Aprepitant

What is aprepitant?

Aprepitant is a medicine that is used to prevent vomiting (throwing up) and nausea (feeling like throwing up) due to chemotherapy (cancer medicines).

Aprepitant is a capsule and is taken by mouth. Certain pharmacies can also make aprepitant as a liquid. You may hear aprepitant called by its brand name, Emend.

Before giving aprepitant to your child

Tell your doctor if your child is allergic to aprepitant or any ingredient in the formulation.

How should you give your child aprepitant?

Follow these instructions when giving your child aprepitant:

• Give your child aprepitant by mouth as the capsule or the liquid. Give the first dose of aprepitant about an hour before your child receives the first dose of chemotherapy.
• Give aprepitant by mouth exactly as your doctor or pharmacist tells you.
• Aprepitant can be given with or without food.
• Measure the dose of aprepitant oral liquid with the special spoon or syringe that the pharmacist gave you.

What should you do if your child misses a dose of aprepitant?

If your child misses a dose of the medicine:

• Give your child the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose and give your child the next dose at the regular time.
• Give your child only one dose at a time. However, if your child vomits (throws up) less than 30 minutes after you gave a dose, give your child another dose. Check to make sure that you have enough aprepitant on hand to give your child the aprepitant doses planned for the next two days. You may need to contact your doctor or pharmacist to get more.

What are the possible side effects of aprepitant?

Your child may have some of these side effects while they take aprepitant. Check with your child's doctor if these side effects do not go away or they bother your child:

• Hiccups
• Feeling tired or weak
• Diarrhea (loose stools)
• Stomach pain
• Loss of appetite
• Dizziness
• Headache

The following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• Swelling of the face, lips, tongue or throat
• Wheezing, trouble breathing or shortness of breath
• Severe skin rash or hives (red raised spots on the skin)
• Signs of infection like fever, chills, sore throat, more phlegm (thick saliva, mucous, sputum) than usual or change in colour of phlegm, pain when urinating (peeing) or a wound that will not heal.

What safety measures should you take when your child is using aprepitant?

There are some medicines that should not be taken together with aprepitant or in some cases the dose of the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, non-prescription or herbal) including dexamethasone or warfarin.

What other important information should you know about aprepitant?

• Let your child’s doctor, nurse or pharmacist know if your child vomits (throws up) and retches (dry heaves) more than twice on a day that your child received chemotherapy.
• Keep all medicines out of your child’s sight and reach.
• Keep aprepitant capsules at room temperature in a cool, dry place away from sunlight. Do not store it in the bathroom.
• Keep aprepitant liquid in the refrigerator. Do not freeze this medicine.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
• Pregnancy should be avoided while taking this medication.

​​References

• Lexicomp Online, Pediatric & Neonatal Lexi-Drugs, Hudson, Ohio: Lexi-Comp, Inc.; April 11, 2016.
• Emend (aprepitant) [prescribing information]. Whitehouse Station, NJ: Merck & Co; December 2015.
  

Keep aprepitant out of your child’s sight and reach and locked up in a safe place. If your child takes too much aprepitant, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.