aprepitant + olanzapine

A combination of aprepitant (a neurokinin-1 receptor antagonist) and olanzapine (an atypical antipsychotic) used for the prevention of chemotherapy-induced nausea and vomiting (CINV), particularly in patients receiving highly or moderately emetogenic chemotherapy regimens. This combination is typically administered with other antiemetics such as palonosetron and dexamethasone as a four-drug regimen for enhanced antiemetic efficacy. Aprepitant blocks substance P binding to NK1 receptors, while olanzapine blocks multiple neurotransmitters, including dopamine, serotonin, catecholamines, histamine, and acetylcholine in the central nervous system. Multiple studies have shown this combination provides superior control of CINV compared to standard regimens without olanzapine. It is generally well-tolerated, with common side effects being sedation and fatigue associated with olanzapine.