Emend-Aprepitant

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication
  • Aprepitant, referred to as an “antiemetic”, is used together with other medications to prevent nausea and vomiting that can occur as a side effect of chemotherapy. Aprepitant helps prevent nausea and vomiting that can occur on the same day as chemotherapy (acute) and up to 2-3 days after chemotherapy (delayed).
  • While aprepitant has been shown to effectively prevent nausea and vomiting, it has not been shown to help treat existing nausea and vomiting.
 

How This Medication Works

Aprepitant belongs to a specific class of antiemetics known as substance P/neurokinin 1 receptor antagonists. Aprepitant works in the brain by blocking the chemical substance P/neurokinin (NK1), which can cause nausea and vomiting. Benefits of This Medication Aprepitant works in the brain to prevent nausea and vomiting that can occur up to 5 days following the administration of chemotherapy. As a result, aprepitant, is effective in helping to decrease the chance of delayed nausea and vomiting, which can occur on days 2-5 following chemotherapy.   Who Should Not Take This Medication You should not take this medication if you:
  • Are also taking pimozide (Orap®), terfenadine (Seldane®), astemizole (Hismanal®), or cisapride (Propulsid®). Taking aprepitant in combination with any of these medications can cause serious or life-threatening problems. Note: Seldane?, Hismanal? and Propulsid? are no longer available in the United States.
  • Are allergic to aprepitant or any of its components
  Precautions to be Aware of Before Taking This Medication

Organ related precautions

This medication is broken down by enzymes (chemicals) in the liver and cleared from the body. In patients with severe liver disease, aprepitant may not break down normally which can lead to high levels of this medication in the body and a greater chance of side effects. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects. Patient specific precautions It is not known if this medication is safe and effective in children.  

Pregnancy and breastfeeding precautions

  • This medication may decrease the effectiveness of birth control pills. If you use birth control pills, you should use a second method of contraception (e.g., condoms) to avoid pregnancy while taking this medication.
  • It is not known whether or not this medication can cause fetal harm. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant while on this medication.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
 

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the-counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with aprepitant and the following foods or medications:
• Astemizole (Hismanal®)† • Amiodarone (Cordarone) • Atazanavir (Reyataz) • Benzodiazepine drugs • Birth control pills • Carbamazepine • Cisapride (Propulsid®)† • Clarithromycin (Biaxin) • Dexamethasone (Decadron) • Diltiazem • Docetaxel (Taxotere) • Erythromycin • Etoposide • Fluconazole (Diflucan) (at high doses) • Grapefruit or grapefruit juice • Ifosfamide • Imatinib mesylate (Gleevec) • Indinavir (Crixivan) • Irinotecan (Camptosar) • Itraconazole (Sporanox) • Ketozonazole (Nizoral) • Methylprednisolone • Nefazodone (Serzone) • Nelfinavir (Viracept) • Paclitaxel (Taxol) • Paroxetine (Paxil) • Phenytoin (Dilantin) • Phenobarbital • Pimozide (Orap®) • Rifabutin (Mycobutin) • Rifampin (Rifadin) • Ritonavir (Norvir) • Saquinavir • St.John’s wort • Terfenadine (Seldane®)† • Tolbutamide • Troleandomycin (TAO)† • Vinorelbine (Navelbine) • Vinblastine • Vincristine • Voriconazole (Vfend) • Warfarin (Coumadin)*
† No longer available in the United States. * Patients who take warfarin (Coumadin) may need to have a blood test after each 3 day treatment with aprepitant to check their blood clotting. NOTE: This list may not include all medications that can have interactions with aprepitant.   Side Effects
  • The side effects associated with aprepitant listed below are taken from the manufacturer package insert.
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Aprepitant is typically given together with chemotherapy medications. Side effects that you may experience with aprepitant can be related to the combination of aprepitant and chemotherapy medications together. The side effects listed below are those reported in patients who were being treated with aprepitant in combination with chemotherapy medications.
 

More common side effects

  • Tiredness (fatigue), loss of strength
  • Nausea, constipation, diarrhea, loss of appetite, hiccups
 

Less common side effects

  • Headache, difficulty sleeping, dizziness, dehydration, fever
  • Vomiting, heartburn, gastritis, stomach pain
  • Ringing in the ears
 

Rare side effects

This is not a complete list of the rare side effects reported with aprepitant. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Blood clots in the legs or lungs
  • Abnormal heart rhythm (heart beat), heart attack
  • Nerve damage, usually affecting the feet and legs, causing pain, numbness, or a tingling feeling
  How To Take This Medication
  • This medication is taken by mouth (orally) with or without food. Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you.
  • There are two different strengths of aprepitant – a 125mg capsule which is white and pink and has “125mg” printed on it, and an 80mg capsule which is white and has “80mg” printed on it.
  • The typical dose of aprepitant is one 125mg capsule taken one hour prior to starting chemotherapy treatment followed by one 80mg capsule taken each morning for the two days following your chemotherapy treatment.
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • Store this medication at room temperature and keep in its original container.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.