Aprepitant (Emend®, Cinvanti®)
About This Drug
Aprepitant is a medication used before chemotherapy to prevent nausea and vomiting (throwing up) during treatment. It is given orally (by mouth).
Possible Side Effects
- Decrease in the number of white blood cells. This may raise your risk of infection
- Tiredness and weakness
- Diarrhea (loose bowel movements)
- Pain in your abdomen
- Dehydration (lack of water in the body from losing too much fluid)
- Changes in your liver function
Note: Each of the side effects above was reported in 3% or greater of patients treated with aprepitant. Not all possible side effects are included above.
Warnings and Precautions
- Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
How to Take Your Medication
- Capsule: Swallow the medicine whole with or without food.
- Oral Suspension: The suspension will be prepared by your healthcare provider. When ready to use, insert dispenser along right or left inner cheek and dispense slowly.
- Missed dose: If you vomit or miss a dose, contact your doctor for further instructions. Do not take 2 doses at the same time or extra doses.
- Storage: Store the capsules at room temperature. Store the prepared oral suspension in the refrigerator for up to 72 hours before using. When ready to use, the medicine can be left at room temperature for 3 hours. Suspension must be used within 72 hours of preparation – discard any remaining doses after 72 hours.
Treating Side Effects
- To decrease the risk of infection, wash your hands regularly.
- Avoid close contact with people who have a cold, the flu, or other infections.
- Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
- Manage tiredness by pacing your activities for the day.
- Be sure to include periods of rest between energy-draining activities.
- Drink plenty of fluids (a minimum of eight glasses per day is recommended).
- If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
- If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
- Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
- Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
- While you are getting this drug, please tell your nurse right away if you get a rash, swelling or bruising or your skin gets red, warm, itchy or painful at the site of your infusion or injection.
Food and Drug Interactions
- This drug may interact with grapefruit and grapefruit juice. Talk to your doctor as this could make side effects worse.
- Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with aprepitant. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
- Avoid the use of St. John’s Wort while taking aprepitant as this may lower the levels of the drug in your body, which can make it less effective.
- There are known interactions of aprepitant with blood thinning medicine such as warfarin. Ask your doctor what precautions you should take.
- Birth control pills (oral contraceptives) may not be effective with this medication, it is recommended to use another form of birth control (such as a condom) during treatment and for 1 month after treatment. Discuss with your doctor and/or nurse what method of birth control may be right for you during your treatment.
When to Call the Doctor
Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:
- Fever of 100.4° F (38° C) or higher
- Tiredness that interferes with your daily activities
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
- Pain that does not go away, or is not relieved by prescribed medicines
- Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, call 911 for emergency care.
- Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
- If you think you may be pregnant
- Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective non-hormonal methods of birth control during your cancer treatment and for at least 1 month after treatment. Let your doctor know right away if you think you may be pregnant. Birth control pills (oral contraceptives) may not be effective with this medication.
- Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
- Fertility warning: This drug is not expected to affect your ability to have children in the future. Human fertility studies have not been done with this drug.
Revised April 2019
This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.
CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.