aprepitant vs rolapitant
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of aprepitant and rolapitant. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Emend
Varubi
Aprepitant (Emend) is a medicine that helps prevent nausea and vomiting. It belongs to a class of drugs called NK1 receptor antagonists.
Varubi is a medicine that helps prevent nausea and vomiting caused by chemotherapy. It is used with other anti-nausea medicines.
Aprepitant is used to prevent nausea and vomiting caused by chemotherapy. It can be used for both strong and moderate chemotherapy treatments. It is also used to prevent nausea and vomiting after surgery in adults.
Varubi is used to prevent delayed nausea and vomiting in adults. This nausea and vomiting is caused by cancer chemotherapy. It is used for both the first and repeat treatments of chemotherapy.
Aprepitant blocks a substance in your body called substance P. Substance P can trigger nausea and vomiting. By blocking it, aprepitant helps reduce these side effects.
Varubi blocks a substance in your body called substance P/neurokinin 1 (NK1). This substance can cause nausea and vomiting. By blocking it, Varubi helps prevent these side effects from chemotherapy.
- • Tiredness
- • Diarrhea
- • Weakness
- • Upset stomach
- • Stomach pain
- • Neutropenia (low white blood cell count)
- • Hiccups
- • Abdominal pain
- • Decreased appetite
- • Dizziness
- Nausea 2,145
- Fatigue 1,769
- Pyrexia 1,589
- Diarrhoea 1,542
- Dyspnoea 1,508
- Death 141
- Nausea 79
- Fatigue 50
- Infusion Related Reaction 40
- Dyspnoea 34
Aprepitant can interact with other medicines. It can affect how well warfarin (a blood thinner) and hormonal birth control work. If you take warfarin, your doctor will check your blood. If you use hormonal birth control, use a backup method while taking aprepitant and for 28 days after your last dose.
You should not take Varubi if you are taking thioridazine or pimozide. These drugs can cause serious heart problems if taken with Varubi. Varubi can increase the levels of these drugs in your blood, leading to QT prolongation and Torsades de Pointes, which are dangerous heart rhythm problems.
There is not enough information about the safety of aprepitant during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if aprepitant passes into breast milk, so discuss breastfeeding with your doctor.
There is not enough information about Varubi use in pregnant women to know if it is safe. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Varubi passes into breast milk. Talk to your doctor if you are breastfeeding.
How to Read This aprepitant vs rolapitant Comparison
aprepitant is classified in the NK1 Receptor Antagonist (Antiemetic) drug class, while rolapitant sits within the NK1 Receptor Antagonist (Antiemetic) class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, aprepitant has 8,553 submissions while rolapitant has 344. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for aprepitant or rolapitant.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.