aprepitant (Oral route)

ap-RE-pi-tant

Commonly used brand name(s)

In the U.S.

  • Emend

Available Dosage Forms:

  • Capsule

Therapeutic Class: Antiemetic

Pharmacologic Class: Neurokinin-1 Receptor Antagonist

Uses For aprepitant

Aprepitant is used with other medicines to prevent the nausea and vomiting that may occur during cancer treatment (chemotherapy). It is also used to prevent nausea and vomiting that may occur after surgery. Aprepitant works in the nervous system to block the action of a chemical that causes vomiting.

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aprepitant is available only with your doctor's prescription.

Before Using aprepitant

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For aprepitant, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to aprepitant or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of aprepitant in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of aprepitant in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking aprepitant, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using aprepitant with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Astemizole
  • Cisapride
  • Lomitapide
  • Pimozide
  • Terfenadine

Using aprepitant with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ado-Trastuzumab Emtansine
  • Amiodarone
  • Bosutinib
  • Brentuximab Vedotin
  • Cabozantinib
  • Carbamazepine
  • Ceritinib
  • Clarithromycin
  • Clozapine
  • Cobicistat
  • Colchicine
  • Crizotinib
  • Dabrafenib
  • Dasatinib
  • Diltiazem
  • Docetaxel
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Elvitegravir
  • Eslicarbazepine Acetate
  • Etoposide
  • Everolimus
  • Fentanyl
  • Hydrocodone
  • Ibrutinib
  • Ifosfamide
  • Imatinib
  • Irinotecan
  • Itraconazole
  • Ketoconazole
  • Lurasidone
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Nilotinib
  • Oxycodone
  • Paclitaxel
  • Pazopanib
  • Piperaquine
  • Ponatinib
  • Primidone
  • Ranolazine
  • Regorafenib
  • Ritonavir
  • Romidepsin
  • Siltuximab
  • Simeprevir
  • Sorafenib
  • Sunitinib
  • Tamoxifen
  • Temsirolimus
  • Tolvaptan
  • Troleandomycin
  • Vandetanib
  • Vemurafenib
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinorelbine
  • Warfarin

Using aprepitant with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alprazolam
  • Desogestrel
  • Dexamethasone
  • Dienogest
  • Drospirenone
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Fosphenytoin
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Mestranol
  • Methylprednisolone
  • Midazolam
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Paroxetine
  • Phenytoin
  • Quetiapine
  • Rifampin
  • Sirolimus
  • Tolbutamide
  • Triazolam

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of aprepitant

Take aprepitant only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Aprepitant is given together with other medicines to prevent vomiting from chemotherapy. Carefully follow your doctor's instructions about how to take the medicines.

aprepitant comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

You may take aprepitant with or without food.

Do not start taking aprepitant if you already have nausea and vomiting. Contact your doctor about what to do.

Dosing

The dose of aprepitant will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of aprepitant. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For nausea and vomiting caused by chemotherapy:
      • Adults—125 milligrams (mg) one hour before chemotherapy treatment (Day 1). Then, 80 mg once in the morning on Days 2 and 3.
      • Children—Use and dose must be determined by your doctor.
    • For nausea and vomiting after surgery:
      • Adults—40 milligrams (mg) within 3 hours before surgery.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of aprepitant, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using aprepitant

It is very important that your doctor check your progress while you are using aprepitant to make sure it is working properly and to check for unwanted effects.

aprepitant may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have itching; hives; rash; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth while you are using aprepitant.

Oral contraceptives (birth control pills) may not work as well while you are using aprepitant. To keep from getting pregnant, use another form of birth control together with your pills while you are using the medicine and for 1 month after your last dose. Other forms of birth control include condoms, diaphragms, or contraceptive foams or jellies.

If your symptoms do not improve or if they become worse, check with your doctor.

You should not use aprepitant if you are also using astemizole (e.g., Hismanal®), cisapride (e.g., Propulsid®), pimozide (e.g., Orap®), or terfenadine (e.g., Seldane®). If you are taking any of these medicines, talk to your doctor before you start aprepitant.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

aprepitant Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Black or tarry stools
  • chills
  • cough
  • fever
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • shortness of breath
  • sore throat
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Incidence not known
  • Blistering, peeling, or loosening of the skin
  • confusion about identity, place, and time
  • diarrhea
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • redness of the skin
  • red, irritated eyes
  • red skin lesions, often with a purple center
  • skin rash
  • slow or irregular heartbeat

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Acid or sour stomach
  • belching
  • confusion
  • decreased urination
  • dizziness
  • dry mouth
  • fainting
  • heartburn
  • hiccups
  • increase in heart rate
  • indigestion
  • lack or loss of strength
  • lightheadedness
  • loss of appetite
  • nausea
  • rapid breathing
  • stomach discomfort upset or pain
  • sunken eyes
  • swelling or inflammation of the mouth
  • thirst
  • weight loss
  • wrinkled skin
Less common
  • Burning feeling in the chest or stomach
  • hot flashes
  • indigestion
  • pain or discomfort in the chest, upper stomach, or throat
  • tenderness in the stomach area

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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