Generic Name and Formulations:
Aprepitant 40mg, 80mg, 125mg; caps.
Merck & Co., Inc.
Indications for EMEND:
In combination with other antiemetic agents, in patients ≥12yrs of age for prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately to highly emetogenic cancer chemotherapy, including high-dose cisplatin. Prevention of post-op nausea and vomiting (PONV) in adults.
Swallow caps whole. Chemotherapy induced: ≥12yrs: give with corticosteroid and 5-HT3 antagonist (see full labeling). 125mg on Day 1; then 80mg on Days 2 and 3. Administer caps 1 hr prior to chemotherapy on Days 1, 2, and 3; if no chemotherapy is given on Days 2 and 3, then administer caps in the AM. PONV: ≥18yrs: 40mg within 3hrs prior to anesthesia.
Chemotherapy induced: <12yrs: use oral susp. PONV: <18yrs: not established.
Not for chronic continuous use. Severe hepatic impairment. Injection: monitor for infusion site or hypersensitivity reactions; discontinue and treat appropriately if occur; do not reinitiate if symptoms (eg, flushing, erythema, dyspnea, hypotension, syncope) develop with first-time use. Avoid infusion into small veins or through a butterfly catheter. Pregnancy. Nursing mothers.
Substance P/NK1 receptor antagonist.
See Contraindications. Monitor, and caution with, CYP3A4 substrates, including chemotherapy agents (eg, ifosfamide, vinblastine, vincristine). Avoid concomitant moderate-to-strong CYP3A4 inhibitors (eg, azole antifungals, macrolides, nefazodone, ritonavir, nelfinavir, diltiazem) or strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin). Potentiates dexamethasone (reduce its dose by 50%), methylprednisolone (reduce its IV dose by 25% and its oral dose by 50%), midazolam, alprazolam, triazolam. May antagonize warfarin (closely monitor INR for 2 weeks after starting each regimen), other CYP2C9 substrates, oral contraceptives (use alternative or backup method during and for 1 month after last dose).
Fatigue, diarrhea, asthenia, dyspepsia, abdominal pain, hiccups, WBC count decreased, dehydration, ALT/AST increased, neutropenia, headache, anorexia, cough, hemoglobin decreased, dizziness, constipation, hypotension. Injection: also anemia, peripheral neuropathy, UTI, extremity pain, infusion-site reactions, anaphylaxis.
Caps 40mg—1, 5; 80mg, 125mg—6; Bi-fold pack (2 x 80mg)—1; Tri-fold pack (1 x 125mg + 2 x 80mg)—1; Susp kit—1 (w. oral dispensers, supplies); Single-dose vial—1