Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Emend
  2. Fosinvez

Descriptions


Fosaprepitant injection is used with other medicines to prevent nausea and vomiting caused by cancer treatment (chemotherapy). It acts in the brain to prevent nausea.

This medicine is to be given only by or under the direct supervision of your doctor.

This product is available in the following dosage forms:

  • Powder for Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of fosaprepitant injection in children younger than 6 months of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fosaprepitant injection in the elderly. However, elderly patients are more likely to have liver, kidney, or heart problems, which may require caution in patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Flibanserin
  • Levoketoconazole
  • Lomitapide
  • Pimozide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adagrasib
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amprenavir
  • Atazanavir
  • Benzhydrocodone
  • Boceprevir
  • Brexpiprazole
  • Buprenorphine
  • Carbamazepine
  • Ceritinib
  • Cilostazol
  • Cimetidine
  • Ciprofloxacin
  • Clarithromycin
  • Clofazimine
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Darunavir
  • Desogestrel
  • Diazepam
  • Dienogest
  • Dihydrocodeine
  • Diltiazem
  • Docetaxel
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Drospirenone
  • Duvelisib
  • Eliglustat
  • Enzalutamide
  • Eplerenone
  • Erythromycin
  • Estetrol
  • Estradiol
  • Ethinyl Estradiol
  • Ethynodiol
  • Etonogestrel
  • Etoposide
  • Fedratinib
  • Fentanyl
  • Fexinidazole
  • Finerenone
  • Fluconazole
  • Fluvoxamine
  • Fosamprenavir
  • Fosnetupitant
  • Fosphenytoin
  • Gestodene
  • Hydrocodone
  • Idelalisib
  • Ifosfamide
  • Imatinib
  • Indinavir
  • Itraconazole
  • Ivabradine
  • Ivosidenib
  • Josamycin
  • Ketoconazole
  • Larotrectinib
  • Lefamulin
  • Lemborexant
  • Lenacapavir
  • Letermovir
  • Levonorgestrel
  • Lonafarnib
  • Lopinavir
  • Lorlatinib
  • Lumacaftor
  • Lurasidone
  • Mavacamten
  • Medroxyprogesterone
  • Meperidine
  • Mestranol
  • Methadone
  • Mibefradil
  • Mifepristone
  • Mitotane
  • Naloxegol
  • Nefazodone
  • Nelfinavir
  • Netupitant
  • Nilotinib
  • Nomegestrol
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Olaparib
  • Olutasidenib
  • Omaveloxolone
  • Oxycodone
  • Paclitaxel
  • Pacritinib
  • Pentazocine
  • Phenobarbital
  • Phenytoin
  • Piperaquine
  • Pirtobrutinib
  • Posaconazole
  • Primidone
  • Ranolazine
  • Ribociclib
  • Rifampin
  • Rifapentine
  • Ritlecitinib
  • Ritonavir
  • Roflumilast
  • Saquinavir
  • Schisandra sphenanthera
  • Segesterone
  • Simeprevir
  • Sirolimus Protein-Bound
  • Sonidegib
  • St John's Wort
  • Sufentanil
  • Tacrolimus
  • Telaprevir
  • Telithromycin
  • Tolvaptan
  • Tramadol
  • Treosulfan
  • Triazolam
  • Trofinetide
  • Troleandomycin
  • Tucatinib
  • Ubrogepant
  • Ulipristal
  • Venlafaxine
  • Verapamil
  • Vinblastine
  • Vincristine
  • Vinorelbine
  • Voriconazole
  • Voxelotor
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Dexamethasone
  • Methylprednisolone
  • Midazolam
  • Quetiapine
  • Warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be given slowly, so the needle will have to remain for 30 minutes in adults, 30 minutes in children 12 to 17 years of age, and 60 minutes in children 6 months to 12 years of age.

This medicine is usually given on the first day of your chemotherapy along with other medicines (eg, dexamethasone, ondansetron) about 30 minutes before the start of treatment. Your child may receive this medicine on Days 1, 2, and 3 of chemotherapy. Your child may also receive Emend® or aprepitant capsules or oral liquid instead of Emend® or Focinvez® injection on Days 2 and 3 of chemotherapy. Fosaprepitant is not for long-term use, but you may need to use this medicine again if you have more chemotherapy in the future.

This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have concerns.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

You should not receive fosaprepitant if you are also using pimozide (Orap®). Using these medicines together may cause serious unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have itching, hives, a rash, trouble breathing, trouble swallowing, warmth or redness in your face, neck, arms, or upper chest, or any swelling of your hands, face, or mouth while you are receiving this medicine.

This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving this medicine.

If you are also using a blood thinner called warfarin (Coumadin®, Jantoven®), your doctor will need to check your blood after receiving this medicine.

Birth control pills may not work as well while you are receiving fosaprepitant. To keep from getting pregnant, use another form of birth control together with your pills during treatment and for 1 month after your last dose. Other forms include condoms, spermicides, a diaphragm, and contraceptive foam or jelly.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  1. Black, tarry stools
  2. blurred vision
  3. chest tightness
  4. chills
  5. confusion
  6. cough
  7. decreased urination
  8. difficult or labored breathing
  9. dizziness
  10. dry mouth
  11. fainting
  12. fever
  13. increase in heart rate
  14. lightheadedness
  15. lower back or side pain
  16. nervousness
  17. pain, swelling, or redness at the injection site
  18. painful or difficult urination
  19. pale skin
  20. pounding in the ears
  21. rapid breathing
  22. slow or fast heartbeat
  23. sore throat
  24. sunken eyes
  25. tenderness, swelling, warmth, or skin discoloration at the injection site
  26. thirst
  27. ulcers, sores, or white spots in the mouth
  28. unusual bleeding or bruising
  29. unusual tiredness or weakness
  30. wrinkled skin

Less common

  1. Hard lump at the injection site

Rare

  1. Blood in the urine
  2. changes in patterns and rhythms of speech
  3. changes in skin color
  4. chest pain or discomfort
  5. fast, slow, irregular, pounding, or racing heartbeat or pulse
  6. general feeling of discomfort or illness
  7. headache
  8. increased sweating
  9. increased thirst
  10. lightheadedness, dizziness, or fainting
  11. loss of consciousness
  12. muscle pain or cramps
  13. nausea
  14. pain, tenderness, or swelling of the foot or leg
  15. seizures
  16. slurred speech
  17. swelling
  18. swelling of the face, ankles, or hands
  19. trouble with speaking
  20. trouble breathing
  21. vomiting

Incidence not known

  1. Diarrhea
  2. difficulty with swallowing
  3. hives or welts, itching
  4. joint pain
  5. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  6. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  7. red skin lesions, often with a purple center
  8. red, irritated eyes
  9. redness of the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Belching
  2. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  3. continuing ringing or buzzing or other unexplained noise in ears
  4. difficulty having a bowel movement
  5. dizziness
  6. feeling of indigestion
  7. hair loss or thinning of the hair
  8. hearing loss
  9. hiccups
  10. indigestion
  11. lack or loss of strength
  12. loss of appetite
  13. pain in the chest below the breastbone
  14. stomach discomfort, upset, or pain
  15. swelling or inflammation of the mouth
  16. weight loss

Less common

  1. Feeling of warmth
  2. pain or discomfort in chest, upper stomach, or throat
  3. redness of the face, neck, arms, and occasionally, upper chest
  4. sudden sweating
  5. unusually warm skin

Rare

  1. Abnormal dreams
  2. blemishes on the skin
  3. bumps on the skin
  4. burning, dry, or itching eyes
  5. change in taste
  6. change in walking and balance
  7. clumsiness or unsteadiness
  8. confusion about identity, place, and time
  9. difficulty with moving
  10. discharge, excessive tearing
  11. excess air or gas in the stomach
  12. extreme thirst
  13. false or unusual sense of well-being
  14. flushed, dry skin
  15. frequent urination
  16. fruit-like breath odor
  17. full feeling
  18. heartburn
  19. increased hunger
  20. increased sensitivity of the skin to sunlight
  21. increased urination
  22. increased volume of pale, dilute urine
  23. muscle ache, cramp, stiffness, or weakness
  24. oily skin
  25. passing gas
  26. pimples
  27. redness or other discoloration of the skin
  28. redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  29. severe constipation
  30. severe sunburn
  31. sleepiness
  32. stomach distension
  33. sweating
  34. swollen joints
  35. trouble performing routine tasks
  36. trouble sleeping
  37. unexplained weight loss
  38. unusual drowsiness, dullness, or feeling of sluggishness
  39. weight gain
  40. white patches with diaper rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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