Pronunciation:

fos-a-PRE-pi-tant dye-MEG-loo-meen

Brand Names:

• Emend
• Fosinvez

Dosage Forms:

• Powder for Solution

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Fosaprepitant

Uses of This Medicine:

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

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of fosaprepitant injection in children younger than 6 months of age. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fosaprepitant injection in the elderly. However, elderly patients are more likely to have liver, kidney, or heart problems, which may require caution in patients receiving this medicine.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of 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.

• Flibanserin
• Levoketoconazole
• Lomitapide
• Pimozide

Using this medicine with any of the following medicines is usually not recommended, but may be required 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.

• 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 cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Dexamethasone
• Methylprednisolone
• Midazolam
• Quetiapine
• Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of This Medicine:

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.

Precautions While Using This Medicine:

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

You should not receive fosaprepitant if you are also using pimozide (Orap®). Using these medicines together may cause 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 have 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 you are 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 have 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 check your blood after receiving this medicine.

Birth control pills may not work as well while you are receiving fosaprepitant. To keep from getting pregnant, use another form of birth control together 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 they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need 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. 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

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.