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Emend (Intravenous)

Generic Name: fosaprepitant (Intravenous route)

fos-a-PRE-pi-tant dye-MEG-loo-meen

Medically reviewed on Oct 31, 2018

Commonly used brand name(s)

In the U.S.

  • Emend

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Antiemetic

Pharmacologic Class: Fosaprepitant

Uses For Emend

Fosaprepitant injection is used with other medicines to prevent nausea and vomiting caused by cancer treatment (chemotherapy). It acts in the brain to prevent nausea.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using Emend

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 fosaprepitant injection in children younger than 6 months of age. 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 fosaprepitant injection in the elderly. However, elderly patients are more likely to have liver, kidney, or heart problems, which may require caution in patients receiving this medicine.

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 receiving this medicine, 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 this medicine 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.

  • Flibanserin
  • Lomitapide
  • Pimozide

Using this medicine 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.

  • Alfentanil
  • Atazanavir
  • Benzhydrocodone
  • Boceprevir
  • Bosutinib
  • Brexpiprazole
  • Buprenorphine
  • Carbamazepine
  • Ceritinib
  • Cilostazol
  • Clarithromycin
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Colchicine
  • Conivaptan
  • Desogestrel
  • Dienogest
  • Dihydrocodeine
  • Diltiazem
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Drospirenone
  • Duvelisib
  • Eliglustat
  • Enzalutamide
  • Eplerenone
  • Erythromycin
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Fentanyl
  • Fluconazole
  • Fosnetupitant
  • Fosphenytoin
  • Hydrocodone
  • Idelalisib
  • Imatinib
  • Indinavir
  • Itraconazole
  • Ivabradine
  • Ivosidenib
  • Ketoconazole
  • Letermovir
  • Levonorgestrel
  • Lopinavir
  • Lumacaftor
  • Lurasidone
  • Medroxyprogesterone Acetate
  • Meperidine
  • Mestranol
  • Methadone
  • Mitotane
  • Naloxegol
  • Nefazodone
  • Nelfinavir
  • Netupitant
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Olaparib
  • Oxycodone
  • Pentazocine
  • Phenytoin
  • Piperaquine
  • Posaconazole
  • Ranolazine
  • Rifampin
  • Ritonavir
  • Saquinavir
  • Simeprevir
  • Sonidegib
  • St John's Wort
  • Sufentanil
  • Tacrolimus
  • Telaprevir
  • Telithromycin
  • Tolvaptan
  • Tramadol
  • Venetoclax
  • Verapamil
  • Voriconazole

Using this medicine 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.

  • Dexamethasone
  • Methylprednisolone
  • Midazolam
  • Quetiapine
  • Suvorexant
  • Warfarin

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 Emend

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be given slowly, so the needle will have to remain for at least 20 minutes.

This medicine is usually given on the first day of your chemotherapy along with other medicines. Fosaprepitant is not for long-term use, but you may need to use this medicine again if you have more chemotherapy in the future.

This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have concerns.

Precautions While Using Emend

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

You should not receive fosaprepitant if you are also using pimozide (OrapĀ®). Using these medicines together may cause serious unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have itching, hives, a rash, trouble breathing, trouble swallowing, warmth or redness in your face, neck, arms, or upper chest, or any swelling of your hands, face, or mouth while you are receiving this medicine.

This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving this medicine.

If you are also using a blood thinner called warfarin (CoumadinĀ®, JantovenĀ®), your doctor will need to check your blood after receiving this medicine.

Birth control pills may not work as well while you are receiving fosaprepitant. To keep from getting pregnant, use another form of birth control together with your pills during treatment and for 1 month after your last dose. Other forms include condoms, spermicides, a diaphragm, and contraceptive foam or jelly.

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.

Emend 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 or nurse immediately if any of the following side effects occur:

More common

  • Black, tarry stools
  • blurred vision
  • chills
  • confusion
  • cough
  • decreased urination
  • difficult or labored breathing
  • dizziness
  • dry mouth
  • fainting
  • fever
  • increase in heart rate
  • lightheadedness
  • lower back or side pain
  • nervousness
  • pain, swelling, or redness at the injection site
  • painful or difficult urination
  • pale skin
  • pounding in the ears
  • rapid breathing
  • slow or fast heartbeat
  • sore throat
  • sunken eyes
  • tenderness, swelling, warmth, or skin discoloration at the injection site
  • thirst
  • tightness in the chest
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • wrinkled skin

Less common

  • Hard lump at the injection site

Rare

  • Blood in the urine
  • changes in patterns and rhythms of speech
  • changes in skin color
  • chest pain or discomfort
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • general feeling of discomfort or illness
  • headache
  • increased sweating
  • increased thirst
  • lightheadedness, dizziness, or fainting
  • loss of consciousness
  • muscle pain or cramps
  • nausea
  • pain, tenderness, or swelling of the foot or leg
  • seizures
  • slurred speech
  • swelling
  • swelling of the face, ankles, or hands
  • trouble with speaking
  • troubled breathing with exertion
  • vomiting

Incidence not known

  • Diarrhea
  • difficulty with swallowing
  • hives or welts, itching
  • joint pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness of the skin

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

  • Belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • continuing ringing or buzzing or other unexplained noise in ears
  • difficulty having a bowel movement
  • dizziness
  • feeling of indigestion
  • hair loss or thinning of the hair
  • hearing loss
  • hiccups
  • indigestion
  • lack or loss of strength
  • loss of appetite
  • pain in the chest below the breastbone
  • stomach discomfort, upset, or pain
  • swelling or inflammation of the mouth
  • weight loss

Less common

  • Feeling of warmth
  • pain or discomfort in chest, upper stomach, or throat
  • redness of the face, neck, arms, and occasionally, upper chest
  • sudden sweating
  • unusually warm skin

Rare

  • Abnormal dreams
  • blemishes on the skin
  • bumps on the skin
  • burning, dry, or itching eyes
  • change in taste
  • change in walking and balance
  • clumsiness or unsteadiness
  • confusion about identity, place, and time
  • difficulty with moving
  • discharge, excessive tearing
  • excess air or gas in the stomach
  • extreme thirst
  • false or unusual sense of well-being
  • flushed, dry skin
  • frequent urination
  • fruit-like breath odor
  • full feeling
  • heartburn
  • increased hunger
  • increased sensitivity of the skin to sunlight
  • increased urination
  • increased volume of pale, dilute urine
  • muscle ache, cramp, stiffness, or weakness
  • oily skin
  • passing gas
  • pimples
  • redness or other discoloration of the skin
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • severe constipation
  • severe sunburn
  • sleepiness
  • stomach distension
  • sweating
  • swollen joints
  • trouble performing routine tasks
  • trouble sleeping
  • unexplained weight loss
  • unusual drowsiness, dullness, or feeling of sluggishness
  • weight gain
  • white patches with diaper rash

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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