Administering and Storing EMEND® (aprepitant)

Administration

Instructions for administering and storing
EMEND or EMEND for Injection

For prevention of CINV, EMEND is given for 3 days as part of a regimen that includes a corticosteroid and a 5-HT₃ receptor antagonist. The recommended dose of EMEND is 125 mg orally 1 hour before chemotherapy treatment (on Day 1) followed by 80 mg once daily in the morning on Days 2 and 3. EMEND may be taken with or without food.

EMEND for Injection 150 mg is part of a regimen that includes a corticosteroid and a 5-HT₃ receptor antagonist, given to prevent CINV induced by highly emetogenic chemotherapy (HEC). EMEND for Injection 150 mg is administered on Day 1 only as an infusion over 20 to 30 minutes, initiated approximately 30 minutes before chemotherapy. No capsules of EMEND are administered on Days 2 and 3.

Preparing EMEND for Injection 150 mg for administration

EMEND for Injection should be administered 30 minutes before chemotherapy.

Step 1
- Aseptically inject 5 mL of normal saline (0.9% Sodium Chloride for Injection) into the vial along the wall to prevent foaming.
- Swirl the vial gently; avoid shaking and avoid jetting saline into the vial.
Step 2
- Aseptically prepare an infusion bag filled with 145 mL of normal saline.
Step 3
- Aseptically withdraw the entire volume from the vial and transfer it into the infusion bag containing 145 mL of normal saline to yield a total volume of 150 mL and a final concentration of 1 mg/1mL.
Step 4
- Gently invert the bag 2 or 3 times.

EMEND storage and compatibility information

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 150-mg single dose in a glass vial containing a white to off-white powder (sterile lyophilized powder for intravenous use only after reconstitution and dilution).
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]).

Important Safety Information

EMEND and EMEND for Injection, in combination with other antiemetic agents, are indicated in adults for prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy, including high-dose cisplatin.

EMEND and EMEND for Injection have not been studied for treatment of established nausea and vomiting. Chronic continuous administration of EMEND or EMEND for Injection is not recommended.

Selected Important Safety Information

There have been isolated reports of immediate hypersensitivity reactions including flushing, erythema, dyspnea, and anaphylaxis during infusion of fosaprepitant. These hypersensitivity reactions have generally responded to discontinuation of the infusion and administration of appropriate therapy. It is not recommended to reinitiate the infusion in patients who have experienced these symptoms during first-time use.

Coadministration of EMEND and EMEND for Injection with warfarin (a CYP2C9 substrate) 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 EMEND or EMEND for Injection with each chemotherapy cycle.

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

Chronic continuous use of EMEND or EMEND for Injection 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.

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

Administering and Storing EMEND® (aprepitant)

Administration

Instructions for administering and storingEMEND or EMEND for Injection

Preparing EMEND for Injection 150 mg for administration

Step 1

Step 2

Step 3

Step 4

EMEND storage and compatibility information

Important Safety Information

Selected Important Safety Information

Instructions for administering and storing
EMEND or EMEND for Injection