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Fosaprepitant (Intravenous route)

Pronunciation:

fos-a-PRE-pi-tant dye-MEG-loo-meen

Brand Names:

  • Emend

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Fosaprepitant

Uses of This Medicine:

Fosaprepitant is used with other medicines to prevent nausea and vomiting caused by cancer treatment (chemotherapy). It acts in the brain to prevent nausea.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of fosaprepitant in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fosaprepitant in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Astemizole
  • Cisapride
  • Pimozide
  • Terfenadine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ado-Trastuzumab Emtansine
  • Amiodarone
  • Brentuximab Vedotin
  • Cabozantinib
  • Carbamazepine
  • Dasatinib
  • Docetaxel
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Elvitegravir
  • Etoposide
  • Everolimus
  • Fentanyl
  • Hydrocodone
  • Ifosfamide
  • Imatinib
  • Irinotecan
  • Nilotinib
  • Paclitaxel
  • Pazopanib
  • Piperaquine
  • Ponatinib
  • Regorafenib
  • Romidepsin
  • Sorafenib
  • Sunitinib
  • Tamoxifen
  • Temsirolimus
  • Vandetanib
  • Vemurafenib
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinorelbine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alprazolam
  • Desogestrel
  • Dexamethasone
  • Dienogest
  • Diltiazem
  • Drospirenone
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Ketoconazole
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Mestranol
  • Midazolam
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Rifampin
  • Tolbutamide
  • Triazolam

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a hospital or clinic. This medicine is given through a needle placed in one of your veins.

This medicine is usually given on the first day of your chemotherapy as part of a three-day regimen along with other medicines. Fosaprepitant is not for long-term use, but you may need to use this medicine again if you have more chemotherapy in the future.

This medicine comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

You should not receive this medicine if you are also using cisapride (Propulsid®) or pimozide (Orap®). Fosaprepitant may cause serious or life-threatening problems if used together with these medicines.

This medicine may cause serious allergic reactions. Tell your doctor or nurse right away if you have itching; hives; a rash; shortness of breath; trouble with breathing; trouble with swallowing; warmth or redness in your face, neck, arms, or upper chest; or any swelling of your hands, face, or mouth while you are receiving this medicine.

If you are also taking a blood thinner called warfarin (Coumadin®, Jantoven®), your doctor will need to check your blood after using this medicine.

Birth control pills may not work as well while you are using fosaprepitant. To keep from getting pregnant, use another form of birth control together with your pills during treatment and for one month after your last treatment. Other forms include condoms, diaphragms, and contraceptive foams or jellies.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Black, tarry stools
blurred vision
chills
confusion
cough
decreased urination
difficult or labored breathing
dizziness
dry mouth
fainting
fever
increase in heart rate
lightheadedness
lower back or side pain
nervousness
pain, swelling, or redness at the injection site
painful or difficult urination
pale skin
pounding in the ears
rapid breathing
shortness of breath
slow or fast heartbeat
sore throat
sunken eyes
tenderness, swelling, warmth, or skin discoloration at the injection site
thirst
tightness in the chest
ulcers, sores, or white spots in mouth
unusual bleeding or bruising
unusual tiredness or weakness
wheezing
wrinkled skin
Less common
Hard lump at the injection site
Rare
Blood in the urine
changes in patterns and rhythms of speech
changes in skin color
chest pain or discomfort
coma
convulsions
fast, slow, irregular, pounding, or racing heartbeat or pulse
general feeling of discomfort or illness
headache
increased sweating
increased thirst
lightheadedness, dizziness, or fainting
muscle pain or cramps
nausea or vomiting
pain, tenderness, or swelling of the foot or leg
slurred speech
swelling
swelling of the face, ankles, or hands
trouble with speaking
troubled breathing with exertion
wheezing
Incidence not known
Difficulty with swallowing
hives or welts
itching
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Acid or sour stomach
belching
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
continuing ringing or buzzing or other unexplained noise in ears
diarrhea
difficulty having a bowel movement (stool)
dizziness
feeling of indigestion
hair loss or thinning of the hair
hearing loss
hiccups
indigestion
lack or loss of strength
loss of appetite
pain in the chest below the breastbone
stomach discomfort, upset, or pain
swelling or inflammation of the mouth
weight loss
Less common
Feeling of warmth
pain or discomfort in chest, upper stomach, or throat
redness of the face, neck, arms, and occasionally, upper chest
sudden sweating
unusually warm skin
Rare
Abdominal or stomach distension or pain
abnormal dreams
blemishes on the skin
bumps on the skin
burning, dry, or itching eyes
change in taste
change in walking and balance
clumsiness or unsteadiness
confusion about identity, place, and time
difficulty with moving
discharge, excessive tearing
excess air or gas in the stomach
extreme thirst
false or unusual sense of well-being
flushed, dry skin
frequent urination
fruit-like breath odor
full feeling
heartburn
increased hunger
increased sensitivity of the skin to sunlight
increased urination
increased volume of pale, dilute urine
joint pain
muscle aching or cramping
muscle stiffness or weakness
oily skin
passing gas
pimples
redness or other discoloration of the skin
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
severe constipation
severe sunburn
sleepiness
sleeplessness
sweating
swollen joints
trouble performing routine tasks
trouble sleeping
unable to sleep
unexplained weight loss
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
weight gain
white patches in the mouth or throat or on the tongue
white patches with diaper rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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