Indications for: EMEND INJECTION
In combination with other antiemetic agents to prevent 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; 2yrs–<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 over 60mins on Day 1; then 2mg/kg (max 80mg) oral susp on Days 2 and 3. 12–17yrs: 115mg IV over 30mins on Day 1; then 80mg oral caps or susp 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