Emend (aprepitant)

How does it work?

Emend capsules contain the active ingredient aprepitant, which is a type of medicine called a neurokinin receptor antagonist. It is used to prevent nausea and vomiting that can be caused by chemotherapy treatment for cancer.

Vomiting is controlled by an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness (nausea) and for the vomiting reflex. It is activated when it receives nerve messages from another area of the brain called the chemoreceptor trigger zone (CTZ) and when it receives nerve messages from the gut.

A protein called substance P is involved in transmitting nerve messages to the vomiting centre. Substance P acts on neurokinin-1 receptors that are found in the vomiting centre in the brain.

Chemotherapy causes substance P to activate these neurokinin-1 receptors, resulting in feelings of sickness.

Aprepitant works by blocking the neurokinin-1 receptors in the brain. This stops substance P from acting on them and so prevents nausea and vomiting.

Aprepitant is used to prevent acute and delayed sickness that can be caused by chemotherapy, in particular by a medicine called cisplatin. It is given in combination with a steroid, eg dexamethasone, and a 5HT3 antagonist, eg ondansetron, as part of a three day regimen around each cycle of chemotherapy. These medicines all work in a different way to prevent sickness.

Emend capsules should be swallowed whole.

What is it used for?

Preventing nausea and vomiting caused by chemotherapy for cancer.

Warning!

This medicine could make hormonal contraceptives, eg the pill, mini-pill or patch less effective at preventing pregnancy. If you are using hormonal contraceptives, you should use an extra back-up method of contraception, eg condoms, to prevent pregnancy, both during treatment with this medicine and for two months after the last dose. Alternatively, your doctor may suggest that you use a different non-hormonal method of contraception instead. Ask your doctor or pharmacist for further advice.

Use with caution in

Moderate to severely decreased liver function.

Not to be used in

Rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency (Emend capsules contain sucrose).

This medicine is not recommended for children and adolescents under 18 years of age, as its safety and efficacy have not been studied in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been studied. It should not be used during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

It is not known if this medicine pases into breast milk. Women who need this medicine should not breastfeed during treatment. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Hiccups

Feeling weak

Fatigue

Disturbances of the gut, such as constipation, diarrhoea, indigestion, abdominal pain, flatulence

Headache

Loss of appetite

Dizziness

Thirst

Disorientation

Anxiety

Abnormal dreams

Hot flushes

Sensation of ringing or other noise in the ears (tinnitus)

Slowed heart rate

Cough

Conjunctivitis

Dry mouth

Skin reactions such as rash or itching

Muscle cramps

Increased need to pass urine, pain passing urine

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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