Aprepitant modestly reduces
warfarin levels and slightly decreases the INR in healthy subjects. Fosaprepitant, a prodrug of
aprepitant, would be expected to interact similarly.
The manufacturer recommends that the INR should be monitored closely for 2 weeks, particularly 7 to 10 days after each 3-day course of
aprepitant. They also recommend similar caution with acenocoumarol.