Heron Therapeutics Announces Inclusion of APONVIE® (aprepitant) Injectable Emulsion in the Newly Released Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting (PONV)

Rhea-AI Summary

Heron Therapeutics (Nasdaq: HRTX) announced that APONVIE (aprepitant) injectable emulsion is included in the newly released Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting (PONV) published Dec 4, 2025. The Guidelines identify APONVIE as an NK-1 receptor antagonist option for adult PONV prevention, note its 30-second IV administration and long half-life, and cite evidence that aprepitant alone or in combinations significantly reduces PONV and postoperative vomiting compared with alternatives such as ondansetron. The Guidelines emphasize multimodal prophylaxis for high-risk patients (three or more risk factors) and recommend long-acting antiemetics before discharge to reduce post-discharge nausea and vomiting (PDNV).

Positive

• Guideline inclusion in Fifth Consensus PONV Guidelines (Dec 4, 2025)
• Only FDA-approved IV NK-1 antagonist indicated for adult PONV (as stated)
• 30-second IV dosing and long half-life for faster onset and extended protection
• Evidence of efficacy showing aprepitant reduces PONV and postoperative vomiting versus ondansetron
• Supports PDNV protection by recommending long-acting antiemetics before discharge

Negative

• None.

News Market Reaction – HRTX

+2.36%

3 alerts

+2.36% News Effect

+$5M Valuation Impact

$222M Market Cap

0.2x Rel. Volume

On the day this news was published, HRTX gained 2.36%, reflecting a moderate positive market reaction. Our momentum scanner triggered 3 alerts that day, indicating moderate trading interest and price volatility. This price movement added approximately $5M to the company's valuation, bringing the market cap to $222M at that time.

Data tracked by StockTitan Argus on the day of publication.

Key Figures

PONV incidence: 30% of postoperative patients High-risk PONV incidence: Up to 80% of high-risk patients APONVIE administration time: 30-second IV administration

3 metrics

PONV incidence 30% of postoperative patients General surgical population impacted by PONV

High-risk PONV incidence Up to 80% of high-risk patients High-risk postoperative patients

APONVIE administration time 30-second IV administration NK-1 antagonist option for adult PONV prevention

Market Reality Check

Price: $1.18 Vol: Volume 1,661,287 is about...

normal vol

$1.18 Last Close

Volume Volume 1,661,287 is about 18% below the 20-day average of 2,033,302, suggesting no outsized trading reaction pre-news. normal

Technical Shares at $1.37 are trading below the 200-day MA of $1.72 and remain 48.88% under the 52-week high.

Peers on Argus

HRTX was up 3.01% while momentum scans flagged only TNYA moving down 12.49%. Oth...

1 Down

HRTX was up 3.01% while momentum scans flagged only TNYA moving down 12.49%. Other high-affinity biotech peers showed mixed, generally modest moves, pointing to a stock-specific response rather than a coordinated sector move.

Historical Context

5 past events · Latest: Dec 04 (Positive)

Pattern 5 events

Date	Event	Sentiment	Move	Catalyst
Dec 04	Clinical guideline mention	Positive	+2.4%	APONVIE added to major PONV guidelines with favorable comparative data.
Nov 04	Earnings and outlook	Positive	-3.4%	Q3 2025 revenue growth and guidance reaffirmation alongside commercial updates.
Oct 29	Board appointment	Neutral	-2.6%	Appointment of Thomas Cusack to board under cooperation agreement with Rubric.
Oct 21	Earnings call notice	Neutral	-8.5%	Announcement of date and webcast details for Q3 2025 earnings call.
Aug 15	Tax preservation plan	Positive	-1.5%	Adoption of Section 382 rights plan to protect sizeable NOL tax assets.

Pattern Detected

Over the last five news events, HRTX showed 4 instances where share performance moved opposite to generally positive or neutral news, and only 1 aligned move, indicating a pattern of muted or contrary reactions to ostensibly favorable updates.

Recent Company History

Across recent months, Heron reported growing Q3 2025 net revenue of $38.2 million and reaffirmed full-year guidance, reshaped governance via the appointment of Thomas Cusack under a cooperation agreement with Rubric Capital, and adopted a tax benefits preservation plan to protect $1.37 billion in NOLs. Despite these steps, several announcements triggered negative price reactions. The current inclusion of APONVIE in the PONV Guidelines on Dec 4, 2025 follows this sequence as another clinically oriented, brand-visibility milestone.

Regulatory & Risk Context

Active S-3 Shelf

Shelf Active

Active S-3 Shelf Registration 2025-09-09

The company has an effective Form S-3 shelf registration dated Sep 9, 2025, expiring Sep 9, 2028, with no recorded usage to date. The filing emphasizes risks around commercialization, financing needs, clinical and regulatory progress, and potential corporate control dynamics, highlighting ongoing capital-access and operational considerations for shareholders.

Market Pulse Summary

This announcement highlighted APONVIE’s inclusion in the Fifth Consensus PONV Guidelines, emphasizin...

Analysis

This announcement highlighted APONVIE’s inclusion in the Fifth Consensus PONV Guidelines, emphasizing its role as an IV NK‑1 antagonist with 30-second dosing and long half-life, and evidence that aprepitant meaningfully reduces PONV and vomiting versus alternatives. It reinforces the importance of multimodal prophylaxis and long-acting antiemetics for both PONV and PDNV. In context of Heron’s recent revenue growth and tax-asset protection, investors may watch how guideline visibility translates into APONVIE adoption and overall Acute Care performance.

Key Terms

neurokinin-1 ("nk-1") antagonist, 5-ht3 receptor antagonists, postoperative nausea and vomiting (ponv), antiemetic

4 terms

neurokinin-1 ("nk-1") antagonist medical

"only FDA-approved IV formulation Neurokinin-1 (“NK-1”) antagonist indicated"

A neurokinin-1 (NK-1) antagonist is a drug that blocks the NK-1 receptor, the cellular docking site for a signaling molecule called substance P that can trigger nausea, vomiting, pain and some inflammatory or mood responses; imagine putting a cap on a fire alarm so it no longer rings. It matters to investors because success or failure in clinical trials, safety and regulatory approval determine whether these drugs can capture markets for indications like chemotherapy- or post-operative nausea and other potential uses, directly affecting commercial prospects and company value.

5-ht3 receptor antagonists medical

"more effective compared to 5-HT3 receptor antagonists for postoperative vomiting"

5-HT3 receptor antagonists are a class of medications that block certain brain and nerve signals related to nausea and vomiting. They are often used to prevent side effects from treatments like chemotherapy. For investors, understanding these drugs is important because they are part of the healthcare sector’s ongoing innovations and can influence the financial performance of companies involved in medical research and drug production.

postoperative nausea and vomiting (ponv) medical

"Management of Postoperative Nausea and Vomiting (PONV)"

Postoperative nausea and vomiting (PONV) is the nausea and vomiting some patients experience after surgery and anesthesia. It affects recovery time, patient comfort and hospital resource use—like a car that needs extra attention after a trip—so reducing PONV can shorten hospital stays, cut costs and improve patient satisfaction. Investors watch it because treatments, prevention products and hospital performance tied to PONV influence demand, revenue and reimbursement risk.

antiemetic medical

"long-acting antiemetic strategies highlighted as extending protection"

An antiemetic is a medication that helps prevent or relieve nausea and vomiting. It is commonly used in medical settings to keep patients comfortable during treatments like chemotherapy or surgery. For investors, understanding antiemetics can be relevant because companies that produce these drugs may be affected by healthcare trends, regulatory changes, or advances in medical research.

AI-generated analysis. Not financial advice.

• APONVIE, an aprepitant product, highlighted as the only FDA-approved IV formulation Neurokinin-1 (“NK-1”) antagonist indicated for the prevention of PONV in adults, with a long half-life and quicker onset than oral aprepitant
  
  
• Aprepitant alone, or added to a multimodal regimen, recognized as significantly reducing the risk of PONV, and aprepitant monotherapies are noted as more effective compared to 5-HT3 receptor antagonists for postoperative vomiting prevention
  
  
• Post-discharge nausea and vomiting (PDNV) recognized as a significant risk to discharged postoperative patients and the role of long-acting antiemetic strategies highlighted as extending protection beyond the recovery room and into the home setting

CARY, N.C., Dec. 04, 2025 (GLOBE NEWSWIRE) -- Heron Therapeutics, Inc. (Nasdaq: HRTX) (“Heron” or the “Company”), a commercial-stage biotechnology company, today announced the inclusion of APONVIE^® (aprepitant) injectable emulsion in the newly released Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: Executive Summary and Full Report as published in Anesthesia and Analgesia (collectively, the “PONV Guidelines”).

PONV impacts about 30% of postoperative patients in the general surgical population and up to 80% of high-risk patients¹ and is a major cause of patient dissatisfaction after surgery, with patients ranking vomiting as the most undesirable outcome when asked about postsurgical complications.²

The PONV Guidelines name APONVIE as an NK-1 receptor antagonist option for the prevention of PONV in adults and note APONVIE’s long half-life and 30-second IV administration, which provides for quicker onset than oral formulations and a long-acting profile. The PONV Guidelines also provide evidence that aprepitant alone or in combination therapies significantly reduced the risk of PONV and that aprepitant is comparable or superior to ondansetron for PONV prophylaxis. The PONV Guidelines also cite evidence for aprepitant’s significant impact on postoperative vomiting.

“The release of the PONV Guidelines comes at a defining moment for surgical care. More procedures than ever are being performed in outpatient and short-stay settings, and patients are going home within hours of anesthesia. Preventing PONV is not just a comfort measure, it is critical to ensuring a safe and satisfying recovery for patients,” said Craig Collard, Chief Executive Officer of Heron. “We see substantial opportunity for APONVIE to help reduce avoidable postoperative complications, enhance patient and caregiver confidence at home, and support clinicians in delivering a smooth and reliable postoperative recovery experience.”

The PONV Guidelines continue to recommend and reinforce an algorithmic approach to risk assessment, mitigation, multimodal PONV prophylaxis, and rescue treatment as most adult patients undergoing surgery and anesthesia will have at least one risk factor for PONV. For patients at high risk of PONV (e.g., having three or more PONV risk factors), the PONV Guidelines recommended a multimodal approach to prophylaxis with three or more agents. The PONV Guidelines also discussed risk factors for PDNV and recommended prophylactic, long acting antiemetics before discharge for patients at risk of PDNV.

“Importantly, the PONV Guidelines bring renewed attention to the burden that nausea and vomiting place on patients after they leave the hospital,” said Kevin Warner, PharmD, Senior Vice President, Medical Affairs Strategy and Engagement of Heron. “By helping clinicians identify who remains at risk and encouraging the use of long-acting antiemetic options before discharge, the recommendations within the PONV Guidelines give us another chance to protect patients when they are back at home, where support may be more limited. Consistent awareness of the PONV Guidelines and disciplined adherence to its recommendations are essential if we want to translate this progress into safer recoveries, fewer complications, and better overall experiences for patients and their families.”

About APONVIE® for Prevention of Postoperative Nausea and Vomiting (“PONV”) Prevention

APONVIE is a substance P/neurokinin 1 (NK-1) Receptor Antagonist (RA), indicated for the prevention of postoperative nausea and vomiting (PONV) in adults. Delivered via a 30-second IV push, APONVIE 32 mg was demonstrated to be bioequivalent to oral aprepitant 40 mg with rapid achievement of therapeutic drug levels. APONVIE is the same formulation as Heron's approved drug product CINVANTI. APONVIE is supplied in a single-dose vial that delivers the full 32 mg dose for prevention of PONV. APONVIE was approved by the FDA in September 2022 and became commercially available in the U.S. on March 6, 2023.

Please see full prescribing information at www.APONVIE.com.

About Heron Therapeutics, Inc.

Heron Therapeutics, Inc. is a commercial-stage biotechnology company focused on improving the lives of patients by developing and commercializing therapeutic innovations that improve medical care. Our advanced science, patented technologies, and innovative approach to drug discovery and development have allowed us to create and commercialize a portfolio of products that aim to advance the standard-of-care for acute care and oncology patients. For more information, visit www.herontx.com.

Forward-Looking Statements

This news release contains "forward-looking statements" as defined by the Private Securities Litigation Reform Act of 1995. All statements contained in this news release other than statements of historical facts, including statements regarding our future results of operations and financial position, business and commercialization strategy as well as plans and objectives of management for future operations, are forward-looking statements. Heron cautions readers that forward-looking statements are based on management's expectations and assumptions as of the date of this news release and are subject to certain risks and uncertainties that could cause actual results to differ materially. Therefore, you should not place undue reliance on forward-looking statements. Examples of forward-looking statements include, among others, statements we make regarding the potential market opportunities for APONVIE. Important factors that could cause actual results to differ materially from those in the forward-looking statements are set forth in our most recent Annual Report on Form 10-K and any subsequent Quarterly Reports on Form 10-Q, and in our other reports filed with the Securities and Exchange Commission, including under the caption "Risk Factors." Forward-looking statements reflect our analysis only on their stated date, and Heron takes no obligation to update or revise these statements except as may be required by law.

References:

1. Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411-448. doi:10.1213/ ane.0000000000004833.

2. Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89(3):652-658. doi:10.1097/00000539-199909000-00022.

Investor Relations and Media Contact:

Ira Duarte
Executive Vice President, Chief Financial Officer
Heron Therapeutics, Inc.
iduarte@herontx.com
858-251-4400

FAQ

What does the inclusion of APONVIE in the Dec 4, 2025 PONV Guidelines mean for HRTX shareholders?

Inclusion signals clinical endorsement that may increase APONVIE adoption in PONV protocols and support commercial uptake.

How is APONVIE (HRTX) described in the Fifth Consensus Guidelines for PONV?

The Guidelines name APONVIE as an NK-1 receptor antagonist option, noting its 30-second IV administration and long half-life for extended protection.

Does the PONV guidance recommend APONVIE for post-discharge nausea and vomiting (PDNV) prevention?

The Guidelines recommend using long-acting antiemetics before discharge for patients at risk of PDNV and cite aprepitant as a long-acting option.

What patient groups do the PONV Guidelines say are most in need of multimodal prophylaxis (per the Dec 4, 2025 release)?

Patients at high risk for PONV (e.g., having three or more PONV risk factors) are recommended to receive a multimodal approach with three or more agents.

How does aprepitant compare to ondansetron according to the PONV Guidelines cited by Heron (HRTX)?

The Guidelines report that aprepitant is comparable or superior to ondansetron for PONV prophylaxis and significantly reduces postoperative vomiting.