Emend

Emend prevents nausea and vomiting associated with chemotherapy and surgery. Do not drive or operate heavy machinery until you know how Emend affects you.

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Pharmacist Trey Robinson, PharmD summarizes the uses, common side effects, and warnings for the Antiemetics class of medications
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Pharmacist Trey Robinson, PharmD summarizes the uses, common side effects, and warnings for the Antiemetics class of medications
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Pharmacist Trey Robinson, PharmD summarizes the uses, common side effects, and warnings for the antiemetics class of medications

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Uses of Emend

Updated: 

Emend is a prescription medicine used in adults to prevent nausea and vomiting:

Capsule:

  • prevent nausea and vomiting that may occur within 24 hours after receiving chemotherapy treatment
  • prevent delayed nausea and vomiting that may occur several days after receiving chemotherapy medications
  • prevent nausea and vomiting caused by surgery

​Injection:

  • prevent nausea and vomiting that may occur within 24 hours after receiving chemotherapy treatment
  • prevent delayed nausea and vomiting that may occur several days after receiving chemotherapy medications

Emend is not used to treat nausea and vomiting that you already have.

Emend should not be used continuously for a long time (chronic use).

It is not known if Emend is safe and effective in children.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
 

Emend Drug Class

Emend is part of the drug class:

Side Effects of Emend

In people taking Emend capsule to prevent nausea and vomiting caused by chemotherapy, the most common side effects include:

  • tiredness
  • nausea
  • hiccups
  • constipation
  • diarrhea
  • loss of appetite
  • headache
  • hair loss

In people taking Emend capsule to prevent nausea and vomiting after surgery, the most common side effects are:

  • constipation
  • nausea
  • itching
  • fever
  • low blood pressure
  • headache

In people taking Emend injection to prevent nausea and vomiting caused by chemotherapy, the most common side effects include:

  • hiccups
  • weakness or tiredness
  • changes in liver function blood test results. Your doctor will check you for this.
  • headache
  • constipation
  • loss of appetite
  • indigestion
  • diarrhea
  • belching
  • infusion site reactions (pain, hardening, redness, or itching at the site of injection)

This is not a complete list of Emend side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Emend Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • anticoagulants ('blood thinners') such as warfarin (Coumadin)
  • antifungals such as itraconazole (Sporanox), ketoconazole (Nizoral), and lansoprazole
  • benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and triazolam (Halcion)
  • diltiazem (Cardizem, Dilacor, Tiazac)
  • cancer chemotherapy medications such as docetaxel (Taxotere), etoposide (Toposar, VePesid), ifosfamide (Ifex), imatinib (Gleevec), irinotecan (Camptosar), paclitaxel (Taxol), tamoxifen (Nolvadex), vinblastine, vincristine (Vincasar), and vinorelbine (Navelbine)
  • carbamazepine (Tegretol)
  • clarithromycin (Biaxin)
  • diltiazem (Cardizem, Dilacor, Tiazac)
  • HIV protease inhibitors such as nelfinavir (Viracept) and ritonavir (Norvir)
  • hormonal contraceptives (birth control pills, patches, rings, and injections)
  • nefazodone (Serzone)
  • oral steroids such as dexamethasone (Decadron, Dexone)
  • methylprednisolone (Medrol)
  • paroxetine (Paxil, Pexeva)
  • phenytoin (Dilantin)
  • rifampin (Rifadin, Rimactane)
  • tolbutamide (Orinase)
  • troleandomycin (TAO)
  • pimozide (Orap)
  • terfenadine (Seldan)
  • astemizole (Hismanal)
  • cisapride (Propulsid)

This is not a complete list of all drug interactions. Ask your doctor or pharmacist for more information.

Emend Precautions

Emend may cause serious side effects, including:

  • Serious allergic reactions. Allergic reactions can happen with Emend and may be serious. Stop taking Emend and call your doctor right away if you have any of these signs or symptoms of an allergic reaction:
    • hives
    • rash
    • itching
    • trouble breathing or swallowing.
  • Severe skin reactions may occur rarely.

Do not take Emend if you:

  • are allergic to any of the ingredients in Emend 
  • are taking pimozide (Orap), terfenadine (Seldan), astemizole (Hismanal), or cisapride (Propulsid)

Taking Emend with any of these medicines could cause serious or life-threatening problems.

Emend Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of this medication, there are no specific foods that you must exclude from your diet.

Inform MD

Before you take Emend, tell your doctor if you:

  • have liver problems
  • are pregnant or plan to become pregnant. It is not known if Emend can harm your unborn baby. Women who use birth control medicines containing hormones to prevent pregnancy (birth control pills, skin patches, implants, and certain IUDs) should also use a back-up method of birth control during treatment with EMEND and for up to 1 month after using EMEND to prevent pregnancy.
  • are breastfeeding

Tell your doctor about all the medicines you are taking or plan to take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Emend and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category B. There are no well-done studies that have been done in humans with Emend. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Emend and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Emend crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using this medication.

Emend Usage

Take Emend exactly as prescribed.

Emend is given for 3 days as part of the chemotherapy induced nausea and vomiting (CINV) regimen that includes a corticosteroid and a 5-HT3 antagonist. 

  • The recommended dose of Emend is 125 mg orally 1 hour prior to chemotherapy treatment (Day 1) and 80 mg orally once daily in the morning on Days 2 and 3. 
  • Emend (fosaprepitant dimeglumine) for Injection may be substituted for oral Emend (125 mg) on Day 1 only as part of the CINV regimen. 

High emetogenic cancer (Single Dose Regimen): Emend for Injection (150 mg) is administered on Day 1 only as an infusion over 20-30 minutes initiated approximately 30 minutes prior to chemotherapy. No capsules of Emend are administered on Days 2 and 3. Emend for Injection is part of a regimen to prevent nausea and vomiting induced by chemotherapy that includes a corticosteroid and a 5-HT3 antagonist. 

High and moderate emetogenic cancer (3-Day Dosing Regimen): Emend for Injection (115 mg) is administered on Day 1 as an infusion over 15 minutes initiated approximately 30 minutes prior to chemotherapy. Emend capsules (80 mg) are given orally on Days 2 and 3. Emend for Injection and Emend capsules are part of a regimen to prevent nausea and vomiting induced by chemotherapy that includes a corticosteroid and a 5-HT3 antagonist. 

For prevention of Postoperative Nausea and Vomiting (PONV): Emend capsule will be given 3 hours prior to administration of anesthesia.

If you take the blood thinner medicine warfarin (Coumadin, Jantoven), your doctor may do blood tests after you take Emend to check your blood clotting.

 

Emend Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

  • the condition being treated
  • other medical conditions you have
  • other medications you are taking
  • how you respond to this medication
  • your weight
  • your height
  • your age
  • your gender

Emend Capsules:

If you are receiving cancer chemotherapy, Emend is taken as 3 doses over 3 days - starting on the day you have chemotherapy, and the two days after chemotherapy. There are two ways that your doctor may prescribe Emend for you:

  1. Capsules of Emend by mouth for all 3 doses:
    • You should get a package that has three capsules of Emend.
    • Day 1 (Day of chemotherapy): Take one 125-mg capsule of Emend (white and pink) by mouth 1 hour before you start your chemotherapy treatment.
    • Day 2 and Day 3 (the two days after chemotherapy): Take one 80-mg capsule of Emend (white) by mouth, each morning for the 2 days after your chemotherapy treatment.
      Or 
  2. Intravenous (IV) injection into a vein the first day, then capsules by mouth on the two days after chemotherapy:
    • Day 1 (Day of chemotherapy): Emend will be given to you by intravenous (IV) injection in your vein 30 minutes before you start your chemotherapy treatment.
    • You should get a package that has two capsules of Emend.
    • Day 2 and Day 3 (the two days after chemotherapy): Take one 80-mg capsule of EMEND (white) by mouth, each morning for the 2 days after your chemotherapy treatment.

If you are receiving chemotherapy, Emend may be taken with or without food.

If you are having surgery:  Your doctor will prescribe a 40-mg capsule of Emend for you before surgery. You take Emend within three hours before surgery. Follow your doctor’s instructions about restrictions on eating and drinking before surgery.

Emend Injection:

You will receive Emend for Injection in one of two ways:

1. Emend for Injection 150 mg given on Day 1 only.

  • Day 1 (Day of chemotherapy): Emend for Injection 150 mg will be given to you by infusion in your vein (intravenous) about 30 minutes before you start your chemotherapy treatment.

Or

2. Emend for Injection 115 mg given along with capsules of Emend.

  • Day 1 (Day of chemotherapy): Emend for Injection 115 mg will be given to you by infusion in your vein (intravenous) about 30 minutes before you start your chemotherapy treatment.
  • You will get a prescription for two capsules of Emend.
  • Day 2 and Day 3 (the two days after chemotherapy): Take one 80-mg capsule of Emend (white) by mouth, each morning for the 2 days after your chemotherapy treatment.

The recommended oral dosage of Emend for the postoperative nausea and vomiting (PONV) indication is 40 mg within 3 hours prior to induction of anesthesia.

Emend Overdose

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

  • Storage requirements:
    • Capsule: Store at room temperature, between 68°F and 77°F (20°C and 25°C).
    • Injection: Store at 36-46°F (2-8°C)
  • Keep Emend and all medicines out of the reach of children.