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Emend Tri-Pack
Emend Tri-Pack contains aprepitant, an antiemetic medication used to prevent nausea and vomiting caused by chemotherapy or surgery. Aprepitant works by blocking neurokinin-1 (NK1) receptors, which play a role in triggering the vomiting reflex. The Emend Tri-Pack is typically used in combination with other antiemetics like dexamethasone and ondansetron to provide comprehensive protection against chemotherapy-induced nausea and vomiting (CINV).
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Frequently Asked Questions
How long does Emend last?
Emend provides protection against nausea and vomiting for up to 5 days when taken as part of the Tri-Pack regimen.
Can I take Emend if I’m pregnant?
There is limited information about the use of Emend during pregnancy. Discuss with your healthcare provider if you are pregnant or planning to become pregnant during treatment.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Can Emend be taken with other anti-nausea medications?
Yes, Emend is often taken in combination with other anti-nausea medications like ondansetron and dexamethasone to provide comprehensive relief from chemotherapy-induced nausea and vomiting.
Can I take Emend if I’m on birth control?
Emend may reduce the effectiveness of hormonal birth control. Use an additional form of contraception (e.g., condoms) during treatment and for 1 month after the last dose of Emend.
Comprehensive Drug Guide
How Does Emend Tri-Pack Work?
Aprepitant works by blocking neurokinin-1 receptors in the brain, preventing the action of substance P, a chemical that triggers nausea and vomiting. By inhibiting these receptors, Emend reduces the likelihood of nausea and vomiting caused by chemotherapy or surgery.
Common Dosages
Emend Tri-Pack is available by prescription only and is not classified as a controlled substance. The Tri-Pack contains three capsules, meant to be taken over three days:
- One 125 mg capsule for Day 1
- Two 80 mg capsules for Day 2 and Day 3
- Emend is usually taken in combination with dexamethasone and ondansetron for maximum anti-nausea effectiveness.
Typical Dosing
FDA Approved Indications
- Prevention of acute and delayed nausea and vomiting associated with highly and moderately emetogenic chemotherapy
- Prevention of postoperative nausea and vomiting (PONV)
Who Shouldn't Take Emend Tri-Pack?
- Known hypersensitivity to aprepitant or any component of the formulation
- Concomitant use of pimozide, terfenadine, astemizole, or cisapride, as aprepitant can increase their levels and cause serious side effects
Advice From The Pharmacist
- Take the Day 1 capsule 1 hour before chemotherapy starts. The Day 2 and Day 3 doses should be taken in the morning.
- Emend may be taken with or without food, but try to take it consistently at the same time each day.
- If you are taking additional antiemetics like dexamethasone or ondansetron, follow the exact schedule provided by your healthcare provider.
- Avoid grapefruit juice while taking Emend, as it can increase aprepitant levels in the blood and lead to side effects.
Side Effects of Emend Tri-Pack
Common Side Effects
- Fatigue
- Dizziness
- Hiccups
- Diarrhea or constipation
- Loss of appetite
Uncommon/Severe Side Effects
- Allergic reactions (rash, itching, swelling, difficulty breathing)
- Stevens-Johnson syndrome (a rare, severe skin reaction)
- Severe liver problems (yellowing of the skin or eyes)
Risks and Warnings of Emend Tri-Pack
- Drug Interactions: Emend can interact with other medications, particularly those metabolized by CYP3A4, including certain chemotherapy drugs, blood thinners, and birth control pills. Patients taking warfarin should have their blood clotting monitored closely.
- Contraceptive Effectiveness: Emend may reduce the effectiveness of hormonal contraceptives. Patients should use an alternative or additional method of birth control during treatment and for 1 month after the last dose.
Interactions with Emend Tri-Pack
Common Drug Interactions
- CYP3A4 Substrates: Aprepitant can increase blood levels of drugs metabolized by CYP3A4 (e.g., dexamethasone, midazolam, fentanyl), leading to increased side effects.
- Warfarin: Emend can reduce the effectiveness of warfarin, requiring close monitoring of INR levels.
- Oral Contraceptives: Emend may reduce the effectiveness of birth control pills. An alternative contraceptive method is recommended during and for 1 month after treatment.
Alternatives to Emend Tri-Pack
- Zofran (ondansetron): A serotonin 5-HT3 receptor antagonist often used alongside Emend to prevent nausea and vomiting.
- Akynzeo (netupitant/palonosetron): A combination NK1 receptor antagonist and 5-HT3 receptor antagonist used to prevent chemotherapy-induced nausea and vomiting.
- Dexamethasone: A corticosteroid used in combination with Emend for the prevention of nausea and vomiting during chemotherapy.
- Granisetron (Kytril): A serotonin receptor antagonist used to prevent nausea and vomiting from chemotherapy or surgery.
