The Scottish Medicines Consortium (SMC) has advised NHS Boards and Area Drug and Therapeutic Committees that fosaprepitant (Ivemend®) is accepted for restricted use within NHS Scotland for the prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer chemotherapy.

Fosaprepitant is marginally more expensive than aprepitant. It is restricted to use in patients for whom aprepitant is indicated but the oral formulation is not appropriate. Prescribing should be initiated by hospital based specialists only.

Fosaprepitant is also licensed for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy. As the manufacturer’s submission related only to its use with highly emetogenic cancer chemotherapy, the SMC cannot recommend its use in this setting.