Emend Information and Uses

Emend

Emend Overview

Emend (generic: aprepitant) is a prescription medication used to prevent nausea and vomiting caused by certain cancer treatments or surgery in adults. Emend belongs to a group of drugs called neurokinin 1 (NK1) antagonists, which block a natural substance called neurokinin from causing nausea and vomiting.

This medication comes in capsule and injectable forms. Emend is taken as 3 doses over 3 days.

Common side effects of Emend include constipation, nausea, and tiredness.

Uses of Emend

Emend is a prescription medication used in adults to PREVENT nausea and vomiting:

caused by certain anti-cancer (chemotherapy) medicines. When used for this purpose, Emend is always used with other medicines.
after surgery.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Side Effects of Emend

Emend may cause serious side effects, including:

Serious allergic reactions. Allergic reactions can happen with Emend and may be serious. Stop taking Emend and call your doctor right away if you have any of these signs or symptoms of an allergic reaction: hives, rash, itching, trouble breathing or swallowing.
Severe skin reactions may occur rarely.

In people taking Emend to prevent nausea and vomiting caused by chemotherapy, the most common side effects of Emend include:

tiredness
nausea
hiccups
constipation
diarrhea
loss of appetite
headache
hair loss

In people taking Emend to prevent nausea and vomiting after surgery, the most common side effects are:

constipation
nausea
itch
fever
low blood pressure
headache

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of Emend. For more information ask your doctor or pharmacist.

Emend Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take any of the following medicines as these medicines may interfere with each other:

"blood thinners" (Coumadin, Jantoven)
hormonal contraceptives (birth control)
rifampin and other rifamycin antibiotics
some chemotherapy medicines
ritonavir (Norvir) and other protease inhibitors
ketoconazole and other antifungal medicines
paroxetine (Paxil)
dexamethasone or other corticosteroids
erythromycin and other antibiotics
alprazolam and other sedatives
diltiazem
tolbutamide
phenytoin (Dilantin)

The following is a list of medicines that could cause serious or life-threatening problems if taken with Emend.

Orap (pimozide)
Seldane (terfenadine)
Hismanal (astemizole)
Propulside (cisapride)
St. John's Wort (an herbal supplement)

This is not a complete list of medicines that may interact with Emend. Ask your doctor or pharmacist for more information.

Emend Precautions

Taking Emend with warfarin (Coumadin) may result in a decrease in INR or prothrombin time, tests that measure how long it takes for blood to clot. Tell your doctor if you take Coumadin (warfarin).

The effectiveness of hormonal contraceptives (birth control), if taken with Emend, and for 28 days following the last dose of Emend, may be reduced. Alternative or back-up methods of contraception (birth control) should be used during treatment with Emend and for 1 month following the last dose of Emend.

Tell your doctor if you have liver problems. There have been no studies in patients taking Emend with severe liver impairment.

Some medicines should not be taken with Emend. Tell your doctor about the medicines you take. Especially tell your doctor if you take:

Orap (pimozide)
Seldane (terfenadine)
Hismanal (astemizole)
Propulside (cisapride)
St. John's Wort (an herbal supplement)

Taking Emend with any of these medicines could cause serious or life-threatening problems. This is not a complete list of medicines that may interact with Emend. Ask your doctor or pharmacist for more information.

Emend Food Interactions

Grapefruit and grapefruit juice may interact with Emend and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Inform MD

Tell your doctor if you are allergic to Emend or any other medicines.

Before you take Emend tell your doctor if:

you have any medical conditions
you are pregnant or intend to become pregnant
you are breastfeeding or plan to breastfeed

"blood thinners" (Coumadin, Jantoven)
hormonal contraceptives (birth control)
rifampin and other rifamycin antibiotics
some chemotherapy medicines
ritonavir (Norvir) and other protease inhibitors
ketoconazole and other antifungal medicines
paroxetine (Paxil)
dexamethasone or other corticosteroids
erythromycin and other antibiotics
alprazolam and other sedatives
diltiazem
tolbutamide
phenytoin (Dilantin)

The following is a list of medicines that could cause serious or life-threatening problems if taken with Emend.

Orap (pimozide)
Seldane (terfenadine)
Hismanal (astemizole)
Propulside (cisapride)
St. John's Wort (an herbal supplement)

This is not a complete list of medicines that may interact with Emend. Ask your doctor or pharmacist for more information.

Emend and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if Emend will harm your unborn baby. Emend has not been studied in pregnant women. Emend should be used during pregnancy only if clearly needed.

Women who use birth control medicines containing hormones to prevent pregnancy (birth control pills, skin patches, implants, and certain IUDs) should also use a back-up method of birth control during treatment with Emend and for up to 1 month after using Emend to prevent pregnancy.

Emend and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if Emend is excreted in human breast milk or if it will harm your nursing baby.

Emend Usage

Emend comes in two forms, capsules to be taken by mouth and Emend for intravenous (IV) injection. Emend is usually taken once daily, with or without food during the first few days of chemotherapy treatment. It is usually taken one hour before the first dose of chemotherapy, and then each morning for two more days. In the case of surgery, Emend is usually taken as one dose within 3 hours before the start of surgery (to prevent nausea and vomiting caused by surgery).

Emend Dosage

Take Emend exactly as prescribed. If you take too much Emend, call your doctor, local emergency department or poison control center right away.  If you are receiving cancer chemotherapy, Emend is taken as 3 doses over 3 days - starting on the day you have chemotherapy, and the two days after chemotherapy. There are two ways that your doctor may prescribe Emend for you:

1. Capsules of Emend by mouth for all 3 doses:

You should get a package that has three capsules of Emend.
Day 1 (Day of chemotherapy): Take one 125 mg capsule of Emend (white and pink) by mouth 1 hour before you start your chemotherapy treatment.
Day 2 and Day 3 (the two days after chemotherapy): Take one 80 mg capsule of Emend (white) by mouth, each morning for the 2 days after your chemotherapy treatment.

2. Intravenous (IV) injection into a vein the first day, then capsules by mouth on the two days after chemotherapy:

Day 1 (Day of chemotherapy): Emend will be given to you by intravenous (IV) injection in your vein 30 minutes before you start your chemotherapy treatment.
You should get a package that has two capsules of Emend.
Day 2 and Day 3 (the two days after chemotherapy): Take one 80 mg capsule of Emend (white) by mouth, each morning for the 2 days after your chemotherapy treatment.

3. Emend for Injection (IV) 150 mg given on Day 1 only.

Day 1 (Day of chemotherapy): Emend for Injection 150 mg will be given to you by infusion in your vein (intravenous) about 30 minutes before you start your chemotherapy treatment.

If you are receiving chemotherapy, Emend may be taken with or without food.

If you are having surgery:  

Your doctor will prescribe a 40 mg capsule of Emend for you before surgery. You take Emend within three hours before surgery.
Follow your doctor’s instructions about restrictions on eating and drinking before surgery. 
If you take the blood thinner medicine warfarin sodium (Coumadin, Jantoven), your doctor may do blood tests after you take Emend to check your blood clotting.