Full Prescribing Information Important Safety Information

CINVANTI demonstrated fewer adverse events within 30 minutes of infusion vs fosaprepitant in healthy subjects

The bioequivalence studies were conducted in healthy subjects who were not being treated with chemotherapy. This allowed for an assessment of the adverse events likely caused by each NK1 RA without interference of the chemotherapy*1


Incidence of any treatment-emergent adverse events within 30 minutes of infusion*1
In 2 pivotal, open-label, randomized, crossover bioequivalence studies, subjects received 130 mg of CINVANTI and 150 mg of fosaprepitant for injection
* In 2 pivotal, open-label, randomized, crossover bioequivalence studies, subjects received 130 mg of CINVANTI and 150 mg of fosaprepitant for injection. Infusion time was 30 minutes for CINVANTI and either 20 or 30 minutes for fosaprepitant for injection. Systemic exposure was equivalent for CINVANTI and fosaprepitant.2

Fewer infusion site reactions and systemic adverse events vs fosaprepitant2

Adverse events in ≥2% of subjects within 30 minutes of infusion†2
Adverse Event Fosaprepitant 150 mg IV infusion (n=200) CINVANTI 130 mg IV infusion (n=196)
Infusion site pain 7% 0%
Dyspnea‡ 3% 0.5%
Nausea 2% 0.5%
† In 2 pivotal, open-label, randomized, crossover bioequivalence studies, subjects received 130 mg of CINVANTI and 150 mg of fosaprepitant for injection. Infusion time was 30 minutes for CINVANTI and either 20 or 30 minutes for fosaprepitant for injection. Systemic exposure was equivalent for CINVANTI and IV fosaprepitant.2
‡ Dyspnea led to study discontinuation in 2 subjects in the fosaprepitant arm and 1 subject in the CINVANTI arm.2

IV=intravenous; NK1 RA=neurokinin-1 receptor antagonist.

Why Synthetic-Surfactant Free?

Find out now
The Need for IV Push

Learn more
Advanced NK1 RA Formulation

See the CINVANTI difference

Indication

CINVANTI is a substance P/neurokinin-1 (NK1) receptor antagonist, indicated in adults, in combination with other antiemetic agents, 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; delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy (MEC) as a single-dose regimen; and nausea and vomiting associated with initial and repeat courses of MEC as a 3-day regimen.

Limitations of Use: CINVANTI has not been studied for treatment of established nausea and vomiting.

Important Safety Information

Contraindications

CINVANTI is contraindicated in patients with hypersensitivity to any of the components of CINVANTI.

Concurrent use of pimozide with CINVANTI is contraindicated.

Warnings and Precautions

Clinically Significant CYP3A4 Drug Interactions

Aprepitant is a substrate, weak-to-moderate (dose-dependent) inhibitor, and an inducer of CYP3A4.

  • Use of CINVANTI with other drugs that are CYP3A4 substrates may result in increased plasma concentration of the concomitant drug.
    • Use of pimozide with CINVANTI is contraindicated due to the risk of significantly increased plasma concentrations of pimozide, potentially resulting in prolongation of the QT interval, a known adverse reaction of pimozide.
  • Use of CINVANTI with strong or moderate CYP3A4 inhibitors (e.g., ketoconazole, diltiazem) may increase plasma concentrations of aprepitant and result in an increased risk of adverse reactions related to CINVANTI.
  • Use of CINVANTI with strong CYP3A4 inducers (e.g., rifampin) may result in a reduction in aprepitant plasma concentrations and decreased efficacy of CINVANTI.

Hypersensitivity Reactions

Serious hypersensitivity reactions, including anaphylaxis, during or soon after administration of CINVANTI have occurred. Symptoms including dyspnea, eye swelling, flushing, pruritus, and wheezing have been reported. If hypersensitivity reactions occur, discontinue CINVANTI. Do not reinitiate CINVANTI in patients who experience these symptoms with previous use.

Decrease in INR with Concomitant Warfarin

Co-administration of CINVANTI 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 10 days, following initiation of CINVANTI with each chemotherapy cycle.

Risk of Reduced Efficacy of Hormonal Contraceptives

The efficacy of hormonal contraceptives may be reduced during administration of and for 28 days following the last dose of CINVANTI. Advise patients to use effective alternative or back-up methods of non-hormonal contraception during treatment with CINVANTI and for 1 month following administration of CINVANTI or oral aprepitant, whichever is administered last.

Use in Specific Populations

Avoid use of CINVANTI in pregnant women as alcohol is an inactive ingredient for CINVANTI. There is no safe level of alcohol exposure in pregnancy.

Adverse Reactions

The most common adverse reactions are:

  • Single-dose fosaprepitant with MEC (≥2%): fatigue, diarrhea, neutropenia, asthenia, anemia, peripheral neuropathy, leukopenia, dyspepsia, urinary tract infection, pain in extremity.
  • 3-day oral aprepitant with MEC (≥1% and greater than standard therapy): fatigue and eructation.
  • Single-dose fosaprepitant with HEC: generally similar to 3-day oral aprepitant. In addition, infusion site reactions (3%) occurred.
  • Single-dose CINVANTI (≥2%): headache and fatigue. The safety profile of CINVANTI in healthy subjects who received a single 2-minute injection was similar to that seen with a 30-minute infusion.

Report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. Report side effects to Heron at 1-844-437-6611.

For more information about CINVANTI, please see full Prescribing Information.

References:
  1. Ottoboni T, Lauw M, Keller MR, et al. Safety of HTX-019 (intravenous aprepitant) and fosaprepitant in healthy subjects. Future Oncol. 2018;14(27):2849-2859.
  2. Data on file [Clinical Summary]. Heron Therapeutics, Inc., San Diego, CA.