NEPA，一種合併固定劑量之抗吐劑用來預防化學治療的噁心和嘔吐

NEPA, a fixed antiemetic combination in the prevention of chemotherapyinduced nausea and vomiting

NEPA乃指合併固定劑量之netupitant 300 mg 和 palonosetron 0.5 mg，可作為預防化學治療所引起之噁心和嘔吐。其機轉乃阻斷 NK1和 5HT3接受器所致嘔吐的作用。口服NEPA，能有效預防化療引起的嘔吐，FDA 和 EMA均已認定其良好效果，並予通過成為臨床試驗的首選藥物。乃在化療第1天口服 NEPA 加上dexamethasone，可有效預防因高、中度致吐藥物所造成的噁心、嘔吐。日後尚待更多的研究，使合併固定劑量能有效應用在其它致吐藥物上。

NEPA is a fixed-dose combination of netupitant 300 mg and palonosetron 0.5 mg designed to target the emesis pathway associated with neurokinin–1 (NK1) receptor and 5–hydroxytryptamin–3 (5HT3) receptor. It was developed as an oral dose to improve the convenience of administering guideline-based antiemetic prophylaxis and recently received FDA (Food and Drug Administration) and EMA (European Medical Agency) approvals. In clinical trials, NEPA administered on day 1 simultaneously with dexamethasone was highly effective and well tolerated in the prevention of chemotherapy-induced emesis in patients with malignant tumors undergoing moderately emetogenic or highly emetogenic chemotherapy. NEPA represents a real step forward in the prophylaxis of chemotherapy-induced nausea and vomiting.