Emend (Oral)

Aprepitant capsules and oral suspension are used along with other medicines to stop nausea and vomiting that may happen during cancer treatment (chemotherapy). Aprepitant capsules are also used to prevent nausea and vomiting that may occur after surgery. Aprepitant works in the nervous system to block the action of a chemical that causes vomiting.

This medicine is available only with your doctor's prescription.

It is very important that your doctor check your progress while you are using this medicine to make sure it is working properly and to check for unwanted effects.

Do not use this medicine if you are also using pimozide (Orap®). Using these medicines together may cause serious unwanted side effects.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have itching, hives, rash, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Birth control pills may not work as well while you are using aprepitant. To prevent pregnancy, use another form of birth control along with your pills while you are using the medicine and for 1 month after your last dose. Other forms of birth control include condoms, diaphragms, or contraceptive foams or jellies.

Do not take other medicines unless they have been discussed 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 will consider the risks of taking the medicine against the benefits it may provide. The following points should be considered for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies have not been done to determine how aprepitant affects children. The safety and effectiveness of aprepitant for preventing nausea and vomiting after surgery have not been established in children, and it has not been studied for preventing nausea and vomiting caused by cancer medicines in children younger than 6 months of age.

Geriatric

Current studies have not shown any problems specific to older adults that would limit the usefulness of aprepitant in the elderly.

Breast Feeding

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

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if an interaction might occur. If you are taking this medicine, it is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

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

• Eliglustat
• 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 change the dose or how often you use one or both of the medicines.

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

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best option for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Amlodipine
• Dexamethasone
• Methylprednisolone
• Midazolam
• Quetiapine
• Sirolimus
• Suvorexant
• Warfarin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around mealtime or with certain foods since interactions may occur. Drinking alcohol or using tobacco with certain medicines may also lead to interactions. The following interactions have been chosen based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may adjust the dose or how often you take this medicine, or provide special instructions regarding food, alcohol, or tobacco use.

• Grapefruit Juice

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

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

Less common

• Black or tarry stools
• Chills
• Cough
• Fever
• Lower back or side pain
• Painful or difficult urination
• Pale skin
• Shortness of breath
• Sore throat
• Ulcers, sores, or white spots in the mouth
• Unusual bleeding or bruising
• Unusual tiredness or weakness

Incidence not known

• Blistering, peeling, or loosening of the skin
• Confusion about identity, place, and time
• Diarrhea
• Itching or skin rash
• Joint or muscle pain
• Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• Redness of the skin
• Red, irritated eyes
• Red skin lesions, often with a purple center
• Slow or irregular heartbeat

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may 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 or are bothersome or if you have any questions about them:

More common

• Acid or sour stomach
• Belching
• Confusion
• Decreased urination
• Dizziness
• Dry mouth
• Fainting
• Heartburn
• Hiccups
• Increase in heart rate
• Indigestion
• Lack or loss of strength
• Lightheadedness
• Loss of appetite
• Nausea
• Rapid breathing
• Stomach discomfort, upset, or pain
• Sunken eyes
• Swelling or inflammation of the mouth
• Thirst
• Weight loss
• Wrinkled skin

Less common

• Burning feeling in the chest or stomach
• Hot flashes
• Indigestion
• Pain or discomfort in the chest, upper stomach, or throat
• Tenderness in the stomach area

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

Available Dosage Forms:

• Capsule
• Powder for Suspension

Therapeutic Class: Antiemetic

Pharmacologic Class: Neurokinin-1 Receptor Antagonist

Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Aprepitant is given together with other medicines to prevent vomiting from chemotherapy. Carefully follow your doctor's instructions about how to take the medicines.

You may take this medicine with or without food.

Swallow the capsule whole. Do not crush, break, or chew it.

To use the oral suspension:

• For each dose of this medicine, you will receive a prefilled oral dosing dispenser that contains your prescribed dose.
• Call your doctor right away if you or your child is not able to take the prescribed dose.
• Throw away the oral dosing dispenser and cap after each use.

Do not start taking aprepitant if you already have nausea and vomiting. Contact your doctor about what to do.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (capsules): For prevention of nausea and vomiting caused by chemotherapy: Adults and children 12 years of age and older—125 milligrams (mg) 1 hour before chemotherapy (Day 1). Then, 80 mg once in the morning on Days 2 and 3. Children younger than 12 years of age, weighing at least 30 kilograms (kg), and can swallow a capsule—125 mg 1 hour before chemotherapy (Day 1). Then, 80 mg once in the morning on Days 2 and 3. Children younger than 12 years of age weighing less than 30 kg—Use and dose must be determined by your doctor. For prevention of nausea and vomiting after surgery: Adults—40 milligrams (mg) within 3 hours before surgery. Children—Use and dose must be determined by your doctor.
• For oral dosage form (powder for suspension):For prevention of nausea and vomiting caused by chemotherapy: Adults and children 6 months to 11 years of age and cannot swallow the capsule—Dose is based on body weight and must be determined by your doctor. The dose is usually 3 milligrams (mg) per kilogram (kg) of body weight up to a maximum dose of 125 mg taken 1 hour before chemotherapy (Day 1). Then, 2 mg per kg of body weight up to a maximum dose of 80 mg taken once in the morning on Days 2 and 3. Children younger than 6 months of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep the oral liquid in the oral dosing dispenser in the refrigerator for up to 72 hours before use. You may also keep the medicine at room temperature for up to 3 hours.

• What is the difference between Cinvanti and Emend?