Fosaprepitant

Summary

Fosaprepitant (CHEMBL1199324) is an approved small-molecule neurokinin-1 receptor antagonist targeting TACR1; indicated across 10 conditions including neoplasm and female reproductive organ cancer.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• Targets: 1 (TACR1)
• Indications: 10 conditions
• Clinical trials: 31
• Chemistry: 614.4 Da · C23H22F7N4O6P

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1199324
Name	Fosaprepitant
Type	Small molecule
Max phase	4
FDA approved	no
PubChem CID	135413538
ChEBI	CHEBI:64321
Molecular formula	C23H22F7N4O6P
Molecular weight	614.4
InChIKey	BARDROPHSZEBKC-OITMNORJSA-N

SMILES: C[C@H](C1=CC(=CC(=C1)C(F)(F)F)C(F)(F)F)O[C@@H]2[C@@H](N(CCO2)CC3=NN(C(=O)N3)P(=O)(O)O)C4=CC=C(C=C4)F

IUPAC name: [3-[[(2R,3S)-2-[(1R)-1-[3,5-bis(trifluoromethyl)phenyl]ethoxy]-3-(4-fluorophenyl)morpholin-4-yl]methyl]-5-oxo-4H-1,2,4-triazol-1-yl]phosphonic acid

ChEBI definition: A morpholine derivative that is the (1R)-1-[3,5-bis(trifluoromethyl)phenyl]ethyl ether of (3-{[(2R,3S)-3-(4-fluorophenyl)-2-hydroxymorpholin-4-yl]methyl}-5-oxo-4,5-dihydro-1H-1,2,4-triazol-1-yl)phosphonic acid.

Pharmacological roles (ChEBI): antiemetic, neurokinin-1 receptor antagonist, prodrug.

Also known as: Fosaprepitant, Ivemend, L-758298, FOSAPREPITANT, Fosaprepitant dimeglumine salt

Parent form; salt/anhydrous children: CHEMBL1159797, CHEMBL1201782

Patent coverage: 799 distinct patent families (2,674 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 2,607 (97%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

Gene	Target	Action	pAffinity	Cancer dependency	UniProt
TACR1	NK1 receptor	Antagonist	8.92	0.7%	P25103

Bioactivity

No ChEMBL bioactivity rows at pChembl ≥ 5 (expected for biologics / antibodies).

Target pathways

Aggregated over 1 target gene(s): TACR1.

Top Reactome pathways

4 total, by targets touching each:

Pathway	Targets	Genes
Tachykinin receptors bind tachykinins	1	TACR1
G alpha (q) signalling events	1	TACR1
Cargo recognition for clathrin-mediated endocytosis	1	TACR1
Clathrin-mediated endocytosis	1	TACR1

Dominant GO biological processes

GO term	Targets
aggressive behavior	1
positive regulation of leukocyte migration	1
angiotensin-mediated drinking behavior	1
inflammatory response	1
adenylate cyclase-activating G protein-coupled receptor signaling pathway	1
phospholipase C-activating G protein-coupled receptor signaling pathway	1
positive regulation of cytosolic calcium ion concentration	1
phospholipase C-activating tachykinin receptor signaling pathway	1
tachykinin receptor signaling pathway	1
long-term memory	1
associative learning	1
detection of abiotic stimulus	1
response to ozone	1
positive regulation of epithelial cell migration	1
response to auditory stimulus	1

Indications & clinical

Indications

10 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
neoplasm	3	MONDO:0005070	EFO:0000616
female reproductive organ cancer	3	MONDO:0001416	EFO:1001331
plasma cell myeloma	1	MONDO:0009693	EFO:0001378
nasopharyngeal carcinoma	1	MONDO:0015459	MONDO:0015459
brain injury	0	MONDO:0043510	MONDO:0043510

5 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 31.

Phase distribution

Phase	Trials
PHASE2	7
PHASE3	6
Not specified	6
PHASE4	5
PHASE1	3
EARLY_PHASE1	2
PHASE2/PHASE3	1
PHASE1/PHASE2	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT05841849	PHASE4	NOT_YET_RECRUITING	Efficacy and Safety of Intravenous Versus Oral 5-HT3 Antagonists Combined With NK-1 Receptor Antagonists for the Prevention of CINV in Breast Cancer
NCT06740812	PHASE4	NOT_YET_RECRUITING	Broadening Antiemetics Research by Comparing the Effectiveness of Fosaprepitant and Metoclopramide
NCT01432015	PHASE4	COMPLETED	Fosaprepitant Versus Aprepitant in the Prevention of Chemotherapy Induced Nausea and Vomiting
NCT03197064	PHASE4	COMPLETED	Effect of Fosaprepitant on Motor Evoked and Somatosensory Evoked Potentials Under General Anesthesia
NCT03586817	PHASE4	UNKNOWN	PALONOSETRON X FOSAPREPITANT IN PONV
NCT06382012	PHASE2/PHASE3	RECRUITING	Antiemetic Fosaprepitant To Remedy Nausea and Vomiting
NCT07413809	PHASE3	RECRUITING	Prevention of Delayed CINV After Autologous Transplant: Olanzapine-Containing Regimen vs. Dexamethasone-Containing Regimen
NCT01594749	PHASE3	COMPLETED	Efficacy and Safety of Fosaprepitant Dimeglumine in Preventing Chemotherapy-Induced Nausea and Vomiting (MK-0517-031)
NCT02106494	PHASE3	COMPLETED	A Prospective, Multicenter, Study of APF530 (Granisetron) SC for Prevention of CINV in Patients Receiving HEC
NCT02519842	PHASE3	TERMINATED	Efficacy and Safety Study of Fosaprepitant (MK-0517) Plus Ondansetron Versus Ondansetron Alone for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Pediatric Participants (MK-0517-044)
NCT04912271	PHASE3	UNKNOWN	Granisetron Transdermal Patch for Prophylaxis of Delayed CINV
NCT05564286	PHASE3	COMPLETED	Triple Antiemetic Regimen for Chemoradiotherapy in Cervical Cancer or Nasopharyngeal Cancer
NCT01697579	PHASE2	COMPLETED	Study of the Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Fosaprepitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Children (MK-0517-029)
NCT01736917	PHASE2	COMPLETED	Fosaprepitant + 5HT3 Receptor Antagonists + Dexamethasone in Germ Cell Tumors
NCT01857232	PHASE2	COMPLETED	Dose-finding Study of APD403 to Prevent Nausea and Vomiting After Chemotherapy
NCT01874119	PHASE2	TERMINATED	Fosaprepitant for N/V With High-dose Interleukin-2 for Metastatic Melanoma and Renal Cell Carcinoma
NCT02407600	PHASE2	UNKNOWN	Study Assessing Fosaprepitant in Advanced NSCLC Patients Treated With Carboplatin Based Chemotherapy
NCT02780609	PHASE1/PHASE2	COMPLETED	Selinexor Plus High-Dose Melphalan (HDM) Before Autologous Hematopoietic Cell Transplantation for Multiple Myeloma
NCT03237611	PHASE2	TERMINATED	Low Dose Aprepitant for Patients Receiving Carboplatin
NCT04508400	PHASE2	COMPLETED	Fosaprepitant for the Prevention of Chemotherapy-induced Nausea and Vomiting in Pediatric Patients
NCT00818259	PHASE1	TERMINATED	A Study of MK-0869 (Aprepitant) and MK-0517 (Fosaprepitant) in Pediatric Participants Receiving Chemotherapy (MK-0869-134)
NCT01111851	PHASE1	COMPLETED	Aprepitant and Fosaprepitant Time-on-Target PET (Positron Emission Tomography) Study (0869-183)
NCT04636632	PHASE1	COMPLETED	Fosaprepitant for the Prevention of Nausea and Emesis During Concurrent Chemoradiotherapy for Nasopharyngeal Carcinoma
NCT06427681	EARLY_PHASE1	NOT_YET_RECRUITING	An Relative Bioavailability Study of BH006 for Injection in Healthy Subjects
NCT03035838	EARLY_PHASE1	WITHDRAWN	Importance of Substance P in Intracranial Pressure Elevation Following Traumatic Brain Injury
NCT05773950	Not specified	ENROLLING_BY_INVITATION	Triple Therapy of Dexamethasone, Palonosetron, and Fosaprepitant As PONV Prevention
NCT01344304	Not specified	COMPLETED	Study of Aprepitant / Fosaprepitant for the Prevention of Chemotherapy-induced Nausea and Vomiting (CINV) in Colorectal Cancer Patients - SENRI Trial
NCT01490060	Not specified	COMPLETED	Fosaprepitant in Patients Receiving Ifosfamide-based Regimen
NCT04873284	Not specified	UNKNOWN	Comparative Study of Fosaprepitant and Aprepitant for the Prevention of Chemotherapy-induced Nausea and Vomiting in Pediatric Caner Patients
NCT05230654	Not specified	UNKNOWN	Efficacy and Safety of Fosaprepitant in Preventing Chemotherapy-induced Vomiting in Children Treated With Medium and High Emetic Chemotherapeutic Drugs
NCT05881486	Not specified	UNKNOWN	Antiemetic Prophylaxis With Fosaprepitant and Ondansetron in Patients Undergoing Thoracic Surgery

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No PharmGKB pharmacogenomic data curated for this drug.

Related molecules

Related molecules

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

45 molecules share ≥1 primary target. Top 45 by shared-target count:

Molecule	Source	Status	Shared targets
ACLIDINIUM BROMIDE	ChEMBL + PubChem	Phase 4 (approved)	TACR1
FIDAXOMICIN	ChEMBL + PubChem	Phase 4 (approved)	TACR1
ROLAPITANT	ChEMBL + PubChem	Phase 4 (approved)	TACR1
AMOXAPINE	ChEMBL	Phase 4 (approved)	TACR1
APREPITANT	ChEMBL	Phase 4 (approved)	TACR1
ARIPIPRAZOLE	ChEMBL	Phase 4 (approved)	TACR1
ASTEMIZOLE	ChEMBL	Phase 4 (approved)	TACR1
BOSUTINIB	ChEMBL	Phase 4 (approved)	TACR1
CARVEDILOL	ChEMBL	Phase 4 (approved)	TACR1
CLOTRIMAZOLE	ChEMBL	Phase 4 (approved)	TACR1
CYCLOSPORINE	ChEMBL	Phase 4 (approved)	TACR1
DEXTROMETHORPHAN	ChEMBL	Phase 4 (approved)	TACR1
DOXAZOSIN	ChEMBL	Phase 4 (approved)	TACR1
ECONAZOLE	ChEMBL	Phase 4 (approved)	TACR1
HALOPERIDOL	ChEMBL	Phase 4 (approved)	TACR1
ITRACONAZOLE	ChEMBL	Phase 4 (approved)	TACR1
LANSOPRAZOLE	ChEMBL	Phase 4 (approved)	TACR1
MICONAZOLE	ChEMBL	Phase 4 (approved)	TACR1
NEFAZODONE	ChEMBL	Phase 4 (approved)	TACR1
NETUPITANT	ChEMBL	Phase 4 (approved)	TACR1
NILOTINIB	ChEMBL	Phase 4 (approved)	TACR1
PAROXETINE	ChEMBL	Phase 4 (approved)	TACR1
RITONAVIR	ChEMBL	Phase 4 (approved)	TACR1
TAMOXIFEN	ChEMBL	Phase 4 (approved)	TACR1
TERFENADINE	ChEMBL	Phase 4 (approved)	TACR1
THIOTHIXENE	ChEMBL	Phase 4 (approved)	TACR1
TRAZODONE	ChEMBL	Phase 4 (approved)	TACR1
CASOPITANT	ChEMBL	Phase 3	TACR1
SAREDUTANT	ChEMBL	Phase 3	TACR1
SERLOPITANT	ChEMBL	Phase 3	TACR1
BEFETUPITANT	ChEMBL	Phase 2	TACR1
DAPITANT	ChEMBL	Phase 2	TACR1
DNK333	ChEMBL	Phase 2	TACR1
LANEPITANT	ChEMBL	Phase 2	TACR1
ORVEPITANT	ChEMBL	Phase 2	TACR1
OSANETANT	ChEMBL	Phase 2	TACR1
SPERGUALIN	ChEMBL	Phase 2	TACR1
TALNETANT	ChEMBL	Phase 2	TACR1
TELMAPITANT	ChEMBL	Phase 2	TACR1
VESTIPITANT	ChEMBL	Phase 2	TACR1
VOFOPITANT	ChEMBL	Phase 2	TACR1
Alogliptin	PubChem	Approved	TACR1
Belzutifan	PubChem	Approved	TACR1
Propoxyphene	PubChem	Approved	TACR1
Tiotropium Bromide Monohydrate	PubChem	Approved	TACR1