Monograph Details

Gastrointestinal Tract > Nausea
EMEND INJECTION
Manufacturer
Merck & Co., Inc.
Legal Classification
Rx
Generic Name
Fosaprepitant dimeglumine (prodrug of aprepitant) 115mg/vial; lyophilized pwd for IV infusion after reconstitution and dilution; contains polysorbate 80.
Also
EMEND
Indications
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.
Children
<18yrs: not recommended.
Adults
≥18yrs: Give with corticosteroid and 5-HT3 antagonist. Day 1 of cycle: give 30 mins before chemotherapy: 115mg infused IV over 15 mins; Days 2 and 3: 80mg orally once daily in the AM.
Contraindications
Concomitant pimozide, cisapride.
Precautions
Not for chronic continuous use. Severe hepatic insufficiency. Pregnancy (Cat.B). Nursing mothers: not recommended.
Interactions
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
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
Related Prescribing Note