Monograph Details
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Gastrointestinal Tract
> Nausea
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EMEND |
| Manufacturer |
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Merck & Co., Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Substance P/neurokinin 1 receptor antagonist. |
| Generic Name |
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Aprepitant 40mg, 80mg, 125mg; caps. |
| Also |
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• EMEND INJECTION
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| Indications |
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In combination with other antiemetic agents to prevent acute and delayed nausea and vomiting associated with initial and repeat courses of moderately to highly emetogenic cancer chemotherapy, including high-dose cisplatin. Prevention of post-op nausea and vomiting. |
| Children |
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<18yrs: not recommended. |
| Adults |
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≥18yrs: Chemotherapy: Give with corticosteroid and 5-HT3 antagonist. Day 1 of chemotherapy cycle: 125mg 1 hour before chemotherapy; Days 2 and 3: 80mg once daily in the AM. Post-op prophylaxis: 40mg within 3hrs prior to anesthesia. |
| Contraindications |
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Concomitant pimozide, cisapride. |
| Precautions |
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Not for chronic continuous use. Severe hepatic insufficiency. Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Monitor, and caution with, CYP3A4 substrates, including chemotherapy agents (eg, ifosfamide, vinblastine, vincristine); CYP3A4 inhibitors (eg, azole antifungals, macrolides, nefazodone, ritonavir, nelfinavir, diltiazem); and with CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin). Potentiates dexamethasone (reduce its dose by 50%), methylprednisolone (reduce its IV dose by 25% and its oral dose by 50%), midazolam, alprazolam, triazolam. May antagonize warfarin (closely monitor INR for 2 weeks after starting each regimen); phenytoin, tolbutamide, other CYP2C9 substrates; paroxetine, oral contraceptives (use alternative or back-up method during and for 1 month after last dose). |
| Adverse Reactions |
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Asthenia, fatigue, hiccups, diarrhea, constipation, anorexia, dyspepsia. Injection: inj site pain, headache. |
| How Supplied |
Caps 125mg—30
40mg—1
Bi-fold pack (2 x 80mg)—1
Tri-fold pack (1 x 125mg + 2 x 80mg)—1
Vial—1 |
| Additional Resources |
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• Related Prescribing Note |
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