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Emend

Generic name: aprepitant (oral/injection) [ a-PREP-i-tant ]
Drug class: NK1 receptor antagonists

Medically reviewed by Judith Stewart, BPharm. Last updated on Oct 2, 2023.

What is Emend?

Emend is used together with other medications to prevent nausea and vomiting that may be caused by chemotherapy.

Emend is given ahead of time and will not treat nausea or vomiting that you already have.

Emend is also used with other medications in adults and children 6 months of age and older to prevent delayed nausea and vomiting that may occur several days after receiving certain chemotherapy medications.

Emend capsules are for use in adults and children who are at least 12 years old. Emend oral suspension (liquid) can be given to adults and children as young as 6 months old.

Aprepitant belongs to a class of medications called antiemetics. Emend works by blocking the action of neurokinin, a natural substance in the brain that causes nausea and vomiting.

Emend side effects

Get emergency medical help if you have signs of an allergic reaction to Emend: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your medical caregiver if you feel dizzy, nauseated, light-headed, itchy, sweaty, or have a headache, chest tightness, back pain, trouble breathing, or swelling in your face.

Emend may cause serious side effects. Call your doctor at once if you have:

Common Emend side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Warnings

You should not use Emend if you also use pimozide. A serious drug interaction can occur when pimozide is used together with aprepitant.

If you have liver disease, you may need a dose adjustment or special tests.

Emend can make birth control pills less effective, resulting in pregnancy. This effect can last for up to 28 days after your last dose of this medication. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking aprepitant and for at least 1 month after your treatment ends.

There are many other drugs that can interact with Emend. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Before taking this medicine

You should not use Emend if you are allergic to aprepitant.

Some drugs should not be used with Emend. Your treatment plan may change if you also use pimozide.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Aprepitant may harm an unborn baby. Tell your doctor if you are pregnant.

Ask a doctor if it is safe to breastfeed while using this medicine.

Aprepitant can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, spermicide, or contraceptive sponge.

Ask your doctor about the best form of birth control while you are using Emend.

Keep using the barrier form of birth control for 1 month after your last dose of Emend.

How should I use Emend?

Take Emend exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Emend injection is injected into a vein by a healthcare provider.

Emend is not for long-term use. Do not use this medicine more often than prescribed.

The first dose of this medicine is usually given 30 to 60 minutes before chemotherapy or surgery. Follow your doctor's dosing instructions very carefully.

Emend oral is taken by mouth with or without food.

Swallow the capsule whole and do not crush, chew, break, or open it.

The oral suspension (liquid) will be prepared by a healthcare provider and provided in a prefilled dosing syringe.

Your blood may need to be tested after receiving Emend if you also take a blood thinner called warfarin.

Store thecapsules at room temperature away from moisture and heat.

Store the oral suspension (liquid) in the refrigerator and use it within 72 hours. Do not freeze. The oral suspension (liquid) must be used within 3 hours if you keep it at room temperature.

Dosing Instructions

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

MODERATELY TO HIGHLY EMETOGENIC CANCER CHEMOTHERAPY (HEC/MEC):

Oral Capsules:-Day 1: 125 mg orally once 1 hour before chemotherapy-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)-Duration of therapy: 3 days/cycleOral Suspension:-Day 1: 3 mg/kg orally once 1 hour before chemotherapy---Maximum dose: 125 mg/dose-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)---Maximum dose: 80 mg/dose-Duration of therapy: 3 days/cycleParenteral:Single-Dose Regimen (HEC/MEC): 130 mg IV via 2-minute injection OR infused over 30 minutes ONCE, completing administration 30 minutes before chemotherapy3-Day Regimen with Oral Formulations (MEC):-Day 1: 100 mg IV via 2-minute injection OR infused over 30 minutes ONCE, completing administration 30 minutes before chemotherapy-Days 2 to 3: 80 mg orally once a dayComments:-The recommended dosage of dexamethasone is 12 mg orally on Day 1 administered 30 minutes prior to chemotherapy and 8 mg orally in the mornings on Days 2 through 4 (HEC) or Days 2 through 3 (MEC).-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the 5-HT3 antagonist dosing prior to initiation of treatment.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

MEC/HEC:

6 months to less than 12 yearsGREATER THAN 6 kg:Oral Suspension:-Day 1: 3 mg/kg orally once 1 hour before chemotherapy---Maximum dose: 125 mg/day-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)----Maximum dose: 80 mg/day-Duration of therapy: 3 days/cycle12 years and older:Oral Capsules:-Day 1: 125 mg orally once 1 hour before chemotherapy-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)-Duration of therapy: 3 days/cycleOral Suspension:-Day 1: 3 mg/kg orally once 1 hour before chemotherapy---Maximum dose: 125 mg/dose-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)---Maximum dose: 80 mg/dose-Duration of therapy: 3 days/cycleComments:-If a corticosteroid (e.g., dexamethasone) is coadministered, patients should be given 50% of the recommended pediatric dose on Days 1 to 4. Consult the package insert for the corticosteroid dosing prior to initiation of treatment.-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the 5-HT3 antagonist dosing prior to initiation of treatment.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of Emend oral.

In a medical setting you are not likely to miss an injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

In a medical setting an overdose would be treated quickly.

What should I avoid while using Emend?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What other drugs will affect Emend?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Many drugs can interact with aprepitant. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Manufacturer

Distributed by: Merck Sharp & Dohme Corp., Whitehouse Station, NJ 08889, USA.

Frequently asked questions

References

  1. Emend Product Label

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Emend only for the indication prescribed.

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