Common Side Effects of Emicade (Aprepitant)
Emicade, used to prevent nausea and vomiting from chemotherapy, radiation, or surgery, causes these side effects in more than 3% of patients: fatigue, diarrhea, constipation, hiccups, decreased appetite, headache, hair loss, itching, high blood sugar, dehydration, and low white blood cell count.[1][2]
Serious Side Effects and Warnings
Rare but severe reactions include allergic responses (hives, swelling, breathing difficulty), severe skin reactions (blisters, peeling), liver damage (yellowing skin, dark urine), and severe pain or weakness. Stop use and seek immediate care for these. It's contraindicated in patients with severe liver issues or taking pimozide due to interaction risks.[1][2]
Side Effects in Specific Uses
- Chemotherapy-induced nausea: Higher rates of constipation (18%), fatigue (15%), and diarrhea (13%) vs. placebo.[2]
- Post-surgery: Abdominal pain (3%), dizziness (3%), and fever (1%) more common.[1]
Differences by Formulation
Emicade comes as capsules (125 mg/80 mg/80 mg doses) or injectable suspension (for ages 6 months+). Injection may add infusion-site pain or reactions; overall profile similar across forms.[1][2]
What Happens if You Miss a Dose?
Take it as soon as possible before chemo, but don't double up. No specific withdrawal effects noted, but efficacy drops.[1]
Interactions Causing Side Effects
Avoid with strong CYP3A4 inhibitors (e.g., ketoconazole) as they raise aprepitant levels, worsening fatigue or liver risks. Moderate interactions with warfarin or hormonal birth control alter effects.[2]
Patient-Reported Concerns
Users often mention tiredness lasting days, taste changes, or sleep issues not always in trials. Pediatric use shows similar profile but monitor growth.[1][2]
[1]: Emend Prescribing Information (Merck)
[2]: Drugs.com - Emend Side Effects