Indications for: EMEND INJECTION
In combination with other antiemetic agents, in patients ≥6mos of age for prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately to highly emetogenic cancer chemotherapy, including high-dose cisplatin.
≥18yrs: Give with corticosteroid and 5-HT3 antagonist (see full labeling). Administer approx. 30mins prior to chemotherapy. 150mg IV over 20–30mins on Day 1.
<6mos or <6kg: not recommended. Give with 5-HT3 antagonist with or without corticosteroid (see full labeling). Administer approx. 30mins prior to chemotherapy. Single-day chemo: 6mos–<2yrs: 5mg/kg (max 150mg) IV once over 60mins; 2–<12yrs: 4mg/kg (max 150mg) IV once over 60mins; 12–17yrs: 150mg IV once over 30mins. Multi-day chemo: 6mos–<12yrs: 3mg/kg (max 115mg) IV once over 60mins on Day 1; then 2mg/kg (max 80mg) IV once over 60mins or may give 2mg/kg oral susp or caps (if ≥40kg & able to swallow caps) on Days 2 and 3. 12–17yrs: 115mg IV once over 30mins on Day 1; then 80mg IV once over 30mins or may give 80mg oral caps or susp (if unable to swallow caps) on Days 2 and 3.
EMEND INJECTION Contraindications:
EMEND INJECTION Warnings/Precautions:
Not for chronic continuous use. Severe hepatic impairment. Injection: monitor for infusion site or hypersensitivity reactions; discontinue and treat appropriately if occur; do not reinitiate if symptoms (eg, flushing, erythema, dyspnea, hypotension, syncope) develop with first-time use. Avoid infusion into small veins or through a butterfly catheter. Elderly. Advise females of reproductive potential using hormonal contraceptives to use an effective alternative or back-up non-hormonal contraceptive (see Interactions). Pregnancy. Nursing mothers.
EMEND INJECTION Classification:
Substance P/NK1 receptor antagonist.
EMEND INJECTION Interactions:
See Contraindications. Monitor, and caution with, CYP3A4 substrates, including chemotherapy agents (eg, ifosfamide, vinblastine, vincristine). Avoid concomitant moderate-to-strong CYP3A4 inhibitors (eg, azole antifungals, macrolides, nefazodone, ritonavir, nelfinavir, diltiazem) or strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin). Potentiates dexamethasone (reduce its dose by 50%), methylprednisolone (reduce its IV dose by 25% and its oral dose by 50%), midazolam, alprazolam, triazolam. May antagonize warfarin (closely monitor INR for 2 weeks after starting each regimen), other CYP2C9 substrates, oral contraceptives (use alternative or backup method during and for 1 month after last dose).
Fatigue, diarrhea, asthenia, dyspepsia, abdominal pain, hiccups, WBC count decreased, dehydration, ALT/AST increased, neutropenia, headache, anorexia, cough, hemoglobin decreased, dizziness, constipation, hypotension. Injection: also anemia, peripheral neuropathy, UTI, extremity pain, infusion-site reactions, anaphylaxis.
Generic Drug Availability:
Caps—6; Bi-fold pack (2 x 80mg)—1; Tri-fold pack (1 x 125mg + 2 x 80mg)—1; Susp kit—1 (w. oral dispensers, supplies); Single-dose vial—1