Why is this medication prescribed?

Aprepitant is primarily prescribed to:

• Prevent Nausea and Vomiting Caused by Chemotherapy: Aprepitant is used to prevent nausea and vomiting associated with highly emetogenic (likely to cause severe nausea and vomiting) chemotherapy, such as certain treatments for cancer. It is especially effective in preventing delayed nausea and vomiting, which can occur more than 24 hours after chemotherapy.
• Prevent Postoperative Nausea and Vomiting: It is also used to prevent nausea and vomiting that can occur after surgery.

Aprepitant works by blocking the action of neurokinin-1 (NK1) receptors in the brain, which are involved in triggering nausea and vomiting.

How should this medicine be used?

How Aprepitant Should Be Used:

• Forms and Dosage: Aprepitant is available in capsules and as an oral suspension. The capsules are typically taken by mouth with or without food, while the oral suspension is taken by mouth. The specific dosage and duration of treatment depend on the type of chemotherapy being received, the patient’s overall condition, and the purpose of the medication (chemotherapy-induced nausea or postoperative nausea).
• Administration Guidelines: When used for chemotherapy, Aprepitant is usually taken one hour before the start of chemotherapy on Day 1, followed by doses in the morning on Days 2 and 3. For postoperative nausea, it is generally taken within 3 hours before anesthesia induction.
• Combination Therapy: It is often used in combination with other antiemetic medications, such as dexamethasone or a 5-HT3 receptor antagonist (like ondansetron), to enhance its effectiveness.
• Important Considerations: Follow the prescribed schedule carefully. Do not skip doses, even if you do not feel nauseated, as the medication works best when taken consistently. Swallow the capsules whole without breaking, crushing, or chewing them. The oral suspension should be shaken well before use and measured with the provided dosing device to ensure accuracy.

If you have any specific questions or concerns about how to use Aprepitant, it’s best to discuss them with your healthcare provider.

Other uses for this medicine

Aprepitant may be used off-label for other types of nausea and vomiting, such as that associated with radiation therapy, opioid use, or cyclic vomiting syndrome. It may also be prescribed to help manage nausea and vomiting in palliative care settings.

What special precautions should I follow?

Special Precautions to Follow When Using Aprepitant:

• Allergies: Inform your doctor if you are allergic to Aprepitant or any other medications, or if you have any other types of allergies (e.g., to foods, dyes, or preservatives).
• Medical History: Share your full medical history with your healthcare provider, especially if you have liver disease, are pregnant, or are breastfeeding.
• Drug Interactions: Aprepitant may interact with several medications. Provide a full list of all medications, supplements, and herbal products you are taking.
• Hormonal Contraceptives: Aprepitant may reduce the effectiveness of hormonal birth control methods, such as pills, patches, and implants. Alternative or additional non-hormonal contraceptive methods (like condoms) should be used during treatment and for at least one month after the last dose.
• Pregnancy and Breastfeeding: Discuss the potential risks and benefits of using Aprepitant if you are pregnant, planning to become pregnant, or breastfeeding. It is not known if Aprepitant passes into breast milk.
• Liver Function: Aprepitant is metabolized in the liver. Patients with liver problems should use it with caution, and regular monitoring of liver function may be necessary.
• Surgery and Anesthesia: If you are having surgery, including dental surgery, inform your surgeon or dentist that you are taking Aprepitant.
• Adherence to Prescription: Follow the prescribed dosage schedule closely. Do not take more or less than directed by your healthcare provider, and do not skip doses.

If you have any specific health conditions or concerns, it’s important to discuss them with your healthcare provider to ensure Aprepitant is appropriate for you.

What special dietary instructions should I follow?

There are no specific dietary restrictions when taking Aprepitant. You can take it with or without food. However, maintaining a balanced diet might help minimize any potential nausea or gastrointestinal discomfort.

What should I do if I forget a dose?

• If you miss a dose of Aprepitant, take it as soon as you remember, unless it is almost time for the next dose. In that case, skip the missed dose and continue with your regular schedule.
• Do not double the dose to make up for a missed one.

What side effects can this medication cause?

Aprepitant can cause a range of side effects, from mild to more severe. Not everyone experiences these side effects, and some people may experience only minor issues.

Common Side Effects:

• Gastrointestinal Issues:
  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
• General Symptoms:
  • Fatigue or tiredness
  • Loss of appetite
  • Hiccups
• Neurological Effects:
  • Headache
  • Dizziness
• Skin Reactions:
  • Mild rash or itching

Serious Side Effects: While less common, some side effects may require immediate medical attention:

• Severe Allergic Reactions:
  • Rash, itching, or swelling (especially of the face, tongue, or throat)
  • Severe dizziness
  • Difficulty breathing
• Liver Issues:
  • Yellowing of the skin or eyes (jaundice)
  • Dark urine
  • Unusual tiredness
  • Upper right-sided stomach pain
• Heart Issues:
  • Irregular heartbeat
  • Fainting or lightheadedness
• Signs of Infection:
  • Fever, chills, or sore throat (as Aprepitant may affect white blood cell count)

These often go away on their own. However, if they persist or worsen, contact your healthcare provider. If you experience any symptoms of a severe allergic reaction, liver issues, or heart problems, seek medical attention immediately.

What should I know about storage and disposal of this medication?

Storage and Disposal of Aprepitant:

• Storage:
  • Capsules: Store Aprepitant capsules at room temperature (between 68°F to 77°F or 20°C to 25°C). Keep them in a tightly closed container, away from moisture, heat, and direct light.
  • Oral Suspension: If using the oral suspension, store it at room temperature and discard any unused portion after 72 hours if not refrigerated. Do not freeze the suspension.
  • Keep all forms of Aprepitant out of reach of children and pets.
• Disposal:
  • Do not flush Aprepitant down the toilet or pour it down a drain unless instructed to do so.
  • The best way to dispose of medication is through a medication take-back program. Check with your local pharmacy or waste disposal service for options.

In case of emergency/overdose

• Signs of Overdose: Symptoms of overdose may include severe dizziness, fainting, severe nausea or vomiting, or other unusual symptoms.
• Actions to Take: If you suspect an overdose, call your local poison control center at 1-800-222-1222 (in the U.S.) or seek emergency medical attention immediately. If the person is not breathing, has collapsed, or is unresponsive, call emergency services (911 in the U.S.) right away.

What other information should I know?

• Regular Monitoring: Regular follow-ups and monitoring by your healthcare provider are essential to check your progress and manage any potential side effects.
• Inform All Healthcare Providers: Make sure to inform all healthcare professionals, including your dentist, that you are taking Aprepitant, as it may interact with other medications.
• Medication List: Keep an updated list of all medications you are taking (prescription, non-prescription, and supplements) and share this with your healthcare provider.
• Avoid Alcohol: It’s advisable to avoid or limit alcohol consumption while taking Aprepitant, as it can increase the risk of certain side effects.
• Driving and Operating Machinery: Aprepitant can cause dizziness or tiredness. Avoid driving or operating heavy machinery until you know how the medication affects you.

If you have any further questions or need clarification, consult your healthcare provider or pharmacist for personalized advice.