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Emend Injection Dosage

Generic name: FOSAPREPITANT DIMEGLUMINE 150mg in 5mL
Dosage form: injection, powder, lyophilized, for solution

Medically reviewed on September 5, 2018.

Prevention of Nausea and Vomiting Associated with HEC and MEC in Adult Patients

The recommended dosage of EMEND for injection, dexamethasone, and a 5-HT3 antagonist for the prevention of nausea and vomiting associated with administration of HEC or MEC in adults is shown in Table 1 or Table 2, respectively. Administer EMEND for injection as an intravenous infusion on Day 1 over 20 to 30 minutes, completing the infusion approximately 30 minutes prior to chemotherapy.

Table 1 Recommended Adult Dosing for the Prevention of Nausea and Vomiting Associated with HEC
Day 1 Day 2 Day 3 Day 4
*
Administer dexamethasone 30 minutes prior to chemotherapy treatment on Day 1 and in the morning on Days 2 through 4. Also administer dexamethasone in the evenings on Days 3 and 4. A 50% dosage reduction of dexamethasone on Days 1 and 2 is recommended to account for a drug interaction with EMEND [see Clinical Pharmacology (12.3)].
EMEND for injection 150 mg intravenously over 20 to 30 minutes approximately 30 minutes prior to chemotherapy none none none
Dexamethasone* 12 mg orally 8 mg orally 8 mg orally twice daily 8 mg orally twice daily
5-HT3 antagonist See selected 5-HT3 antagonist prescribing information for the recommended dosage none none none
Table 2 Recommended Adult Dosing for the Prevention of Nausea and Vomiting Associated with MEC
Day 1
*
Administer dexamethasone 30 minutes prior to chemotherapy treatment on Day 1. A 50% dosage reduction of dexamethasone is recommended to account for a drug interaction with EMEND [see Clinical Pharmacology (12.3)].
EMEND for injection 150 mg intravenously over 20 to 30 minutes approximately 30 minutes prior to chemotherapy
Dexamethasone* 12 mg orally
5-HT3 antagonist See selected 5-HT3 antagonist prescribing information for the recommended dosage

Prevention of Nausea and Vomiting Associated with HEC and MEC in Pediatric Patients

The recommended pediatric dose regimens of EMEND, to be administered with a 5-HT3 antagonist, with or without a corticosteroid, for the prevention of nausea and vomiting associated with administration of single or multi-day chemotherapy regimens of HEC or MEC, are shown in Tables 3 and 4. Single-day chemotherapy regimens include those regimens in which HEC or MEC is administered for a single day only. Multi-day chemotherapy regimens include chemotherapy regimens in which HEC or MEC is administered for 2 or more days.

EMEND Dosage Regimens for Use with Single-Day Chemotherapy Regimens

For pediatric patients weighing at least 6 kg receiving single-day HEC or MEC, EMEND may be administered as:

  • a single dose regimen of EMEND for injection infused through a central venous catheter on Day 1, as shown in Table 3; or
  • as a 3-day EMEND regimen consisting of EMEND for injection as an intravenous infusion through a central venous catheter on Day 1 and EMEND capsules or EMEND for oral suspension on Days 2 and 3, as shown in Table 4.

Administer EMEND for injection on Day 1 over 30 minutes (12 years to 17 years) or 60 minutes (6 months to less than 12 years), completing the infusion approximately 30 minutes prior to chemotherapy.

Table 3 Single Dose Regimen of EMEND for injection for Pediatric Patients 6 Months* to 17 Years for the Prevention of Nausea and Vomiting Associated with Single-Day Regimens of HEC or MEC
Drug Age Regimen
*
Dosing in pediatric patients less than 6 kg is not recommended
Administer dexamethasone 30 minutes prior to chemotherapy treatment on Day 1
EMEND for injection 12 Years to 17 Years 150 mg
intravenously over 30 minutes
2 Years to less than 12 Years 4 mg/kg
(maximum dose 150 mg)
intravenously over 60 minutes
6 Months to less than 2 Years 5 mg/kg
(maximum dose 150 mg)
intravenously over 60 minutes
Dexamethasone 6 Months to 17 Years If a corticosteroid, such as dexamethasone, is co-administered, administer 50% of the recommended corticosteroid dose on Days 1 and 2.
5-HT3 antagonist 6 Months to 17 Years See selected 5-HT3 antagonist prescribing information for the recommended dosage

EMEND Dosage Regimen for Use with Multi-Day Chemotherapy Regimens

For pediatric patients weighing at least 6 kg receiving multi-day regimens of HEC or MEC, administer EMEND on Days 1, 2, and 3. Administer EMEND for injection as an intravenous infusion through a central venous catheter on Day 1 and EMEND capsules or EMEND for oral suspension on Days 2 and 3, as shown in Table 4.

Administer EMEND for injection on Day 1 over 30 minutes (12 years to 17 years) or 60 minutes (6 months to less than 12 years), completing the infusion approximately 30 minutes prior to chemotherapy.

Table 4 Pediatric Patients 6 Months* to 17 Years Recommended 3-Day EMEND Dosage Regimen for Prevention of Nausea and Vomiting Associated with Single or Multi-day Regimens of HEC or MEC
Age Group Drug Day 1 Day 2 Day 3
*
Dosing in pediatric patients less than 6 kg is not recommended
For patients 12 years to 17 years who cannot swallow oral capsules, EMEND for oral suspension can be used instead.
Administer dexamethasone 30 minutes prior to chemotherapy treatment on Day 1
12 Years to 17 Years EMEND for injection 115 mg
intravenously over 30 minutes
-- --
EMEND capsules -- 80 mg orally 80 mg orally
6 Months to Less than 12 Years EMEND for injection 3 mg/kg
(maximum dose 115 mg)
intravenously over 60 minutes
-- --
EMEND for oral suspension -- 2 mg/kg orally
(maximum 80 mg)
2 mg/kg orally
(maximum 80 mg)
6 Months to 17 Years Dexamethasone If a corticosteroid, such as dexamethasone, is co-administered, administer 50% of the recommended corticosteroid dose on Days 1 through 4
6 Months to 17 Years 5-HT3 antagonist See selected 5-HT3 antagonist prescribing information for the recommended dosage

Preparation of EMEND for injection

Table 5 Preparation Instructions for EMEND for injection (150 mg)
The recommended dose of EMEND for injection is based on the patient's age and weight.
Step 1 Aseptically inject 5 mL 0.9% Sodium Chloride Injection, USP into the vial. Assure that 0.9% Sodium Chloride Injection, USP is added to the vial along the vial wall in order to prevent foaming. Swirl the vial gently. Avoid shaking and jetting 0.9% Sodium Chloride Injection, USP into the vial.
Step 2 Aseptically prepare an infusion bag filled with 145 mL of 0.9% Sodium Chloride Injection, USP.
Step 3 Aseptically withdraw the entire volume from the vial and transfer it into the infusion bag containing 145 mL of 0.9% Sodium Chloride Injection, USP to yield a total volume of 150 mL and a final concentration of 1 mg/mL.
Step 4 Gently invert the bag 2 to 3 times.
Step 5 Determine the volume to be administered from this prepared infusion bag, based on the recommended dose [see Dosage and Administration (2.1, 2.2)].
Adults
The entire volume of the prepared infusion bag (150 mL) should be administered.
Pediatrics
In patients 12 years and older, the volume to be administered is calculated as follows:
  • Volume to administer (mL) equals the recommended dose (mg)
In patients 6 months to less than 12 years, the volume to be administered is calculated as follows: In pediatric patients, the entire volume in the infusion bag may not be required.
Step 6 If necessary, for volumes less than 150 mL, the calculated volume can be transferred to an appropriate size bag or syringe prior to administration by infusion.
Step 7 Before administration, inspect the bag for particulate matter and discoloration. Discard the bag if particulate and/or discoloration are observed.

Caution: Do not mix or reconstitute EMEND for injection with solutions for which physical and chemical compatibility have not been established. EMEND for injection is incompatible with any solutions containing divalent cations (e.g., Ca2+, Mg2+), including Lactated Ringer's Solution and Hartmann's Solution.

Storage

The reconstituted final drug solution is stable for 24 hours at ambient room temperature [at or below 25°C (77°F)].

Further information

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

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