Aprepitant/Fosaprepitant Dimeglumine and XaQuil XR

• Generic Name: aprepitant
• Dosage Forms: n.a.
• Other Brand Names: Cinvanti, Emend, Emend 3-Day, Emend 2-Day

Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy, including high-dose cisplatin therapy. Used in combination with other antiemetic agents.

Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Used in combination with other antiemetic agents.

For prevention of nausea and vomiting associated with highly emetogenic chemotherapy regimens (including an anthracycline plus cyclophosphamide), ASCO recommends a 3-drug antiemetic regimen consisting of an NK1 receptor antagonist (e.g., either oral aprepitant or IV fosaprepitant), a 5-HT3 receptor antagonist (e.g., dolasetron, granisetron, ondansetron, palonosetron), and dexamethasone. ASCO states that fixed-combination netupitant and palonosetron plus dexamethasone is an additional treatment option.

For moderately emetogenic chemotherapy regimens, ASCO recommends a 2-drug antiemetic regimen preferably consisting of palonosetron and dexamethasone. If palonosetron is not available, a first-generation 5-HT3 receptor antagonist (preferably granisetron or ondansetron) may be substituted. Limited evidence suggests that aprepitant may be added to this regimen; in such cases, use of any 5-HT3 receptor antagonist is appropriate.

For chemotherapy regimens with a low emetogenic risk, ASCO recommends administration of a single dose of dexamethasone prior to chemotherapy.

For chemotherapy regimens with minimal emetogenic risk, ASCO states that routine antiemetic administration is not necessary.

Safety and efficacy for chronic use or for treatment of established nausea and vomiting not established.

Prevention of postoperative nausea and vomiting.

Safety and efficacy for chronic use or for treatment of established nausea and vomiting not established.

• Generic Name: l-methylfolate
• Dosage Forms: n.a.
• Other Brand Names: Deplin, L-Methylfolate Formula, XaQuil XR, L-Methylfolate Formula 75

Folate is a form of B vitamin that occurs naturally in many foods. Folic acid is the man-made form of folate that is added to processed foods or vitamin and mineral supplements. Folate is needed in the human body for production of red blood cells.

A lack (deficiency) of folate in the human body can be caused by certain diseases, by taking certain medications, or by not getting enough folate in your diet. Folate deficiency can lead to decreased red blood cells, or anemia. Folate deficiency can also cause high levels of a certain amino acid in the blood, a condition called hyperhomocysteinemia (HYE-per-HOE-moe-sis-tin-EE-mee-a).

XaQuil XR is a medical food for use in people who have conditions related to folate deficiency. This medicine is also used in people with major depressive disorder who have folate deficiency, or in people with schizophrenia who have hyperhomocysteinemia related to folate deficiency.

XaQuil XR is not an antidepressant or anti-psychotic medication. However, this medicine may enhance the effects of antidepressant medications.

XaQuil XR may also be used for purposes not listed in this medication guide.