Background After including aprepitant in the hospital’s pharmacotherapy guide 5 years ago, we decided to cheque if it is being used as defined by the Drug and Therapeutics Committee, which approved its use after the failure of other antiemetic treatments.
Purpose To evaluate the use of aprepitant in the Oncology Department of our hospital.
Materials and Methods We used the cytostatic prescription programme (Oncofarm Farmis-version 188.8.131.52) and dispensing programme (AS-400) to obtain the patients treated with aprepitant. The study period was from May 2010 to December 2011.
Results A total of 52 patients (84% women) were prescribed aprepitant during the study period. The average age was 49 years (age range: 19–69 years). The following data were collected: diagnosis and stage of disease, chemotherapy scheme, anti-emesis change cycle number, combination with radiotherapy and alcohol intake. 65% of patients had breast cancer followed by non-small lung cancer (5%). 27% and 25% of cancers were in stages IA and IIA respectively. The most common chemotherapy scheme (55%) for which the change of antiemetic therapy was seen, was FEC 500–100–500. 26% of patients started ondansetron 4 or 8 mg before aprepitant was prescribed. The rest (74%) received aprepitant directly after failing the first line antiemetic therapy. In 40% of patients the antiemetic regimen was changed to the study drug in cycle 2 and in 25% in cycle 3, demonstrating that aprepitant is not used as first-line antiemetic. Only 5 patients received radiotherapy combined with chemotherapy and only in 4 was alcohol intake recorded.
Conclusions In our hospital aprepitant is mainly used in chemotherapy regimens that include anthracyclines in combination with cyclophosphamide. It is prescribed after first line antiemetic regimen failure; meeting the indications established by Drug and Therapeutics Committee.
However, it would be advisable to cheque the antiemetic guidelines periodically for compliance with reference guides such as NCCN, ASCO, MASCC etc.
No conflict of interest.
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