Frequently Asked Questions
aThe relationship between receptor occupancy and efficacy has not been established.
bTwo drugs are considered by FDA to be bioequivalent if the rate and extent of absorption of the proposed drug do not show a significant difference from the rate and extent of absorption of the therapeutic/approved drug when administered.
cAPONVIE will be reimbursed at WAC + 3% until ASP is established. Medicare reimbursement is subject to CMS updates, co-pay amounts, sequestration, and other factors.
dReimbursement comparisons do not imply safety or efficacy.
References: 1. APONVIE [package
insert]. San Diego, CA: Heron Therapeutics Inc; 2022.
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Important Safety Information!
APONVIE is contraindicated in patients with a history of hypersensitivity to aprepitant or any component of the product, and in patients taking pimozide. Increased pimozide levels may cause serious or life-threatening reactions, such as QT prolongation.
Warnings and Precautions
Hypersensitivity Reactions: Serious hypersensitivity reactions, including anaphylaxis, during or soon after administration of aprepitant have occurred. Symptoms including dyspnea, eye swelling, flushing, pruritus, and wheezing have been reported. Monitor patients during and after administration. If hypersensitivity reactions occur, administer appropriate medical therapy. Do not administer APONVIE in patients who experienced these symptoms with previous use of aprepitant.
Clinically Significant CYP3A4 Drug Interactions: Aprepitant is a substrate, weak-to-moderate (dose-dependent) inhibitor, and an inducer of CYP3A4. Use of pimozide, a CYP3A4 substrate, with APONVIE is contraindicated. Use of APONVIE with strong CYP3A4 inhibitors (eg, ketoconazole) may increase plasma concentrations of aprepitant and result in an increased risk of adverse reactions related to APONVIE. Use of APONVIE with strong CYP3A4 inducers (eg, rifampin) may result in a reduction in aprepitant plasma concentrations and decreased efficacy of APONVIE.
Decrease in INR with Concomitant Warfarin: Use of aprepitant with
warfarin, a CYP2C9 substrate, may result in a clinically significant
decrease in the International Normalized Ratio (INR) of prothrombin time.
Monitor the INR in patients on chronic warfarin therapy in the 2-week period
particularly at 7 to
Risk of Reduced Efficacy of Hormonal Contraceptives: The efficacy of
hormonal contraceptives may be reduced for
Use in Specific Populations
Avoid use of APONVIE in pregnant women as alcohol is an inactive ingredient in APONVIE. There is no safe level of alcohol exposure in pregnancy.
Most common adverse reactions (incidence ≥3%) for APONVIE are constipation, fatigue, and headache and for oral aprepitant are constipation and hypotension.
Report side effects to Heron at
APONVIE is a substance P/neurokinin-1 (NK1) receptor antagonist, indicated for the prevention of postoperative nausea and vomiting (PONV) in adults.
Limitations of Use: APONVIE has not been studied for treatment of established nausea and vomiting.
Please see full Prescribing Information.
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