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Antiemetic Medication

The information on this site is intended for healthcare professionals in the United States and is not intended for the general public.

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Merck

EMEND for Injection should be administered 30 minutes before chemotherapy.

  1. Step 1
  2. Step 2
  3. Step 3

  1. Step 1

    • Aseptically inject 5 mL of saline (0.9% Sodium Chloride for Injection)
      into the vial along the wall to prevent foaming.
    • Swirl the vial gently; avoid jetting saline into the vial and
      avoid shaking.

  2. Step 1

    • Aseptically prepare an infusion bag filled with 110 mL of saline.

  3. Step 1

    • Aseptically withdraw the entire volume from the vial and transfer to
      the 110-mL infusion bag.

  4. Step 1

    • Gently invert the bag 2 to 3 times.

Realize the full benefit of EMEND.

For patients at risk of CINV due to HEC or MEC, EMEND always should be taken on Days 1, 2, and 3 of chemotherapy treatment. When using EMEND for Injection, remember to prescribe the oral regimen of EMEND (Bifold Pack).

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Compatibility and Storage

  • Caution: EMEND for Injection should not be mixed or reconstituted with solutions for which physical and chemical compatibility have not been established. EMEND for injection is incompatible with any solutions containing divalent cations (eg, Ca2+, Mg2+), including Lactated Ringer's Solution and Hartmann's Solution.
  • How supplied: A 115-mg single dose in a 10-mL glass vial containing a white to off-white powder.
  • Storage: Vials should be stored at 36°F–46°F (2°C–8°C).
  • Stability of reconstituted final drug solution: 24 hours at ambient room temperature (at or below 77°F [25°C]).

I.V. antiemetic coadministration

I.V. Antiemetic Coadministration

In clinical trials, EMEND was given with ondansetron and dexamethasone.

Selected Important Risk Information

EMEND should be used with caution in patients receiving concomitant medications that are primarily metabolized through CYP3A4. Inhibition of CYP3A4 by EMEND could result in elevated plasma concentrations of these concomitant medications. Conversely, when EMEND is used concomitantly with another CYP3A4 inhibitor, aprepitant plasma concentrations could be elevated.

Because a small number of patients in clinical studies received the CYP3A4 substrates vinblastine, vincristine, or ifosfamide, particular caution and careful monitoring are advised in patients receiving these agents or other chemotherapy agents metabolized primarily by CYP3A4 that were not studied.

There have been isolated reports of immediate hypersensitivity reactions including flushing, erythema, and dyspnea during infusion of fosaprepitant. These reactions have generally receded when the infusion was stopped and appropriate therapy was provided. It is not recommended to reinitiate the infusion in patients who have these reactions.

The efficacy of hormonal contraceptives may be reduced during coadministration with EMEND and for 28 days after the last dose of EMEND. Alternative or backup methods of contraception should be used during treatment with EMEND and for 1 month after the last dose of EMEND.

Chronic continuous use of EMEND for prevention of nausea and vomiting is not recommended because it has not been studied and because the drug interaction profile may change during chronic continuous use.

Coadministration of EMEND with warfarin may result in a clinically significant decrease in international normalized ratio (INR) of prothrombin time. In patients on chronic warfarin therapy, the INR should be closely monitored in the 2-week period, particularly at 7 to 10 days, following initiation of the 3-day regimen of EMEND with each chemotherapy cycle.

The most frequent adverse events reported in clinical trials of EMEND for highly emetogenic chemotherapy were asthenia/fatigue (17.8%), nausea (12.7%), hiccups (10.8%), constipation (10.3%), diarrhea (10.3%), and anorexia (10.1%).

The most frequent clinical adverse events reported in patients receiving EMEND for Injection were infusion site pain (7.6%), headache (3.0%), and infusion site induration (1.5%).

Before prescribing EMEND or EMEND for Injection, please read the Prescribing Information. The Patient Information also is available.

For information about Merck products or services, please call 866-448-7590. The Merck National Service Center will be pleased to assist you Monday through Friday from 8 AM to 7 PM ET.

20906183(6)-11/09-EME