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Aprepitant side effects: what 18,353 FDA adverse event reports show

Aprepitant · Cinvanti · 1,102 reaction terms · 134,392 drug–reaction co-reports · data 2026-09-14
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Drug class

Substance P/Neurokinin-1 Receptor Antagonist

FDA label (Established Pharmacologic Class)

Brand names

Cinvanti

openFDA label

Who reports

18,353 reports · 89% serious · 3,080 with death outcome · 63% female

openFDA FAERS counts, all years, deduplication not applied

Used for

CINVANTI, in combination with other antiemetic agents, is indicated in adults for the prevention of: acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (HEC) including high-dose cisplatin as a single-dose regimen.

FDA label, Indications and Usage

What it is

CINVANTI injectable emulsion contains the active ingredient, aprepitant. Aprepitant is a substance P/neurokinin 1 (NK 1 ) receptor antagonist, an antiemetic agent, chemically described as 5-[[.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Lab value / disease marker 9Not in label — unassessed 29
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,062 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Computerised tomogram thorax392,091.9
1,230.9–3,555.1ROR 2,096.4 · χ² 27,800 / p <1e-300
538.2 EB05 410.8 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=39 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Grip strength1211,262.0
974.0–1,635.2ROR 1,270.4 · χ² 71,310 / p <1e-300
544.2 EB05 467.5 · IC025 +7.1
3/3 methods agree
Not in label — unassessedserious n=121 · ♀ 100% (drug 63%) · 97% cliniciannot reported in cached trials
Testicular germ cell cancer metastatic131,046.0
491.7–2,224.9ROR 1,046.7 · χ² 6,505 / p <1e-300
301.8 EB05 187.7 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Swollen joint count93698.4
539.4–904.2ROR 701.9 · χ² 39,548 / p <1e-300
396.2 EB05 333.1 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=93 · ♀ 100% (drug 63%) · 97% cliniciannot reported in cached trials
Lupus vulgaris267331.2
289.2–379.4ROR 336.1 · χ² 67,678 / p <1e-300
251.6 EB05 227.3 · IC025 +7.2
3/3 methods agree
Not in label — unassessedserious n=267 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody126266.3
219.4–323.2ROR 268.1 · χ² 26,720 / p <1e-300
208.8 EB05 179.9 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=126 · ♀ 100% (drug 63%) · 98% cliniciannot reported in cached trials
Procalcitonin decreased12237.1
127.3–441.9ROR 237.3 · χ² 2,140 / p <1e-300
149.9 EB05 91.4 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
C-reactive protein147221.1
185.4–263.7ROR 222.9 · χ² 26,738 / p <1e-300
180.7 EB05 157.4 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=147 · ♀ 100% (drug 63%) · 98% cliniciannot reported in cached trials
Acquired porphyria11210.0
110.3–399.7ROR 210.1 · χ² 1,756 / p <1e-300
136.0 EB05 81.0 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Porphyria acute212207.5
179.3–240.0ROR 209.9 · χ² 36,614 / p <1e-300
172.7 EB05 154.0 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=212 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Deep vein thrombosis postoperative296203.3
179.8–229.9ROR 206.6 · χ² 50,311 / p <1e-300
170.5 EB05 154.8 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=296 · ♀ 100% (drug 63%) · 93% cliniciannot reported in cached trials
X-ray abnormal269203.0
178.4–230.9ROR 206.0 · χ² 45,637 / p <1e-300
170.1 EB05 153.7 · IC025 +6.8
3/3 methods agree
Lab value / disease markerserious n=269 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Facet joint syndrome432181.6
164.2–200.8ROR 185.9 · χ² 66,663 / p <1e-300
155.4 EB05 143.5 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=432 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Pulmonary septal thickening12175.5
95.6–322.5ROR 175.7 · χ² 1,654 / p <1e-300
122.8 EB05 74.9 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Retinitis221174.4
151.5–200.9ROR 176.6 · χ² 32,854 / p <1e-300
149.3 EB05 133.5 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=221 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Adjustment disorder with depressed mood254164.8
144.6–187.9ROR 167.1 · χ² 35,937 / p <1e-300
142.4 EB05 128.3 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=254 · ♀ 100% (drug 63%) · 93% cliniciannot reported in cached trials
Dislocation of vertebra265154.6
136.1–175.6ROR 156.8 · χ² 35,426 / p <1e-300
134.7 EB05 121.7 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=265 · ♀ 100% (drug 63%) · 91% cliniciannot reported in cached trials
Duodenal ulcer perforation836146.9
136.9–157.7ROR 153.9 · χ² 107,081 / p <1e-300
129.7 EB05 122.5 · IC025 +6.8
3/3 methods agree
Not in label — unassessedserious PRR 84.2 · ♀ 100% (drug 63%) · 93% clinicianNCT00619359: 1/1,143 (0.1%) on Aprepitant (serious AE)
Sleep disorder due to general medical condition, insomnia type708141.2
130.8–152.5ROR 146.9 · χ² 87,497 / p <1e-300
125.2 EB05 117.6 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=708 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Swollen joint count increased343141.2
126.3–157.8ROR 143.9 · χ² 42,315 / p <1e-300
124.7 EB05 114.0 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=343 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody positive718128.4
119.1–138.6ROR 133.6 · χ² 81,408 / p <1e-300
115.0 EB05 108.2 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious PRR 75.0 · ♀ 100% (drug 63%) · 93% cliniciannot reported in cached trials
Computerised tomogram thorax abnormal66119.5
92.8–154.0ROR 120.0 · χ² 6,906 / p <1e-300
104.9 EB05 85.4 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=66 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Rheumatic fever410118.4
107.0–130.9ROR 121.0 · χ² 43,077 / p <1e-300
106.7 EB05 98.3 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious n=410 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Muscle injury769118.1
109.8–127.1ROR 123.3 · χ² 80,767 / p <1e-300
106.7 EB05 100.6 · IC025 +6.5
3/3 methods agree
Not in label — unassessedserious PRR 75.1 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Nail bed inflammation29114.6
78.2–167.9ROR 114.8 · χ² 2,862 / p <1e-300
97.6 EB05 71.3 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=28 · ♀ 100% (drug 63%)not reported in cached trials
Helicobacter infection860105.3
98.3–112.7ROR 110.4 · χ² 81,175 / p <1e-300
96.2 EB05 90.9 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 66.0 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Folliculitis870105.1
98.2–112.5ROR 110.3 · χ² 81,989 / p <1e-300
96.0 EB05 90.8 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 73.3 · ♀ 99% (drug 63%) · 94% cliniciannot reported in cached trials
Rheumatoid factor positive43593.2
84.6–102.6ROR 95.4 · χ² 36,553 / p <1e-300
85.8 EB05 79.2 · IC025 +6.1
3/3 methods agree
Lab value / disease markerserious n=435 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Tonsillar haemorrhage1191.8
49.7–169.7ROR 91.8 · χ² 831 / p 4e-183
74.4 EB05 44.3 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Intestinal strangulation1290.7
50.4–163.3ROR 90.8 · χ² 904 / p 6e-199
74.5 EB05 45.4 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Bone erosion25086.7
76.3–98.6ROR 87.9 · χ² 19,594 / p <1e-300
80.1 EB05 72.1 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=250 · ♀ 100% (drug 63%) · 98% cliniciannot reported in cached trials
C-reactive protein abnormal43182.4
74.8–90.8ROR 84.3 · χ² 32,223 / p <1e-300
76.6 EB05 70.7 · IC025 +6.0
3/3 methods agree
Lab value / disease markerserious n=431 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Eosinophil percentage decreased1381.8
46.6–143.6ROR 81.9 · χ² 893 / p 1e-196
68.9 EB05 42.9 · IC025 +3.4
3/3 methods agree
Lab value / disease markerserious n=13not reported in cached trials
Hand deformity87381.7
76.4–87.3ROR 85.7 · χ² 64,829 / p <1e-300
76.1 EB05 72.0 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious PRR 53.7 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Intestinal scarring1279.5
44.3–142.8ROR 79.6 · χ² 797 / p 1e-175
66.8 EB05 40.7 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Chemotherapeutic drug level increased1070.4
37.2–133.3ROR 70.4 · χ² 580 / p 2e-128
59.2 EB05 34.4 · IC025 +2.9
3/3 methods agree
Lab value / disease markerserious n=10not reported in cached trials
Subcutaneous drug absorption impaired3168.9
47.9–99.0ROR 69.0 · χ² 1,891 / p <1e-300
62.6 EB05 46.2 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=31 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Pemphigus70168.3
63.3–73.6ROR 70.9 · χ² 43,762 / p <1e-300
64.3 EB05 60.4 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious PRR 41.9 · ♀ 100% (drug 63%) · 93% cliniciannot reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Aprepitant as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (1 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Nausea2,2453.3
3.1–3.4ROR 3.6 · χ² 3,637 / p <1e-300
3.2 EB05 3.1 · IC025 +1.6
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 3.5NCT00619359: 3/1,169 (0.3%) on Aprepitant (serious AE)
Fatigue (tiredness)1,9432.9
2.7–3.0ROR 3.1 · χ² 2,437 / p <1e-300
2.9 EB05 2.8 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.3NCT00619359: 1/1,169 (0.1%) on Aprepitant (serious AE)
Pyrexia (fever)1,6535.5
5.2–5.7ROR 5.9 · χ² 6,116 / p <1e-300
5.4 EB05 5.2 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious PRR 4.4 · 92% clinicianNCT00619359: 2/1,169 (0.2%) on Aprepitant (serious AE)
Diarrhoea (diarrhea)1,6032.9
2.7–3.0ROR 3.0 · χ² 1,982 / p <1e-300
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.1NCT00619359: 8/1,169 (0.7%) on Aprepitant (serious AE)
Dyspnoea (shortness of breath)1,5833.2
3.1–3.4ROR 3.4 · χ² 2,457 / p <1e-300
3.2 EB05 3.1 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.7 · ♀ 84% (drug 63%)NCT00619359: 5/1,169 (0.4%) on Aprepitant (serious AE)
Vomiting1,5423.8
3.6–4.0ROR 4.0 · χ² 3,192 / p <1e-300
3.8 EB05 3.6 · IC025 +1.8
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 3.3NCT00619359: 7/1,169 (0.6%) on Aprepitant (serious AE)
Off label use (used outside approved label)1,4231.9
1.8–2.0ROR 1.9 · χ² 604 / p 1e-133
1.9 EB05 1.8 · IC025 +0.8Reporting / coding artifactserious PRR 2.2not reported in cached trials
Alopecia (hair loss)1,3277.8
7.4–8.2ROR 8.3 · χ² 7,816 / p <1e-300
7.7 EB05 7.3 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious PRR 9.7 · ♀ 95% (drug 63%)NCT00619359: 16/1,169 (1.4%) on Aprepitant
Rash1,2693.4
3.2–3.5ROR 3.5 · χ² 2,128 / p <1e-300
3.3 EB05 3.2 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.6 · ♀ 86% (drug 63%)not reported in cached trials
Hypersensitivity (allergic reaction)1,1827.3
6.9–7.7ROR 7.8 · χ² 6,466 / p <1e-300
7.3 EB05 6.9 · IC025 +2.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 8.7 · ♀ 85% (drug 63%) · 93% cliniciannot reported in cached trials
Decreased appetite (loss of appetite)1,0965.4
5.1–5.7ROR 5.7 · χ² 3,979 / p <1e-300
5.4 EB05 5.1 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious PRR 5.0not reported in cached trials
Pruritus (itching)1,0763.3
3.1–3.5ROR 3.4 · χ² 1,709 / p <1e-300
3.2 EB05 3.1 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 5.0 · ♀ 90% (drug 63%) · 92% cliniciannot reported in cached trials
Febrile neutropenia1,07618.9
17.8–20.0ROR 20.0 · χ² 17,934 / p <1e-300
18.6 EB05 17.6 · IC025 +4.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 12.1 · 93% clinicianNCT00619359: 27/1,169 (2.3%) on Aprepitant (serious AE)
Infusion related reaction (reaction during infusion)1,04018.3
17.2–19.4ROR 19.3 · χ² 16,735 / p <1e-300
18.0 EB05 17.1 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious PRR 14.2 · ♀ 91% (drug 63%) · 94% cliniciannot reported in cached trials
Stomatitis (mouth sores)1,03519.8
18.7–21.0ROR 20.9 · χ² 18,206 / p <1e-300
19.5 EB05 18.5 · IC025 +4.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 18.7 · ♀ 86% (drug 63%) · 92% clinicianNCT00619359: 1/1,169 (0.1%) on Aprepitant (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Aprepitant?

In FDA FAERS, the most frequently co-reported reaction terms for Aprepitant are nausea, fatigue, pyrexia, diarrhoea, dyspnoea, vomiting. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Aprepitant have an FDA boxed warning?

No. The FDA label retrieved for Aprepitant has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Aprepitant causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.