Pronunciation:

ap-RE-pi-tant

Brand Names:

• Emend

Dosage Forms:

• Capsule
• Powder for Suspension

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Neurokinin-1 Receptor Antagonist

Uses of This Medicine:

Aprepitant capsules and oral suspension are used in combination with other medicines to prevent the nausea and vomiting that may occur 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.

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 in the pediatric population. Safety and efficacy of aprepitant to prevent nausea and vomiting after surgery have not been established in children, and to prevent nausea and vomiting caused by cancer medicines in children younger than 6 months of age.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of aprepitant in the elderly.

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 taking 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

Proper Use of This Medicine:

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.

Precautions While Using This Medicine:

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 keep from getting pregnant, use another form of birth control together 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.

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:

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 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

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.