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ATC Group: A04AD Other antiemetics

Anatomical Therapeutic Chemical Classification System

Hierarchical Position

Level
Code
Title
1
A
Alimentary tract and metabolism
2
A04
Antiemetics and antinauseants
3
A04A
Antiemetics and antinauseants
4
A04AD
Other antiemetics

Contents

Code
Title
A04AD01
Scopolamine
A04AD02
Cerium oxalate
A04AD04
Chlorobutanol
A04AD05
Metopimazine
A04AD10
Dronabinol
A04AD11
Nabilone
A04AD12
Fosaprepitant
A04AD14
Rolapitant
A04AD51
Scopolamine, combinations
A04AD54
Chlorobutanol, combinations

Active Ingredients

Chemical substance
Description
Aprepitant

Aprepitant is a selective high-affinity antagonist at human substance P neurokinin 1 (NK1) receptors.

Chlorobutanol
Dimenhydrinate

Dimenhydrinate is a theoclate salt of the ethanolamine derivative diphenhydramine. It exhibits reversible competitive antagonism with histamine for the capture of H1 receptors. It has anticholinergic (antimuscarinic) properties that explain the anti-emetic action of the drug in cases of labyrinthial irritation (nausea, vertigo), and the central suppression it causes.

Dronabinol

Dronabinol is an active ingredient of cannabis, which has complex effects on the CNS, including central sympathomimetic activity. Dronabinol exerts its action by activating CB1 and CB2 recepors which makes it a CNS active medicine.

Fosaprepitant

Fosaprepitant is the prodrug of aprepitant and when administered intravenously is converted rapidly to aprepitant. The contribution of fosaprepitant to the overall antiemetic effect has not fully been characterised, but a transient contribution during the initial phase cannot be ruled out.

Metopimazine
Nabilone

Nabilone is a synthetic cannabinoid and dibenzopyrane derivative, an analog of dronabinol (also known as tetrahydrocannabinol or THC), the psychoactive ingredient in cannabis with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. It has been suggested that nabilone is a highly selective and strong agonist for the cannabinoid receptors CB1 and CB2, both of which are coupled to Gi/o proteins. The CB1 receptors are expressed predominantly in central and peripheral neurons and receptor stimulation has been implicated in the reduction of chemotherapy-induced nausea.

Rolapitant

Rolapitant is a selective antagonist of human substance P/neurokinin 1 (NK1) receptors.

Scopolamine

Scopolamine is a naturally occurring belladonna alkaloid and has anticholinergic properties. It acts as a competitive antagonist to acetylchloline and other parasympathomimetic agents. Its mechanism of action in the central nervous system in preventing motion sickness has yet to be elucidated. Scopolamine produces classical symptoms of parasympathetic blockade.

Monographs

Monograph
Type
Country
CESAMET Capsule
MPI, US: SPL/Old
US
EMEND Hard capsule
MPI, EU: SmPC
IVEMEND Powder for solution for infusion
MPI, EU: SmPC
SCOPODERM Transdermal patch
MPI, EU: SmPC
UK