Aprepitant (By mouth)

Introduction:

Aprepitant (ap-RE-pi-tant)

Used with other medicines to prevent nausea and vomiting caused by cancer treatment (chemotherapy) or nausea and vomiting occurring after surgery.

Brand Name(s):

Emend

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• You may take this medicine with or without food.
• This medicine is usually used once a day for 3 days in a row, beginning on the first day of your chemotherapy treatment.
• Take your first dose 1 hour before your chemotherapy treatment starts. Take your second and third doses each morning for the next 2 days.
• Your doctor will give you this medicine 3 hours before your surgery starts.
• You might need to use other medicines at the same time you use aprepitant. Aprepitant is not for long-term use, but you may need to use this three-dose routine again if you have more chemotherapy treatments in the future.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. If your medicine comes in a bottle, you might find a small packet in the bottle with your medicine. Keep this packet inside the bottle with the capsules. It helps keep the capsules from getting damp. Do not eat or swallow this packet.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many other medicines that you should not use together with aprepitant. These include prescription and nonprescription medicines, vitamins, and herbal supplements. Make sure your doctor knows about all other medicines you use.
• Make sure your doctor knows if you are also using a blood thinner (such as warfarin, Coumadin®), tolbutamide (Orinase®), diltiazem (Cartia®, Tiazac®), rifampin (Rifadin®), medicine for seizures (such as carbamazepine, phenytoin, Dilantin®, or Tegretol®), a sedative (such as alprazolam, midazolam, triazolam, Halcion®, Versed®, or Xanax®), medicine for depression (such as nefazodone, paroxetine, Paxil®, or Serzone®), medicine to treat fungal infections (such as itraconazole, ketoconazole, Nizoral®, or Sporanox®), medicine to treat bacterial infection (such as clarithromycin, troleandomycin, or Biaxin®), or medicines to treat HIV/AIDS (such as nelfinavir, ritonavir, Norvir®, or Viracept®).
• Your doctor might need to change your dose of some other medicines while you are using aprepitant. These include drugs often used during chemotherapy, such as paclitaxel (Taxol®), etoposide (VePesid®), irinotecan (Camptosar®), ifosfamide (Ifex®), imatinib (Gleevec®), vinblastine (Velban®), vincristine (Oncovin®), methylprednisolone, and dexamethasone (Decadron®) by mouth.
• Birth control pills may not work while you are using aprepitant. To keep from getting pregnant, use another form of birth control for up to 1 month after your last treatment. Other forms of birth control include condoms, a diaphragm, or contraceptive foam or jelly.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant, planning to become pregnant, or breastfeeding, or if you have liver disease.
• This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have itching; hives; rash; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
• Do not use this medicine to treat nausea or vomiting that has already started.
• Your doctor will need to check your blood after using this medicine if you are also taking warfarin (Coumadin®).

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, or red skin rash.
• Chest pain or shortness of breath.
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Severe stomach pain, nausea, or vomiting.
• Slow heartbeat.
• Unusual bleeding, bruising, or weakness.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, heartburn, or stomach pain or upset.
• Continuing ringing or buzzing or other unexplained noise in the ears.
• Hair loss.
• Headache.
• Hiccups.
• Increased thirst, dry skin, or itching.
• Loss of appetite.
• Sores or white patches on your lips, mouth, or throat.
• Tiredness or weakness.
• Trouble with sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor: