Aprepitant, Oral ap-RE-pi-tant

What are other names for this medicine?

Type of medicine: antiemetic (antinausea)

Generic and brand names: aprepitant, oral; Emend

What is this medicine used for?

This medicine is taken by mouth to prevent nausea and vomiting that can occur during or after chemotherapy. It is taken along with 2 other drugs (such as dexamethasone and ondansetron). This medicine may also be used to prevent nausea and vomiting after surgery.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• liver disease

Do not take this medicine if you take pimozide (Orap). Taking these medicines together could be life-threatening.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. This medicine can make birth control pills less effective. While taking this medicine and for 1 month after the last dose of this medicine, use birth control pills plus another birth control method. Talk with your healthcare provider about this. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine at the exact dosages and at the exact times as prescribed by your healthcare provider. The success of this treatment depends on taking these medicines in the proper dosages and at the proper times.

You may take this medicine with or without food. Take it with a full glass of water.

If you do not understand the directions, ask your healthcare provider or pharmacist to explain.

Do not start taking this medicine if you already have nausea and vomiting. Do not continue taking this medicine for more than 3 days after chemotherapy.

What if I miss a dose?

If you miss a dose, contact your healthcare provider right away for advice.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, headache.

What should I watch out for?

If you take warfarin (Coumadin), you need to have your blood clotting time checked for 2 weeks after each treatment with this medicine.

While taking this medicine and for 1 month after the last dose of this medicine, use birth control pills plus another birth control method. Talk with your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Heart rate less than 50 or greater than 100 beats per minute; fainting; unexplained fever; itching; pain when urinating.

Other: Tiredness, weakness, hiccups, loss of appetite, nausea, constipation, diarrhea, dizziness, headache.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods, may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab), and telithromycin (Ketek)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), and primidone (Mysoline)
• antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• anti-HIV medicines such as delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and stavudine (Zerit)
• antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• birth control pills, rings, patches, and implants and hormones such as conjugated estrogens (Premarin), estradiol (Estrace), medroxyprogesterone (Provera), and norethindrone (Aygestin, Camila, Jolivette, Micronor)
• chemotherapy medicines such as docetaxel (Taxotere), etoposide (Toposar, VePesid), ifosfamide (Ifex), imatinib (Gleevec), irinotecan (Camptosar), paclitaxel, vinblastine, vinorelbine (Navelbine), and vincristine
• corticosteroids such as dexamethasone and methylprednisolone (Medrol)
• diltiazem (Cardizem, Dilacor)
• isoniazid
• antidepressants such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox CR), nefazodone, paroxetine (Paxil), and sertraline (Zoloft)
• pimozide (Orap)
• ranolazine (Ranexa)
• rifampin (Rifadin, Rimactane)
• St. John's wort
• tolbutamide
• warfarin (Coumadin)

The effects of this medicine may be increased if you take it with grapefruit juice. Talk with your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.