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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.

What is the most important information I should know about aprepitant?

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

What should I discuss with my health care provider before taking aprepitant?

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 to prevent pregnancy while you are taking aprepitant, and for 1 month after your last dose. Non-hormonal birth control includes barrier forms such as a condom or diaphragm with spermicide.

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, skin sores, skin peeling; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • low blood cell counts--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed;

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

HIGHLY EMETOGENIC CANCER CHEMOTHERAPY:
Day 1: 125 mg orally 1 hour prior to chemotherapy
Day 2 and 3: 80 mg orally in the morning
Duration of therapy: Three days
Comments:
-Aprepitant is administered in conjunction with a corticosteroid and a 5-HT3 antagonist.
-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.
-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.
-Aprepitant may be taken with or without food.

Fosaprepitant dimeglumine for Injection (115 mg) may be substituted for oral aprepitant (125 mg), 30 minutes prior to chemotherapy, on Day 1 only of the CINV regimen as an intravenous infusion administered over 15 minutes.

MODERATELY EMETOGENIC CANCER CHEMOTHERAPY:
Day 1: 125 mg orally 1 hour prior to chemotherapy
Day 2 and 3: 80 mg orally in the morning
Duration of therapy: Three days
Comments:
-Aprepitant is administered in conjunction with a corticosteroid and a 5-HT3 antagonist.
-The recommended dosage of dexamethasone is 12 mg orally on day 1 administered 30 minutes prior to chemotherapy.
-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.
-Aprepitant may be taken with or without food.

Usual Adult Dose for Nausea/Vomiting -- Postoperative:

Recommended dose: a single, oral 40 mg dose administered within 3 hours prior to the induction of anesthesia

What other drugs will affect aprepitant?

Many drugs can interact with aprepitant, and some drugs should not be used together. 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 medicines you use, and those you start or stop using during your treatment with aprepitant. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about aprepitant.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01. Revision Date: 2016-01-29, 7:42:30 PM.

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