One of the biggest problems and discomforts that many people have when undergoing cancer treatment, that is, chemotherapy, is nausea and vomiting. This is something that really puts a lot of stress on the body and the mind. So today we are going to talk about a special type of medication that is given to control and prevent this discomfort. The name of this medication is Aprepitant.
What is Aprepitant?
Simply put, Aprepitant is a medicine that blocks some of the signals in your body that make you feel sick and vomit. We call these antiemetics. It is mainly used to prevent nausea and vomiting that occurs during cancer treatment (chemotherapy). This is a medicine that prevents you from vomiting, rather than a medicine that stops you from vomiting already. In Sri Lanka, you may find it under the brand name Emend.
Things you need to tell your doctor before taking this medicine
It is very important that your doctor is aware of these facts before prescribing this medication to you, as it greatly affects your safety.
| Situation to be reported | Why is that important? |
|---|---|
| If you have liver disease | This medicine is cleared from the body through the liver, so if you have liver problems, you may need to adjust the dosage or take special care. |
| If you have an allergy to Aprepitant, Fosaprepitant or any other medicine or food | This is essential to prevent serious allergies. |
| If you are pregnant, or trying to get pregnant | There is still no complete data on the safety of this medication during pregnancy, so it is essential to discuss this with your doctor. |
| If you are a breastfeeding mother | It is important to confirm whether the medicine passes to the baby through breast milk or not. Therefore, it is important to seek medical advice. |
How exactly do you use this medicine?
The method of using this medicine is very simple, but it is very important to follow it exactly.
- This comes in the form of a capsule. Swallow it whole with a glass of water.
- Your first dose is usually taken about an hour before your chemotherapy treatment begins.
- Then, for the next two days after chemotherapy treatment, you will be instructed to take one dose daily in the morning .
- This medicine can be taken with or without food. That's not a problem.
- The most important thing is to take this only as prescribed by your doctor, for the prescribed amount of time. Do not take more than that.
Can this medicine be given to small children?
Children over the age of 12 may be prescribed this medicine in some special cases. However, only your doctor can decide on this. Therefore, if you are giving this medicine to a child, you should follow the doctor's instructions exactly.
What to do if you take too much medicine?
If you think you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital. Treat this as an emergency.
What if I miss a dose of medicine?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose when you remember, skip the missed dose and take your next dose at the scheduled time. Do not take double doses for any reason.
Medicines that should not be used with this medicine and which you should be careful with
Aprepitant is a medication that can interact with many other medications. Therefore, you should inform your doctor about all the medications you are taking, including prescription and over-the-counter medications, herbal products, vitamins, and herbal products.
Do not take Aprepitant with these medications:
- Cisapride
- Flibanserin
- Lomitapide
- Pimozide
You should be especially careful if you take Aprepitant with these medicines:
- Medicines for heart disease and high blood pressure: For example, Diltiazem, Ranolazine.
- Female hormones: This includes birth control pills, hormone patches, or other hormone treatments.
- Medicines for fungal infections: Ketoconazole, Itraconazole.
- Medicines for HIV infection.
- Medicines for epilepsy or seizures: such as Carbamazepine and Phenytoin.
- Medicines that calm the mind or make you sleepy: such as Alprazolam, Diazepam, Midazolam.
- Some antibiotics: such as Clarithromycin and Erythromycin.
- Types of steroids: Dexamethasone, Methylprednisolone.
- Blood thinner: Warfarin.
- Some anti-cancer drugs: Etoposide, Vinblastine, Vincristine.
This list is not complete, so it is important to tell your doctor about all medications you are taking.
Things to be careful about when taking medicine
Very important: If you are using birth control pills or other hormonal birth control methods (e.g., patch, IUD), they may not work as well while you are taking Aprepitant and for one month after you stop taking it. Therefore, it is important to use an additional form of birth control (e.g., condoms) during this time. Talk to your doctor about this.
- Do not take this medicine if you already have nausea and vomiting. Ask your doctor what to do during this time.
- This medicine is not prescribed for long-term continuous use.
- Continue to have check-ups as directed by your doctor. This medicine may change the results of your liver function tests.
What are the possible side effects?
Like all medicines, Aprepitant can cause side effects in some people, although not everybody gets them.
| Classification of side effects | |
|---|---|
| Things to report to the doctor or ETU immediately | |
Allergic reactions: Skin rash, itching, hives, swelling of the face, lips, tongue, or throat. These can be very serious. | |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
|
|
If you experience any other unusual symptoms that are not on this list, talk to your doctor about them as well.
How do you keep medicine safe?
- Keep it out of reach of children. This is very important.
- Store at room temperature (between 20-25 Celsius). Protect from excessive heat and moisture.
- Throw away expired medicine.
Take-Home Message
- Aprepitant is a medication used to prevent nausea and vomiting caused by cancer treatment (chemotherapy).
- Before taking this medicine, tell your doctor about all other medicines you are taking, your liver problems, and any allergies you have.
- Take the medicine exactly as the doctor tells you. Usually, you have to take it an hour before chemotherapy and for two days afterwards.
- Most importantly: Birth control pills will not work as well while taking this medicine. So stop taking the medicine and use an additional form of birth control for a month.
- If you take too much medicine, go to the National Poison Information Center or ETU immediately.
- This article is just a summary. Please discuss any questions you may have with your doctor.
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