Pronunciation:

ap-RE-pi-tant

Brand Names:

• Aponvie
• Cinvanti

Dosage Forms:

• Emulsion

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Neurokinin-1 Receptor Antagonist

Uses of This Medicine:

Aprepitant injection is used together with other medicines (eg, dexamethasone, granisetron, ondansetron) to prevent acute and delayed nausea and vomiting caused by cancer medicines (chemotherapy). It is also used to prevent nausea and vomiting that may occur after surgery. Aprepitant is a substance P/neurokinin 1 (NK1) receptor antagonist that works by blocking the signals to the brain that cause nausea and vomiting.

This medicine is 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 aprepitant injection in the pediatric population. 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 aprepitant injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for 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.

• Eliglustat
• 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.

• 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 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.

• Amlodipine
• Dexamethasone
• Methylprednisolone
• Midazolam
• Quetiapine
• Sirolimus
• Suvorexant
• 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. 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 is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Liver disease, severe—Use with caution. May make this condition worse.

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.

For chemotherapy: This medicine may be injected for at least 2 minutes. It may also be given slowly, so the IV tube will have to stay in place for at least 30 minutes. It will be given on the first day of your chemotherapy session, along with other medicines (eg, dexamethasone, granisetron, ondansetron) about 30 minutes before the start of treatment.

For surgery: This medicine may be injected for at least 30 seconds before receiving anesthesia.

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

Precautions While Using This Medicine:

Check with your doctor if severe nausea and vomiting continue after leaving the medical facility.

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

Birth control that contains hormones (eg, pills, rings, implants, other devices) may not work as well to prevent pregnancy when used with this medicine. Use another form of birth control (including condoms or spermicide) along with your pills during treatment with this medicine and for 1 month after the last dose. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause a serious allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may decrease the prothrombin time (time it takes for your blood to clot) when used together with warfarin (Coumadin®) in patients with blood clotting problems. Talk to your doctor if you have concerns.

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 immediately if any of the following side effects occur:

More common

Blurred vision

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sweating

unusual tiredness or weakness

Rare

Bloody, black, or tarry stools

burning feeling while urinating

chest pain or discomfort

chills

cough

defects in intelligence, short-term memory, learning ability, and attention

difficult or painful urination

fast, irregular, pounding, or racing heartbeat or pulse

fever

frequent urination

general feeling of discomfort or illness

heartburn

increased sensitivity of the skin to sunlight

increased volume of pale, dilute urine

indigestion

lightheadedness, dizziness, or fainting

lower back or side pain

pale skin

redness or other discoloration of the skin

severe and continuing nausea

severe stomach pain, cramping, burning

severe sunburn

slow heartbeat

sore throat

swelling

tender, swollen glands in the neck

trouble breathing

trouble walking

trouble breathing

ulcers, sores, or white spots in the mouth

unusual bleeding or bruising

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

vomiting

vomiting of material that looks like coffee grounds

Incidence not known

Blistering, peeling, or loosening of the skin

chest tightness

diarrhea

difficulty swallowing

hives, itching, skin rash

joint or muscle pain

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

sore throat

sores, ulcers, or white spots in the mouth or on the lips

unusual tiredness or weakness

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

Constipation

Rare

Abnormal dreams

acne

anxiety

body aches or pain

burning, dry, or itching eyes

change or loss in taste

confusion about identity, place, and time

congestion

continuing ringing or buzzing or other unexplained noise in the ears

discharge, excessive tearing

dry throat

false or unusual sense of well-being

feeling of warmth

hearing loss

hoarseness

increased sweating

increased thirst

muscle cramp or weakness

oily skin

redness of the face, neck, arms and occasionally, upper chest

redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

runny nose

sleepiness or unusual drowsiness

sneezing

stomach discomfort

voice changes

weight gain

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.