Emend Injection Generic Name & Formulations
Fosaprepitant dimeglumine (prodrug of aprepitant) 150mg/vial; lyophilized pwd for IV infusion after reconstitution and dilution; contains polysorbate 80.
Substance P/NK1 receptor antagonist.
Caps—6; Bi-fold pack (2 x 80mg)—1; Tri-fold pack (1 x 125mg + 2 x 80mg)—1; Susp kit—1 (w. oral dispensers, supplies); Single-dose vial—1
Emend Injection Indications
In combination with other antiemetic agents, in patients ≥6mos of age for prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately to highly emetogenic cancer chemotherapy, including high-dose cisplatin.
Emend Injection Dosage and Administration
≥18yrs: Give with corticosteroid and 5-HT3 antagonist (see full labeling). Administer approx. 30mins prior to chemotherapy. 150mg IV over 20–30mins on Day 1.
<6mos or <6kg: not recommended. Give with 5-HT3 antagonist with or without corticosteroid (see full labeling). Administer approx. 30mins prior to chemotherapy. Single-day chemo: 6mos–<2yrs: 5mg/kg (max 150mg) IV once over 60mins; 2–<12yrs: 4mg/kg (max 150mg) IV once over 60mins; 12–17yrs: 150mg IV once over 30mins. Multi-day chemo: 6mos–<12yrs: 3mg/kg (max 115mg) IV once over 60mins on Day 1; then 2mg/kg (max 80mg) IV once over 60mins or may give 2mg/kg oral susp or caps (if ≥40kg & able to swallow caps) on Days 2 and 3. 12–17yrs: 115mg IV once over 30mins on Day 1; then 80mg IV once over 30mins or may give 80mg oral caps or susp (if unable to swallow caps) on Days 2 and 3.
Emend Injection Contraindications
Emend Injection Boxed Warnings
Emend Injection Warnings/Precautions
Not for chronic continuous use. Severe hepatic impairment. Injection: monitor for infusion site or hypersensitivity reactions; discontinue and treat appropriately if occur; do not reinitiate if symptoms (eg, flushing, erythema, dyspnea, hypotension, syncope) develop with first-time use. Avoid infusion into small veins or through a butterfly catheter. Elderly. Advise females of reproductive potential using hormonal contraceptives to use an effective alternative or back-up non-hormonal contraceptive (see Interactions). Pregnancy. Nursing mothers.
Emend Injection Pharmacokinetics
Emend Injection Interactions
See Contraindications. Monitor, and caution with, CYP3A4 substrates, including chemotherapy agents (eg, ifosfamide, vinblastine, vincristine). Avoid concomitant moderate-to-strong CYP3A4 inhibitors (eg, azole antifungals, macrolides, nefazodone, ritonavir, nelfinavir, diltiazem) or strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin). Potentiates dexamethasone (reduce its dose by 50%), methylprednisolone (reduce its IV dose by 25% and its oral dose by 50%), midazolam, alprazolam, triazolam. May antagonize warfarin (closely monitor INR for 2 weeks after starting each regimen), other CYP2C9 substrates, oral contraceptives (use alternative or backup method during and for 1 month after last dose).
Emend Injection Adverse Reactions
Fatigue, diarrhea, asthenia, dyspepsia, abdominal pain, hiccups, WBC count decreased, dehydration, ALT/AST increased, neutropenia, headache, anorexia, cough, hemoglobin decreased, dizziness, constipation, hypotension. Injection: also anemia, peripheral neuropathy, UTI, extremity pain, infusion-site reactions, anaphylaxis.
Emend Injection Clinical Trials
Emend Injection Note
Emend Injection Patient Counseling