We all know that cancer treatment, or chemotherapy, is not an easy thing to do. One of the things that makes many people feel uncomfortable, both mentally and physically, is nausea and vomiting. So, today we are talking about a special, powerful injection that doctors use to control this discomfort. Its name is Fosaprepitant .
Simply put, what is Fosaprepitant?
Fosaprepitant is a medicine that is given to prevent nausea and vomiting that you may experience during chemotherapy. It belongs to a group of medicines called antiemetics.
Imagine, there are chemicals in our body that send signals to our brains to "make us feel sick now." What this injection does is stop those signals from being sent. To be precise, it `blocks` those signal pathways. As a result, the discomfort you feel after chemo treatment is greatly reduced. This drug is most commonly found under the brand name `Emend`.
The most important thing is that this is given to prevent nausea and vomiting before it occurs . If you are already vomiting, this is not the right treatment for it. You should ask your doctor what to do at that time.
Things your doctor should know before giving you this medicine
Before you start this treatment, there are a few things you should definitely tell your doctor. Don't hide these things, because it's for your own safety. It's essential that your medical team knows these things.
- Liver disease: If you have any liver disease, be sure to tell us about it.
- Allergies: Tell your doctor if you are allergic to this medicine, either fosaprepitant or aprepitant. Also, tell your doctor if you are allergic to any other medicines, foods, preservatives, or dyes.
- Pregnancy: Tell your doctor if you are pregnant or planning to have a baby soon.
- If you are a breastfeeding mother: If you are a breastfeeding mother, you should definitely inform your child about that as well.
How do you use this medicine?
This medicine is given as an injection into a vein. It is given only in a hospital or clinic under medical supervision. Therefore, you will not be given this medicine to take home.
Do you give this to small children?
Yes, sometimes doctors prescribe this medicine for children as young as 6 months. But special precautions must be followed. Therefore, if you give this to a child, only your doctor can decide.
What if the medication dose increases?
Since this is given in a hospital, the chance of an overdose is very low. However, if you suspect that something has happened, tell a doctor or nurse immediately . In an emergency, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other drugs that interact with Fosaprepitant
There are other medications that may interact with this medicine. Some medications are completely contraindicated for use. For other medications, talk to your doctor and adjust the dosage if necessary.
Therefore, give your doctor a complete list of all medications you are taking, including vitamins, herbal remedies, and supplements .
| Drugs that interact with Fosaprepitant | |
|---|---|
| Avoid taking Fosaprepitant with: | |
| Cisapride | Pimozide |
| Flibanserin | Lomitapide |
| Talk to your doctor about these: | |
| Warfarin (a blood thinner) | Birth control pills (estrogen/progestin) |
| Antibiotics - e.g. clarithromycin, erythromycin | Antifungals - e.g. ketoconazole, itraconazole |
| Medicines for epilepsy/ seizures - e.g. carbamazepine, phenytoin | Medications for HIV |
| Medicines that help you sleep or calm you down - e.g. alprazolam, diazepam, midazolam | Diltiazem, Ranolazine (for heart disease) |
| Paroxetine, Nefazodone (for depression) | Steroid types - e.g. dexamethasone, methylprednisolone |
| Other chemo drugs - eg: etoposide, vinblastine | Rifampin (a medicine for tuberculosis) |
Things to consider when undergoing treatment
Special awareness about birth control!
This is very important. If you are taking birth control pills (which contain estrogen and/or progestin hormones), the effectiveness of those pills may be reduced while you are taking Fosaprepitant . This means that you are at risk of becoming pregnant.
Therefore, you should use another form of birth control, such as a condom or diaphragm, while taking this injection and for a month after your last dose . Talk to your doctor about this and get clear advice on the safest method for you.
Other points
- This medicine is not recommended for long-term continuous use.
- Your doctor will check you at regular intervals. This medicine may cause changes in your liver function tests.
What are the possible side effects?
Like any medicine, this can cause side effects in some people, but not everyone gets them.
| Side effect | What to do? |
|---|---|
| Notify your medical team immediately: | |
| Allergic reactions Skin rash, itching, hives, swelling of the face, lips, tongue or throat, difficulty breathing. | These are serious symptoms. Seek medical advice immediately. If necessary, go to the Emergency Treatment Unit (ETU). |
| Tell your doctor if it persists or is bothersome: | |
| Diarrhea | These symptoms are usually not serious, but if they persist or bother you a lot, tell your doctor. |
| Fatigue | |
| Pain, redness, or swelling where the injection was given | |
| Pain, numbness in the hands and feet | |
| Unusual weakness of the body | |
| Stomach discomfort/fullness | |
This list is not all possible side effects. If you experience any unusual symptoms, please consult your doctor.
Take-Home Message
- Fosaprepitant is a medicine that is given to prevent nausea and vomiting caused by chemotherapy, not to treat them once they occur.
- Give your doctor a complete description of all your medical conditions and all other medications you are taking (including traditional medicines).
- If you are taking birth control pills, be sure to use an additional form of birth control (e.g. condoms) while taking this medication and for a month afterward.
- If you experience symptoms of an allergy (skin rash, swelling, difficulty breathing), seek medical advice immediately.
- If you have any questions about this medicine, don't hesitate to ask your doctor.
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