Fosup 150 mg contains Fosaprepitant dimeglumine, a water-soluble prodrug of aprepitant, used to help prevent nausea and vomiting caused by chemotherapy (CINV — chemotherapy-induced nausea and vomiting).
It is given as a single-dose intravenous infusion, usually on the first day of chemotherapy, and is particularly effective against delayed nausea and vomiting, which can occur 24–120 hours after chemotherapy.
This approach improves patient comfort and helps maintain nutrition and hydration during cancer treatment.

Mechanism of Action

Fosaprepitant is rapidly converted in the body to its active form, aprepitant, after intravenous administration.

• Aprepitant blocks neurokinin-1 (NK1) receptors in the brain, which are activated by a natural substance called substance P.

• Substance P is a key player in triggering nausea and vomiting pathways, especially in the delayed phase after chemotherapy.

By preventing substance P from binding to NK1 receptors, fosaprepitant significantly reduces the chances of delayed vomiting and complements standard anti-nausea drugs like ondansetron (a 5-HT3 blocker) and dexamethasone (a steroid).

Uses / Indications

Fosup is used for:

• Prevention of acute and delayed nausea and vomiting associated with highly or moderately emetogenic chemotherapy regimens, such as those containing cisplatin or anthracyclines plus cyclophosphamide.

It is generally administered:

• As a single intravenous infusion of 150 mg on Day 1, before chemotherapy starts, in combination with a 5-HT3 antagonist (like ondansetron) and a corticosteroid (like dexamethasone).

This triple regimen significantly improves control over nausea and vomiting, enhancing overall quality of life during chemotherapy.

Adverse Effects

Fosaprepitant is generally well tolerated, but as with any medication, some side effects may occur.

Common side effects include:

• Infusion site reactions: pain, redness, or swelling at the injection site.

• Fatigue, hiccups.

• Mild headache or dizziness.

• Constipation or diarrhoea.