Aprepitant brands and prices in Pakistan

About Aprepitant

Aprepitant is an anti-sickness (antiemetic) medicine. It belongs to a group called NK1 receptor antagonists: it blocks a natural brain chemical (neurokinin) that sets off nausea and vomiting. It is used to prevent sickness caused by cancer chemotherapy, always together with other anti-sickness medicines. It comes as capsules, as a liquid (oral suspension) for children, and as an injection into a vein. It is prescribed by the cancer care team, and WHO includes it on its Essential Medicines List for people having chemotherapy that is strongly or moderately likely to cause sickness.

Who should not take it, or should take care

• Do not take it if you are allergic to aprepitant or any ingredient in the product.
• Do not take it with pimozide, terfenadine, astemizole or cisapride. Your doctor must change your treatment first.
• Tell your doctor if you have liver disease. Your liver may need checking during treatment.
• The capsules contain sucrose. Tell your doctor if you cannot digest some sugars.
• Pregnancy: it should not be used in pregnancy unless clearly needed. Tell your doctor if you are pregnant, could be pregnant or are planning a baby.
• Breastfeeding: it is not known if it passes into breast milk. The UK leaflet says breastfeeding is not recommended during treatment. Ask your doctor.
• Children: the capsules are for adults and teenagers only; younger children are given the liquid form by their cancer team.

Medicines and drinks that can interact

• Pimozide, terfenadine, astemizole and cisapride: must not be taken with aprepitant
• Hormonal contraception (pills, patches, rings, implants, injections and hormone coils) may not work properly during treatment and for some time after. Use a non-hormonal method such as condoms as well, and ask your doctor how long to keep using it.
• Warfarin and acenocoumarol (blood thinners): you may need extra blood tests
• Steroids such as dexamethasone and methylprednisolone: your doctor may change the amount you take
• Some chemotherapy medicines, such as ifosfamide, irinotecan, etoposide and vinorelbine
• Medicines that suppress the immune system, such as ciclosporin, tacrolimus, sirolimus and everolimus
• Antifungals such as ketoconazole, itraconazole, voriconazole and posaconazole, the antibiotics clarithromycin and rifampicin, and HIV protease inhibitors
• Epilepsy and mood medicines such as phenytoin, carbamazepine, phenobarbital and nefazodone
• Sedatives such as midazolam, triazolam and alprazolam; the painkillers fentanyl and alfentanil; quinidine; ergotamine; and tolbutamide
• St John's wort (a herbal remedy)
• Tell your doctor or pharmacist about every medicine, herbal remedy and supplement you take.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor, nurse or pharmacist tells you, together with your other anti-sickness medicines.
• Capsules can be taken with or without food. Swallow them whole with some liquid; do not split, chew or crush them.
• Keep each capsule in its blister pack until you are ready to take it.
• The liquid for children is prepared by the pharmacy in an oral syringe. Keep it in the fridge and follow the pharmacy's instructions on how long it can be kept.
• If you miss a dose, contact your doctor or cancer team for advice.
• It can make some people dizzy or sleepy. Do not drive, cycle or use machines if it affects you.
• Store out of the reach of children and return unused medicine to a pharmacy.

Common questions

Why do I need aprepitant as well as my other anti-sickness medicines?
Some chemotherapy is very likely to make people sick. Aprepitant works in a different way from other anti-sickness medicines, so using it together with a steroid and a medicine such as ondansetron gives better protection, including against sickness that starts some days later.

Can aprepitant stop my contraceptive pill working?
Yes. It can make hormonal contraception less reliable during treatment and for some time afterwards. Use a non-hormonal method, such as condoms, as well, and ask your doctor how long to continue.

Will it stop sickness I already have?
No. Aprepitant is used to prevent nausea and vomiting, not to treat it once it has started. Tell your care team if you are being sick.

Can children have aprepitant?
Yes, under a cancer specialist. Teenagers can have the capsules, and younger children are given a liquid form. WHO lists it as an essential medicine for children as well as adults having chemotherapy that is strongly or moderately likely to cause sickness.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.