Emend

Generic name: Aprepitant (oral/injection)
Drug class: NK1 receptor antagonists

Usage of Emend

Emend is used together with other medications to prevent nausea and vomiting that may be caused by chemotherapy.

Emend is given ahead of time and will not treat nausea or vomiting that you already have.

Emend is also used with other medications in adults and children 6 months of age and older to prevent delayed nausea and vomiting that may occur several days after receiving certain chemotherapy medications.

Emend capsules are for use in adults and children who are at least 12 years old. Emend oral suspension (liquid) can be given to adults and children as young as 6 months old.

Aprepitant belongs to a class of medications called antiemetics. Emend works by blocking the action of neurokinin, a natural substance in the brain that causes nausea and vomiting.

Emend side effects

Get emergency medical help if you have signs of an allergic reaction to Emend: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your medical caregiver if you feel dizzy, nauseated, light-headed, itchy, sweaty, or have a headache, chest tightness, back pain, trouble breathing, or swelling in your face.

Emend may cause serious side effects. Call your doctor at once if you have:

worsening of your skin condition, skin peeling or sores;

a light-headed feeling, like you might pass out; or

fast or slow heart rate.

Common Emend side effects may include:

stomach pain or discomfort, burping, loss of appetite;

low blood pressure, headache, dizziness;

low blood cell counts;

diarrhea, constipation;

hiccups, cough;

abnormal liver function tests;

dehydration;

urinary tract infection;

pain, weakness, or numbness in your arms or legs; 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.

Before taking Emend

You should not use Emend if you are allergic to aprepitant.

Some drugs should not be used with Emend. Your treatment plan may change if you also use pimozide.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

to use a blood thinner (or a medicine called warfarin) and you have routine "INR" or prothrombin time tests; or

severe liver disease.

Aprepitant may harm an unborn baby. Tell your doctor if you are pregnant.

Ask a doctor if it is safe to breastfeed while using this medicine.

Aprepitant can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, spermicide, or contraceptive sponge.

Ask your doctor about the best form of birth control while you are using Emend.

Keep using the barrier form of birth control for 1 month after your last dose of Emend.

Relate drugs

How to use Emend

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/cycleOral 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/cycleParenteral:Single-Dose Regimen (HEC/MEC): 130 mg IV via 2-minute injection OR infused over 30 minutes ONCE, completing administration 30 minutes before chemotherapy3-Day Regimen with Oral Formulations (MEC):-Day 1: 100 mg IV via 2-minute injection OR infused over 30 minutes ONCE, completing administration 30 minutes before chemotherapy-Days 2 to 3: 80 mg orally once a dayComments:-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.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

MEC/HEC:

6 months to less than 12 yearsGREATER THAN 6 kg:Oral Suspension:-Day 1: 3 mg/kg orally once 1 hour before chemotherapy---Maximum dose: 125 mg/day-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/day-Duration of therapy: 3 days/cycle12 years and older: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/cycleOral 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/cycleComments:-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.

Warnings

You should not use Emend if you also use pimozide. A serious drug interaction can occur when pimozide is used together with aprepitant.

If you have liver disease, you may need a dose adjustment or special tests.

Emend can make birth control pills less effective, resulting in pregnancy. This effect can last for up to 28 days after your last dose of this medication. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking aprepitant and for at least 1 month after your treatment ends.

There are many other drugs that can interact with Emend. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

What other drugs will affect Emend

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines 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 here. Tell your doctor about all other medicines you use.

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