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fosaprepitant (Intravenous route)

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

Commonly used brand name(s)

In the U.S.

  • Emend

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Antiemetic

Pharmacologic Class: Fosaprepitant

Uses For fosaprepitant

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.

fosaprepitant is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, fosaprepitant is used in certain patients with the following medical conditions:

  • Prevention of nausea and vomiting during chemoradiotherapy.

Before Using fosaprepitant

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 fosaprepitant, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to fosaprepitant 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 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 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 fosaprepitant.

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 fosaprepitant, 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 fosaprepitant 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 fosaprepitant 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.

  • Atazanavir
  • Boceprevir
  • Bosutinib
  • Brexpiprazole
  • Carbamazepine
  • Ceritinib
  • Cilostazol
  • Clarithromycin
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Colchicine
  • Conivaptan
  • Dasatinib
  • Diltiazem
  • Docetaxel
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Enzalutamide
  • Eplerenone
  • Erythromycin
  • Fentanyl
  • Fluconazole
  • Fosphenytoin
  • Hydrocodone
  • Ibrutinib
  • Idelalisib
  • Ifosfamide
  • Imatinib
  • Indinavir
  • Itraconazole
  • Ivabradine
  • Ivacaftor
  • Ketoconazole
  • Lopinavir
  • Lumacaftor
  • Lurasidone
  • Mitotane
  • Naloxegol
  • Nefazodone
  • Nelfinavir
  • Olaparib
  • Oxycodone
  • Phenytoin
  • Piperaquine
  • Posaconazole
  • Ranolazine
  • Rifampin
  • Ritonavir
  • Saquinavir
  • Simeprevir
  • Sonidegib
  • St John's Wort
  • Tacrolimus
  • Telaprevir
  • Telithromycin
  • Tolvaptan
  • Venetoclax
  • Verapamil
  • Voriconazole

Using fosaprepitant 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.

  • Desogestrel
  • Dexamethasone
  • Dienogest
  • Drospirenone
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Mestranol
  • Midazolam
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Quetiapine
  • Suvorexant

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 fosaprepitant

A nurse or other trained health professional will give you fosaprepitant in a hospital or clinic. fosaprepitant is given through a needle placed in one of your veins. The infusion may take up to 30 minutes.

fosaprepitant 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 fosaprepitant again if you have more chemotherapy in the future.

fosaprepitant comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using fosaprepitant

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

You should not receive fosaprepitant if you are also using pimozide (Orap®). Fosaprepitant may cause serious or life-threatening problems if used together with fosaprepitant.

fosaprepitant may cause serious allergic reactions, including anaphylaxis. Anaphylaxis 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 fosaprepitant.

If you are also using a blood thinner called warfarin (Coumadin®, Jantoven®), your doctor will need to check your blood after using fosaprepitant.

Birth control pills may not work as well while you are using fosaprepitant. To keep from getting pregnant, use another form of birth control together with your pills during treatment and for one month after your last treatment. Other forms include condoms, 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.

fosaprepitant 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
  • coma
  • convulsions
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • general feeling of discomfort or illness
  • headache
  • increased sweating
  • increased thirst
  • lightheadedness, dizziness, or fainting
  • muscle pain or cramps
  • nausea or vomiting
  • pain, tenderness, or swelling of the foot or leg
  • slurred speech
  • swelling
  • swelling of the face, ankles, or hands
  • trouble with speaking
  • troubled breathing with exertion
Incidence not known
  • Difficulty with swallowing
  • hives or welts, itching
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • 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
  • Acid or sour stomach
  • belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • continuing ringing or buzzing or other unexplained noise in ears
  • diarrhea
  • difficulty having a bowel movement (stool)
  • 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
  • Abdominal or stomach distension or pain
  • 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
  • joint pain
  • muscle aching or cramping
  • muscle 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
  • sweating
  • swollen joints
  • trouble performing routine tasks
  • trouble sleeping
  • unexplained weight loss
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • weight gain
  • white patches in the mouth or throat or on the tongue
  • 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.

See also: Side effects (in more detail)

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