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What Is Emend?

Emend (aprepitant) is a substance P/neurokinin 1 (NK1) receptor antagonist that is used in combination with other antiemetic agents to prevent chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV). In other words, it is used to prevent an upset stomach and throwing up. It is currently available as a generic and as the trademarked brand names, Emend, Cinvanti, and Aponvie.

While there are some limitations to using aprepitant as the treatment of established nausea and vomiting, research suggests that aprepitant may have antiproliferative, anti-angiogenic, and antimetastatic effects. It is currently FDA-approved mainly for the prevention of chemotherapy-induced nausea and vomiting and postoperative nausea and vomiting.

Additionally, this medication may be used for chronic refractory pruritus (non-FDA approved) as off-label use. Individuals who have this condition may experience severe itchy skin that does not respond well to conventional treatments. More extensive research is required to evaluate this medication’s overall safety and effectiveness for the specific treatment of chronic refractory pruritus.

Aprepitant requires a prescription from your doctor and is currently available as oral capsules in the following dosage strengths: 40 mg, 80 mg, and 125 mg. It is also available as an injectable emulsion (Cinvanti). It is possible to use this medication in combination with other medications, depending on the treatment regimen.

Directions for Use

Individuals who have severe liver disease, are breastfeeding, or are pregnant should talk to their doctor before taking this medication.

This drug is only effective during the chemotherapy cycle’s first 3 days. After that, nausea has usually already set in. Since this medication is solely for preventative measures, it is not useful once the patients start to experience symptoms.

There are different options for this medication: oral and injectable emulsion (Cinvanti). In the oral forms, it can be given as a liquid  (also called oral suspension) and as a capsule. The liquid comes in a powder form and is mixed as an oral suspension, which is typically prepared by your physician’s office. While this medication is safe for up to 3 hours at room temperature, it is  better to keep it in the refrigerator at all times. Once the liquid suspension is prepared, it can be stored in the refrigerator for up to 72 hours (3 days) prior to use. The capsules can be safely stored at room temperature. As for the injectable emulsion, it comes in a single glass vial that contains 130 mg/18 ml aprepitant, and it is administered intravenously via injection over a 2-minute period or by infusion over a 30-minute period on day 1. The injection or infusion should be completed approximately 30 minutes prior to chemotherapy. The injectable emulsion must be refrigerated, and it is typically prepared and administered by a licensed healthcare provider.