Emend (Intravenous)

Fosaprepitant injection is used along with other medicines to stop nausea and vomiting caused by cancer treatment (chemotherapy). It works in the brain to prevent nausea.

This medicine should only be given by your doctor or under their direct supervision.

It is very important for your doctor to check your progress at regular visits to ensure this medicine is working properly and to look for unwanted effects.

You should not receive fosaprepitant if you are also using pimozide (Orap®). Using these medicines together may lead to serious unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you experience itching, hives, a rash, trouble breathing, trouble swallowing, warmth or redness in your face, neck, arms, or upper chest, or any swelling of your hands, face, or mouth while receiving this medicine.

This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to experience a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving this medicine.

If you are also using a blood thinner called warfarin (Coumadin®, Jantoven®), your doctor will need to monitor your blood after you receive this medicine.

Birth control pills may not be as effective while you are receiving fosaprepitant. To prevent pregnancy, use another form of birth control along with your pills during treatment and for 1 month after your last dose. Other forms include condoms, spermicides, a diaphragm, and contraceptive foam or jelly.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine compared to the benefits it may provide. For this medicine, the following factors should be taken into account:

Allergies

Inform your doctor if you have ever experienced any unusual or allergic reactions to this medicine or any other medications. Also, let your healthcare provider know if you have any other allergies, including those to foods, dyes, preservatives, or animals. For over-the-counter products, carefully read the label or package ingredients.

Pediatric

Studies have not been conducted to determine how fosaprepitant injection affects children younger than 6 months. Its safety and effectiveness have not been established for this age group.

Geriatric

Current studies have not shown any specific problems in elderly patients that would limit the usefulness of fosaprepitant injection. However, older patients are more likely to have liver, kidney, or heart issues, which may require careful monitoring when using this medicine.

Breast Feeding

There are no adequate studies to determine the risk to infants when this medication is used during breastfeeding. Consider the potential benefits and risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. In such situations, your doctor might adjust the dose or take other precautions. It is especially important for your healthcare provider to know if you are taking any of the following medicines while receiving this medicine. The following interactions are highlighted based on their importance and may not include all possibilities.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or may change some of the other medicines you take.

• Flibanserin
• Levoketoconazole
• Lomitapide
• Pimozide

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medications.

• Adagrasib
• Alfentanil
• Alprazolam
• Amiodarone
• Amprenavir
• Atazanavir
• Belzutifan
• Benzhydrocodone
• Boceprevir
• Brexpiprazole
• Buprenorphine
• Carbamazepine
• Ceritinib
• Cilostazol
• Cimetidine
• Ciprofloxacin
• Clarithromycin
• Clofazimine
• Clozapine
• Cobicistat
• Cobimetinib
• Codeine
• Conivaptan
• Crizotinib
• Cyclosporine
• Dabrafenib
• Darunavir
• Desogestrel
• Diazepam
• Dienogest
• Dihydrocodeine
• Diltiazem
• Docetaxel
• Domperidone
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Drospirenone
• Duvelisib
• Eliglustat
• Enzalutamide
• Eplerenone
• Erythromycin
• Estetrol
• Estradiol
• Ethinyl Estradiol
• Ethynodiol
• Etonogestrel
• Etoposide
• Fedratinib
• Fentanyl
• Fexinidazole
• Finerenone
• Fluconazole
• Fluvoxamine
• Fosamprenavir
• Fosnetupitant
• Fosphenytoin
• Gestodene
• Hydrocodone
• Idelalisib
• Ifosfamide
• Imatinib
• Indinavir
• Itraconazole
• Ivabradine
• Ivosidenib
• Josamycin
• Ketoconazole
• Larotrectinib
• Lefamulin
• Lemborexant
• Lenacapavir
• Letermovir
• Levonorgestrel
• Lonafarnib
• Lopinavir
• Lorlatinib
• Lumacaftor
• Lurasidone
• Mavacamten
• Medroxyprogesterone
• Meperidine
• Mestranol
• Methadone
• Mibefradil
• Mifepristone
• Mitotane
• Naloxegol
• Nefazodone
• Nelfinavir
• Netupitant
• Nilotinib
• Nomegestrol
• Norelgestromin
• Norethindrone
• Norgestimate
• Norgestrel
• Olaparib
• Olutasidenib
• Omaveloxolone
• Oxycodone
• Paclitaxel
• Pacritinib
• Pentazocine
• Phenobarbital
• Phenytoin
• Piperaquine
• Pirtobrutinib
• Posaconazole
• Primidone
• Ranolazine
• Ribociclib
• Rifampin
• Rifapentine
• Ritlecitinib
• Ritonavir
• Saquinavir
• Schisandra sphenanthera
• Segesterone
• Simeprevir
• Sirolimus Protein-Bound
• Sonidegib
• St John's Wort
• Sufentanil
• Tacrolimus
• Telaprevir
• Telithromycin
• Tocilizumab
• Tolvaptan
• Tramadol
• Treosulfan
• Triazolam
• Trofinetide
• Troleandomycin
• Tucatinib
• Ubrogepant
• Ulipristal
• Verapamil
• Vinblastine
• Vincristine
• Vinorelbine
• Voriconazole
• Voxelotor
• Zolpidem

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be necessary for your treatment. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medications.

• Dexamethasone
• Methylprednisolone
• Midazolam
• Quetiapine
• Warfarin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around mealtime or with certain types of food because interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk to your healthcare provider about how to use this medicine with food, alcohol, or tobacco.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may require medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

• Black, tarry stools
• blurred vision
• chest tightness
• chills
• confusion
• cough
• decreased urination
• difficult or labored breathing
• dizziness
• dry mouth
• fainting
• fever
• increase in heart rate
• lightheadedness
• lower back or side pain
• nervousness
• pain, swelling, or redness at the injection site
• painful or difficult urination
• pale skin
• pounding in the ears
• rapid breathing
• slow or fast heartbeat
• sore throat
• sunken eyes
• tenderness, swelling, warmth, or skin discoloration at the injection site
• thirst
• ulcers, sores, or white spots in the mouth
• unusual bleeding or bruising
• unusual tiredness or weakness
• wrinkled skin

Less common

• Hard lump at the injection site

Rare

• Blood in the urine
• changes in patterns and rhythms of speech
• changes in skin color
• chest pain or discomfort
• fast, slow, irregular, pounding, or racing heartbeat or pulse
• general feeling of discomfort or illness
• headache
• increased sweating
• increased thirst
• lightheadedness, dizziness, or fainting
• loss of consciousness
• muscle pain or cramps
• nausea
• pain, tenderness, or swelling of the foot or leg
• seizures
• slurred speech
• swelling
• swelling of the face, ankles, or hands
• trouble with speaking
• trouble breathing
• vomiting

Incidence not known

• Diarrhea
• difficulty with swallowing
• hives or welts, itching
• joint pain
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red skin lesions, often with a purple center
• red, irritated eyes
• redness of the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

More common

• Belching
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• continuing ringing or buzzing or other unexplained noise in ears
• difficulty having a bowel movement
• dizziness
• feeling of indigestion
• hair loss or thinning of the hair
• hearing loss
• hiccups
• indigestion
• lack or loss of strength
• loss of appetite
• pain in the chest below the breastbone
• stomach discomfort, upset, or pain
• swelling or inflammation of the mouth
• weight loss

Less common

• Feeling of warmth
• pain or discomfort in chest, upper stomach, or throat
• redness of the face, neck, arms, and occasionally, upper chest
• sudden sweating
• unusually warm skin

Rare

• Abnormal dreams
• blemishes on the skin
• bumps on the skin
• burning, dry, or itching eyes
• change in taste
• change in walking and balance
• clumsiness or unsteadiness
• confusion about identity, place, and time
• difficulty with moving
• discharge, excessive tearing
• excess air or gas in the stomach
• extreme thirst
• false or unusual sense of well-being
• flushed, dry skin
• frequent urination
• fruit-like breath odor
• full feeling
• heartburn
• increased hunger
• increased sensitivity of the skin to sunlight
• increased urination
• increased volume of pale, dilute urine
• muscle ache, cramp, stiffness, or weakness
• oily skin
• passing gas
• pimples
• redness or other discoloration of the skin
• redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
• severe constipation
• severe sunburn
• sleepiness
• stomach distension
• sweating
• swollen joints
• trouble performing routine tasks
• trouble sleeping
• unexplained weight loss
• unusual drowsiness, dullness, or feeling of sluggishness
• weight gain
• white patches with diaper rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Emend
• Fosinvez

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antiemetic

Pharmacologic Class: Fosaprepitant

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be given slowly, so the needle will have to remain for 30 minutes in adults, 30 minutes in children 12 to 17 years of age, and 60 minutes in children 6 months to 12 years of age.

This medicine is usually given on the first day of your chemotherapy along with other medicines (eg, dexamethasone, ondansetron) about 30 minutes before the start of treatment. Your child may receive this medicine on Days 1, 2, and 3 of chemotherapy. Your child may also receive Emend® or aprepitant capsules or oral liquid instead of Emend® or Focinvez® injection on Days 2 and 3 of chemotherapy. Fosaprepitant is not for long-term use, but you may need to use this medicine again if you have more chemotherapy in the future.

This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have concerns.

• What is the difference between Cinvanti and Emend?