director, Clinical Pharmacology Research Unit, Clinical Pharmacology of Miami, Inc, 550 West 84th Street, Hialeah, FL 33014; e-mail: kclasseter{at}gmail.com.

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