Emend Tri-Pack

In combination w/ other antiemetic agents for the prevention of acute & delayed nausea & vomiting associated w/ initial & repeat courses of highly emetogenic cancer chemotherapy, including high-dose cisplatin, & moderately emetogenic cancer chemotherapy.

125 mg 1 hr prior to chemotherapy on day 1 & 80 mg once daily in the morning on days 2 & 3, as part of a regimen that includes a corticosteroid & a 5-HT₃ antagonist.

May be taken with or without food.

Hypersensitivity. Concurrent use w/ pimozide, terfenadine, astemizole, or cisapride.

Caution in patients receiving concomitant orally administered medicinal products that are primarily metabolized through CYP3A4. Closely monitor INR in patients on chronic warfarin therapy during the 2-wk period, particularly at 7-10 days, following initiation of the 3-day regimen of Emend w/ each chemotherapy cycle. No clinical data in patients w/ severe hepatic insufficiency (Child-Pugh score >9). Alternative or back-up methods of contraception should be used during treatment & for 1 mth following the last dose of Emend. Should be used during pregnancy only if potential benefit justifies potential risk to mother & fetus. Discontinue nursing or discontinue Emend therapy. Safety & effectiveness in ped patients have not been established.

Highly emetogenic chemotherapy: Hiccups, increased ALT, dyspepsia, constipation, headache, decreased appetite. Moderately emetogenic chemotherapy: Fatigue.

Increased plasma conc of CYP3A4 substrates eg, pimozide, terfenadine, astemizole, cisapride, dexamethasone, methylprednisolone, midazolam, alprazolam, triazolam. Decreased plasma conc of CYP2C9 substrates eg, S(-) warfarin, tolbutamide, phenytoin. Caution & careful monitoring when co-administered w/ chemotherapeutic agents metabolized primarily or in part by CYP3A4 eg, etoposide, vinorelbine, docetaxel, ifosfamide, cyclophosphamide, irinotecan, paclitaxel. Post-marketing events of neurotoxicity after co-administration w/ ifosfamide. Efficacy of hormonal contraceptives may be reduced during & for 28 days after administration of Emend. Increased plasma conc w/ strong CYP3A4 inhibitors eg, ketoconazole. Decreased plasma conc w/ strong CYP3A4 inducers eg, rifampin. Increased AUC of aprepitant & diltiazem. Decreased AUC of aprepitant & paroxetine.

Antiemetics / Supportive Care Therapy

A04AD12 - aprepitant ; Belongs to the class of other antiemetics.

P₁S₁S₃