Broadening Antiemetics Research by Comparing the Effectiveness of Fosaprepitant and Metoclopramide
Starting soon · Phase 4
Conditions studied: Nausea and Vomiting, Nausea, Vomiting
In brief
The study team proposes a double-blind, comparative effectiveness, randomized controlled trial (RCT) to address the following goal: to determine the relative efficacy and adverse event profile of fosaprepitant compared to the standard of care antiemetic metoclopramide. Fosaprepitant and its active metabolite aprepitant are a relatively new class of antiemetic that exclusively acts in the central nervous system by blocking neurokinin (NK-1) which is a key signaling molecule in the centrally mediated aspects of the vomiting reflex. Currently, fosaprepitant and aprepitant both have only two United Stated Food and Drug Administration (USFDA) approved indications for nausea and vomiting: chemotherapy-induced and postoperative. Neurokinin inhibitors are highly effective and generally well-tolerated. Therefore, this class of medication may be a more appropriate medication for the millions of patients with nausea and vomiting that seek care in emergency departments (EDs). Intravenous fosaprepitant is converted to the active metabolite aprepitant on the order of minutes and is significantly cheaper to procure at this time.
Key facts
- Study ID
- NCT06740812
- Run by
- Montefiore Medical Center
- People needed
- 212
- Starts
- 2026-12-01
- Expected to finish
- 2027-09-01
- Last updated by the study team
- 2026-06-29
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Adults at least 18 years old
- Present to ED for treatment of Nausea and/or vomiting as defined by the International Classification of Diseases (ICD-10) or identified by treating clinician
You may not qualify if…
- Pregnancy, desiring pregnancy, or lactating
- Antiemetic use or intravenous fluids prior to presenting to ED for evaluation and management
- Bradycardia (< 60 bpm heart rate)
- Prolonged QTc (greater than 490ms)
- Not conversant in English or Spanish
- Altered mental status
- Dementia
- Lack of phone for follow-up communication
Where it is running
- Montefiore Medical Center — The Bronx, New York, United States
Full record on ClinicalTrials.gov
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