aprepitant
Generic Name: aprepitant (a PREP i tant)
Brand Name: Emend, Emend 2-Day, Emend 3-Day
What is aprepitant?
Aprepitant blocks the actions of chemicals in the body that trigger nausea and vomiting.
Aprepitant is used in adults and children to prevent nausea and vomiting caused by cancer chemotherapy. Aprepitant is also used (only in adults) to prevent nausea and vomiting that may be caused by surgery.
Aprepitant is given ahead of time and will not treat nausea or vomiting that you already have.
Aprepitant capsules are for use in adults and children who are at least 12 years old. Aprepitant oral suspension (liquid) can be given to adults and children as young as 6 months old.
Aprepitant may also be used for purposes not listed in this medication guide.
Important Information
You should not take aprepitant if you also take pimozide. A serious drug interaction can occur when pimozide is used together with aprepitant.
Before taking this medicine
You should not use aprepitant if you are allergic to it, or if you take another medicine called pimozide (Orap). Aprepitant can cause unwanted or dangerous effects when used with pimozide.
To make sure aprepitant is safe for you, tell your doctor if you have:
· liver disease.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Aprepitant can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy, and for 1 month after your last dose.
It is not known whether aprepitant passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take aprepitant?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Aprepitant is not for long-term use. For use in chemotherapy, you will most likely need only 3 separate doses. When used before surgery, you will likely receive only 1 dose.
The first dose of aprepitant is usually taken 1 hour before treatment with chemotherapy, or 3 hours before a surgery. Follow your doctor's dosing instructions very carefully.
You may also be given other medicines with aprepitant to further help prevent nausea and vomiting.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Aprepitant can be taken with or without food. If you take aprepitant before surgery, follow your doctor's instructions about any restrictions on food or beverages.
Do not crush, chew, break, or open an aprepitant capsule. Swallow it whole.
Give the oral suspension (liquid) using only the dosing syringe provided.
Do not share this medicine with another person. Aprepitant should not be used to treat general nausea that is unrelated to chemotherapy or surgery.
If you also take warfarin (Coumadin, Jantoven), you may need extra "INR" or prothrombin time tests after you have taken aprepitant.
Store aprepitant capsules at room temperature away from moisture and heat.
Store the prefilled liquid dosing syringe in the refrigerator, do not freeze. After taking the liquid out of the refrigerator, you must use it within 3 hours.
Throw away any liquid medicine not used within 3 days (72 hours) after you received it. Do not save it for later use.
What happens if I miss a dose?
Call your doctor for instructions if you forget to take your medicine within the prescribed length of time before your chemotherapy or surgery.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking aprepitant?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Aprepitant side effects
Get emergency medical help if you have signs of an allergic reaction: hives, rash, itching, skin sores or peeling; warmth or tingly feeling; trouble breathing or swallowing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
· a light-headed feeling, like you might pass out;
· low blood cell counts--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding; or
· dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.
Common side effects may include:
· stomach pain, indigestion, loss of appetite;
· diarrhea, constipation;
· hiccups;
· abnormal liver function tests;
· headache, dizziness;
· cough; or
· feeling weak or tired.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Aprepitant dosing information
Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:
MODERATELY TO HIGHLY EMETOGENIC CANCER CHEMOTHERAPY (HEC/MEC):
Oral Capsules:
-Day 1: 125 mg orally once 1 hour before chemotherapy
-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)
-Duration of therapy: 3 days/cycle
Oral Suspension:
-Day 1: 3 mg/kg orally once 1 hour before chemotherapy
---Maximum dose: 125 mg/dose
-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)
---Maximum dose: 80 mg/dose
-Duration of therapy: 3 days/cycle
Comments:
-The recommended dosage of dexamethasone is 12 mg orally on Day 1 administered 30 minutes prior to chemotherapy and 8 mg orally in the mornings on Days 2 through 4 (HEC) or Days 2 through 3 (MEC).
-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the 5-HT3 antagonist dosing prior to initiation of treatment.
-This drug may be taken with or without food.
Uses:
-In combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of HEC including high-dose cisplatin
-In combination with other antiemetic agents for the prevention of nausea and vomiting associated with initial and repeat courses of MEC
Usual Adult Dose for Nausea/Vomiting -- Postoperative:
40 mg orally once within 3 hours prior to induction of anesthesia
Use: Prevention of nausea and vomiting
Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:
12 years and older:
MEC/HEC:
Oral Capsules:
-Day 1: 125 mg orally once 1 hour before chemotherapy
-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)
-Duration of therapy: 3 days/cycle
Oral Suspension:
-Day 1: 3 mg/kg orally once 1 hour before chemotherapy
---Maximum dose: 125 mg/dose
-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)
---Maximum dose: 80 mg/dose
-Duration of therapy: 3 days/cycle
Comments:
-If a corticosteroid (e.g., dexamethasone) is coadministered, patients should be given 50% of the recommended pediatric dose on Days 1 to 4. Consult the package insert for the corticosteroid dosing prior to initiation of treatment.
-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the 5-HT3 antagonist dosing prior to initiation of treatment.
-This drug may be taken with or without food.
Uses:
-In combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of HEC including high-dose cisplatin
-In combination with other antiemetic agents for the prevention of nausea and vomiting associated with initial and repeat courses of MEC
What other drugs will affect aprepitant?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Many drugs can interact with aprepitant. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.
