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Emend
Emend (generic name: aprepitant) is an antiemetic medication used to prevent nausea and vomiting caused by chemotherapy and surgery. It belongs to a class of drugs known as substance P/neurokinin 1 (NK1) receptor antagonists, which block signals that trigger nausea and vomiting in the brain. Emend is often used in combination with other anti-nausea medications for better efficacy.
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Frequently Asked Questions
How soon before chemotherapy should I take Emend?
For chemotherapy, you should take the first dose of Emend (125 mg) 1 hour before the start of chemotherapy.
Can Emend be used with other anti-nausea medications?
Yes, Emend is often used in combination with other medications like ondansetron and dexamethasone to provide more comprehensive control of nausea and vomiting.
How long does Emend stay in your system?
Emend stays in the system for several days, providing extended protection against nausea and vomiting, which is why it's effective for delayed nausea following chemotherapy.
Can Emend be used for motion sickness?
No, Emend is not indicated for the treatment of motion sickness. It is specifically used for nausea and vomiting caused by chemotherapy and surgery.
Does Emend affect birth control pills?
Yes, Emend can reduce the effectiveness of oral contraceptives. Use alternative contraception during treatment and for 28 days after your last dose of Emend.
Comprehensive Drug Guide
How Does Emend Work?
Emend works by blocking neurokinin-1 (NK1) receptors in the brain, which prevents the action of substance P, a natural substance that causes nausea and vomiting. By inhibiting these receptors, Emend effectively reduces nausea and vomiting associated with chemotherapy and surgery.
Common Dosages
- Oral capsules: 40 mg, 80 mg, and 125 mg
- Intravenous form (fosaprepitant): Administered as a single IV dose before chemotherapy
Typical Dosing
- For chemotherapy-induced nausea and vomiting: Start with 125 mg orally 1 hour before chemotherapy on Day 1, followed by 80 mg on Days 2 and 3.
- For postoperative nausea and vomiting: 40 mg orally within 3 hours before anesthesia.
Typical Dosing
FDA Approved Indications
- Chemotherapy-induced nausea and vomiting (CINV)
- Postoperative nausea and vomiting (PONV)
Who Shouldn't Take Emend?
- Hypersensitivity to aprepitant or any other NK1 receptor antagonists
- Concurrent use with pimozide or cisapride due to risk of serious drug interactions
Advice From The Pharmacist
- Take Emend as directed, based on whether it’s being used for chemotherapy or postoperative nausea prevention.
- Emend is often used in combination with other anti-nausea medications (like ondansetron or dexamethasone) for better protection against nausea and vomiting.
- If you miss a dose, contact your healthcare provider for advice on the best course of action.
- Emend can interfere with the effectiveness of oral contraceptives, so alternative forms of birth control should be used during and for 28 days after treatment.
Side Effects of Emend
Common Side Effects
- Fatigue
- Diarrhea
- Dizziness
- Hiccups
Uncommon/Severe Side Effects
- Severe allergic reactions
- Liver problems (jaundice, dark urine, yellowing of skin or eyes)
Risks and Warnings of Emend
- Drug Interactions: Emend can interact with a variety of medications, including warfarin, oral contraceptives, and certain chemotherapy agents, so always inform your doctor of all medications you are taking.
- Hepatic Effects: Emend may affect liver function, so patients with liver disease should be closely monitored.
Interactions with Emend
Common Drug Interactions
- Oral contraceptives: The effectiveness of birth control pills can be reduced when taking Emend, so alternative forms of contraception should be used.
- Warfarin: Emend can affect the metabolism of warfarin, requiring closer monitoring of INR levels.
- CYP3A4 inhibitors/inducers: Medications that affect the enzyme CYP3A4 may alter the metabolism of Emend, leading to either increased side effects or reduced effectiveness.
Alternatives to Emend
- Zofran (ondansetron): Another antiemetic used for chemotherapy-induced nausea and vomiting.
- Aloxi (palonosetron): A serotonin 5-HT3 receptor antagonist used to prevent nausea and vomiting caused by chemotherapy.
- Kytril (granisetron): A selective 5-HT3 receptor antagonist for preventing nausea and vomiting.
