Emend (aprepitant)

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine should not be taken in combination with the following medicines, as it could increase the amount of these medicines in the blood, potentially causing serious side effects:

astemizole

cisapride

pimozide

terfenadine.

Aprepitant may also increase the blood levels of various other medicines, including the following:

benzodiazepines, eg alprazolam, midazolam, triazolam

dexamethasone

dihydroergotamine

docetaxel

ergotamine

etoposide

irinotecan

methylprednisolone

paclitaxel

vinorelbine.

If you are having treatment with any of these medicines, you should let your doctor know if you get any new or increased side effects after you start taking this medicine. Your doctor may need to adjust your doses.

Aprepitant may decrease the blood levels of the following medicines, which could make them less effective:

phenytoin

tolbutamide.

Aprepitant may decrease the anti-blood-clotting effect of the anticoagulant medicine warfarin. If you regularly take warfarin your blood clotting time (INR) should be monitored closely, both while you are taking this medicine and for two weeks following each three day course.

Aprepitant may reduce the effectiveness of hormonal contraceptives, eg the pill, mini-pill or patch. 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.

The following medicines are not recommended while you are having treatment with this medicine, as they could decrease the amount of aprepitant in your blood and make it less effective:

carbamazepine

phenobarbital

phenytoin

rifampicin

the herbal remedy St John's wort (Hypericum perforatum).

The following medicines should be used with caution while you are having treatment with this medicine, as they could increase the amount of aprepitant in your blood and so increase the risk of side effects:

clarithromycin

ketoconazole

ritonavir

telithromycin.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain aprepitant as the active ingredient.

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