Aprepitant, Oral

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KEY POINTS

• This medicine is taken by mouth to prevent nausea and vomiting from chemotherapy or after surgery. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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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 happen during or after chemotherapy. It is usually taken along with 2 other medicines (such as dexamethasone and ondansetron). This medicine may also be used to prevent nausea and vomiting after surgery.

This medicine may be used to treat other conditions as determined by your healthcare provider.

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 hormonal birth control less effective. If you are using hormonal birth control medicines (such as birth control pills, skin patches, implants, and certain IUDs) you should also use a backup method of birth control (such as a condom) during treatment with this medicine and for up to 1 month after the last dose of this medicine. 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. Do not take more or less or take it longer than prescribed. Ask your healthcare provider or pharmacist about anything you do not understand.

Check with your healthcare provider before using this medicine in children under age 18.

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

Do not start taking this medicine if you already have nausea and vomiting.

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. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, 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.): Slow, fast, or irregular heartbeat; severe dizziness or fainting; unexplained fever; itching; pain when urinating; cough; sore throat; severe skin redness, burning, peeling, or blistering.

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:

• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), and silodosin (Rapaflo)
• Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), and midazolam (Versed)
• Antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antidepressants such as fluoxetine (Prozac), nefazodone, and vilazodone (Viibryd)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antipsychotic medicines such as aripiprazole (Abilify), haloperidol (Haldol), lurasidone (Latuda), pimozide (Orap), and quetiapine (Seroquel)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Cancer medicines such as abiraterone (Zytiga), docetaxel (Docefrez, Taxotere), enzalutamide (Xtandi), etoposide, ifosfamide (Ifex), imatinib (Gleevec), irinotecan (Camptosar), mitotane (Lysodren), paclitaxel (Abraxane, Taxol), tamoxifen, vinblastine, vincristine (Marqibo), and vinorelbine (Navelbine)
• Cimetidine (Tagamet)
• Colchicine (Colcrys)
• Corticosteroids such as dexamethasone, methylprednisolone (Medrol, Solu-Medrol), and prednisone (Prednisone Intensol)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), and tolbutamide
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Heart medicines such as amiodarone (Cordarone, Pacerone), amlodipine (Norvasc), amlodipine/atorvastatin (Caduet), diltiazem (Cardizem, Cartia, Tiazac), dronedarone (Multaq), eplerenone (Inspra), losartan (Cozaar), nicardipine (Cardene), quinidine, ranolazine (Ranexa), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• Hormonal birth control pills, implants, shots, patches, vaginal rings, and IUDs, and hormones such as conjugated estrogens (Premarin), estradiol (Climara, Estrace, Estraderm, Vivelle), medroxyprogesterone (Depo-Provera, Provera), and norethindrone (Aygestin, Micronor) (talk with your healthcare provider if you need birth control)
• Ivacaftor (Kalydeco)
• Lomitapide (Juxtapid)
• Medicines to treat low sodium levels such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), cilostazol (Pletal), rivaroxaban (Xarelto), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as bosentan (Tracleer), sildenafil (Revatio), and tadalafil (Adcirca)
• Migraine medicines such as dihydroergotamine (D.H.E. 45, Migranal), eletriptan (Relpax), and ergotamine (Ergomar)
• Naloxegol (Movantik)
• Pain medicines such as celecoxib (Celebrex), fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), and oxycodone (OxyContin, Roxicodone)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Simeprevir (Olysio)
• Sleeping pills such as flurazepam, temazepam (Restoril), and triazolam (Halcion)
• St. John's wort
• Sulfa antibiotics such as sulfadiazine, sulfamethoxazole/trimethoprim (Bactrim, Septra), and sulfasalazine (Azulfidine)

Ask your healthcare provider or pharmacist if you need to avoid products that contain grapefruit, Seville oranges, and tangelos while you are taking this medicine. These fruits and juices can affect the way this medicine works and may increase your risk of serious side effects.

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.

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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.