fosaprepitant

Generic Name: fosaprepitant (FOS a PREP i tan t)Brand Names: Emend for Injection

What is fosaprepitant?

Fosaprepitant blocks the actions of chemicals in the body that trigger nausea and vomiting.

Fosaprepitant is used together with other medications to prevent nausea and vomiting that may be caused by cancer chemotherapy.

Fosaprepitant is given ahead of time and will not treat nausea or vomiting that you already have.

Fosaprepitant may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about fosaprepitant?

You should not receive fosaprepitant if you are taking cisapride (Propulsid) or pimozide (Orap). These drugs may cause life-threatening interactions when taken together with fosaprepitant. Before you receive fosaprepitant, tell your doctor if you have liver disease. You may need a dose adjustment or special tests to safely use this medication. Fosaprepitant can make birth control pills less effective, resulting in pregnancy. This effect can last for up to 28 days after your last dose of this medication. Talk to your doctor about the use of a non-hormonal back-up form of birth control (such as condoms, a diaphragm, or spermicides) during treatment with fosaprepitant, and for 1 month afterward.

There are many other medicines that can interact with fosaprepitant. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

What should I discuss with my health care provider before I receive fosaprepitant?You should not use this medication if you are allergic to fosaprepitant, aprepitant (oral Emend), or if you are taking any of the following drugs:

• cisapride (Propulsid); or

• pimozide (Orap).

The drugs listed above may cause life-threatening interactions when taken together with fosaprepitant.

Before you receive fosaprepitant, tell your doctor if you have liver disease. You may need a dose adjustment or special tests to safely use this medication. FDA pregnancy category B. Fosaprepitant is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while you are being treated with fosaprepitant. It is not known whether fosaprepitant passes into breast milk or if it could harm a nursing baby. Before you receive this medication, tell your doctor if you are breast-feeding a baby.

How is fosaprepitant given?

Fosaprepitant is given as an injection through a needle placed into a vein. You will receive this injection in a hospital or cancer treatment center. The medicine must be given slowly through an IV infusion, and can take at least 15 minutes to complete.

The first dose of fosaprepitant is usually given 30 minutes before your chemotherapy treatment begins.

You may also be given other medicines, including oral Emend (aprepitant capsules), for 3 or 4 days to further help prevent nausea and vomiting.

Fosaprepitant is not for long-term use.

What happens if I miss a dose?

Since fosaprepitant injection is given only once on the first day of your chemotherapy treatment, you are not likely to be on a dosing schedule.

What happens if I overdose?

An overdose of this medication is not likely to occur since it is given by a healthcare professional. However, overdose symptoms may include drowsiness and headache.

What should I avoid while receiving fosaprepitant?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are being treated with fosaprepitant.

Fosaprepitant side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• slow heart rate;

• pale skin, easy bruising or bleeding; or

• pain or burning when you urinate.

Less serious side effects may include:

• nausea, vomiting, heartburn, stomach pain;

• diarrhea or constipation;

• loss of appetite;

• hiccups;

• increased thirst or hot, dry skin;

• weakness, dizziness, tired feeling;

• headache;

• ringing in your ears;

• fever, chills, body aches, flu symptoms;

• sleep problems (insomnia); or

• pain or a hard lump where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Fosaprepitant Dosing Information

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

Fosaprepitant for injection is a prodrug of aprepitant to be administered intravenously as an infusion. Aprepitant is available in capsule form for oral administration. Fosaprepitant for injection (115 mg) may be substituted for aprepitant (125 mg) 30 minutes prior to chemotherapy, on day 1 only of the Chemotherapy-Induced Nausea and Vomiting (CINV) regimen as an infusion administered over 15 minutes.Initial dose of aprepitant as a part of the CINV regimen:125 mg orally one hour prior to chemotherapy on day 1. This dose can be substituted with fosaprepitant for injection (115 mg) administered intravenously as an infusion 30 minutes prior to chemotherapy.The first dose is then followed by aprepitant 80 mg orally once daily in the morning on days 2 and 3.Doses may be taken with or without food.Aprepitant/fosaprepitant are administered for 3 days as part of a regimen that also includes a corticosteroid and a 5-HT3 antagonist.The antiemetic effectiveness in patients receiving the aprepitant regimen throughout repeated cycles has been reported to be maintained in each of the multiple cycles. However, chronic continuous dosing is not recommended.

Usual Geriatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

No dosage adjustment is necessary for the elderly.

What other drugs will affect fosaprepitant?

Fosaprepitant can make birth control pills less effective, resulting in pregnancy. This effect can last for up to 28 days after your last dose of this medication. Talk to your doctor about the use of a non-hormonal back-up form of birth control (such as condoms, a diaphragm, or spermicides) during treatment with fosaprepitant and for at least 1 month after your treatment ends.

Before taking fosaprepitant, tell your doctor if you are using any of the following drugs:

• diltiazem (Cardizem, Cartia, Tiazac);

• tolbutamide (Orinase);

• a blood thinner such as warfarin (Coumadin);

• midazolam (Versed) or similar medicines such as Valium, Xanax, or Tranxene;

• an antidepressant such as nefazodone (Serzone) or paroxetine (Paxil);

• an antibiotic such as clarithromycin (Biaxin) or rifampin (Rifater, Rifamate);

• an antifungal medication such as itraconazole (Sporanox), or ketoconazole (Nizoral);

• certain cancer medicines such as etoposide (VePesid), irinotecan (Camptosar), ifosfamide (Ifex), imatinib (Gleevec), paclitaxel (Onxol, Taxol), vinblastine (Velban), or vincristine (Oncovin, Vincasar);

• HIV medicines such as nelfinavir (Viracept), lopinavir/ritonavir (Kaletra), or ritonavir (Norvir);

• seizure medication such as carbamazepine (Tegretol, Carbatrol) or phenytoin (Dilantin); or

• steroid medicine such as dexamethasone (Decadron, Hexadrol) or methylprednisolone (Medapred, Solu-Medrol).

This list is not complete and there may be other drugs that can interact with fosaprepitant. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about fosaprepitant.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.05. Revision Date: 08/03/2009 11:13:51 AM.