Emend

Overview

aprepitant

substance P/NK-1 antagonist

• CYP3A4 substrate
• CYP3A4 inhibitor, moderate
• CYP2C9 inducer, weak
• CYP3A4 inducer, minor

Contraindicated

• cisapride
Emend (aprepitant)

+

cisapride

1 interaction

Contraindicated

aprepitant + cisapride

if aprepitant 3-day regimen, contraindicated; aprepitant single dose-regimen OK: combo may incr. cisapride levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• eliglustat
Emend (aprepitant)

+

eliglustat

1 interaction

Contraindicated

aprepitant + eliglustat

CYP2D6 EM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, monitor ECG; decr. eliglustat dose to 84 mg qd; CYP2D6 IM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, avoid combo; CYP2D6 PM: avoid combo: combo w/ aprepitant 3-day regimen may incr. eliglustat levels, incr. risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects; aprepitant single dose-regimen OK (hepatic metab. inhibited)

• flibanserin
Emend (aprepitant)

+

flibanserin

1 interaction

Contraindicated

aprepitant + flibanserin

if aprepitant 3-day regimen, contraindicated w/in 14 days prior to, during, and x2 days after flibanserin tx; aprepitant single dose-regimen OK: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (incl. syncope), other adverse effects (hepatic metab. inhibited)

• lomitapide
Emend (aprepitant)

+

lomitapide

1 interaction

Contraindicated

aprepitant + lomitapide

if aprepitant 3-day regimen, contraindicated; aprepitant single dose-regimen OK: combo may incr. lomitapide levels, risk of adverse effects (hepatic metab. inhibited)

• pimozide
Emend (aprepitant)

+

pimozide

1 interaction

Contraindicated

aprepitant + pimozide

contraindicated: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

Avoid/Use Alternative

• adagrasib
Emend (aprepitant)

+

adagrasib

1 interaction

Avoid/Use Alternative

aprepitant + adagrasib

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• alfentanil
Emend (aprepitant)

+

alfentanil

1 interaction

Avoid/Use Alternative

aprepitant + alfentanil

if aprepitant 3-day regimen, use alternative or monitor resp. rate; consider decr. alfentanil dose; aprepitant single dose-regimen OK: combo may incr. alfentanil levels, risk of CNS and resp. depression, psychomotor impairment, delayed recovery from anesthesia, other adverse effects (hepatic metab. inhibited)

• alprazolam
Emend (aprepitant)

+

alprazolam

1 interaction

Avoid/Use Alternative

aprepitant + alprazolam

if aprepitant 3-day regimen, use alternative or monitor resp. rate; consider decr. alprazolam dose; aprepitant single dose-regimen OK: combo may incr. alprazolam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• amiodarone
Emend (aprepitant)

+

amiodarone

1 interaction

Avoid/Use Alternative

aprepitant + amiodarone

if aprepitant 3-day regimen, use alternative or monitor ECG; aprepitant single dose-regimen OK: combo may incr. amiodarone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• apalutamide
Emend (aprepitant)

+

apalutamide

1 interaction

Avoid/Use Alternative

aprepitant + apalutamide

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• atazanavir
Emend (aprepitant)

+

atazanavir

1 interaction

Avoid/Use Alternative

aprepitant + atazanavir

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• avacopan
Emend (aprepitant)

+

avacopan

1 interaction

Avoid/Use Alternative

aprepitant + avacopan

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• avapritinib
Emend (aprepitant)

+

avapritinib

1 interaction

Avoid/Use Alternative

aprepitant + avapritinib

GIST: if aprepitant 3-day regimen, use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 100 mg qd; ADVANCED SYSTEMIC MASTOCYTOSIS: if aprepitant 3-day regimen, use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 50 mg qd; INDOLENT SYSTEMIC MASTOCYTOSIS: if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. avapritinib levels, risk of bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• berotralstat
Emend (aprepitant)

+

berotralstat

1 interaction

Avoid/Use Alternative

aprepitant + berotralstat

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• bosentan
Emend (aprepitant)

+

bosentan

1 interaction

Avoid/Use Alternative

aprepitant + bosentan

avoid combo: combo may incr. bosentan levels, risk of adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• bosutinib
Emend (aprepitant)

+

bosutinib

1 interaction

Avoid/Use Alternative

aprepitant + bosutinib

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. bosutinib levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• brigatinib
Emend (aprepitant)

+

brigatinib

1 interaction

Avoid/Use Alternative

aprepitant + brigatinib

if aprepitant 3-day regimen, use alternative or monitor BP, HR; decr. brigatinib dose by approx. 40% as follows: if taking 180 mg, decr. to 120 mg, if taking 120 mg, decr. to 90 mg; if taking 90 mg, decr. to 60 mg; otherwise, caution advised: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• buspirone
Emend (aprepitant)

+

buspirone

1 interaction

Avoid/Use Alternative

aprepitant + buspirone

if aprepitant 3-day regimen, consider alternative or restart buspirone dose at 2.5 mg bid; aprepitant single dose-regimen OK: combo may incr. buspirone levels, risk of adverse effects (hepatic metab. inhibited)

• butalbital
Emend (aprepitant)

+

butalbital

1 interaction

Avoid/Use Alternative

aprepitant + butalbital

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• carbamazepine
Emend (aprepitant)

+

carbamazepine

1 interaction

Avoid/Use Alternative

aprepitant + carbamazepine

avoid combo: combo may decr. aprepitant levels, efficacy; may incr. carbamazepine levels, risk of adverse effects (hepatic metab. induced; hepatic metab. inhibited)

• cenobamate
Emend (aprepitant)

+

cenobamate

1 interaction

Avoid/Use Alternative

aprepitant + cenobamate

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ceritinib
Emend (aprepitant)

+

ceritinib

1 interaction

Avoid/Use Alternative

aprepitant + ceritinib

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• chloramphenicol
Emend (aprepitant)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

aprepitant + chloramphenicol

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• ciprofloxacin
Emend (aprepitant)

+

ciprofloxacin

1 interaction

Avoid/Use Alternative

aprepitant + ciprofloxacin

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• clarithromycin
Emend (aprepitant)

+

clarithromycin

1 interaction

Avoid/Use Alternative

aprepitant + clarithromycin

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• clofazimine
Emend (aprepitant)

+

clofazimine

1 interaction

Avoid/Use Alternative

aprepitant + clofazimine

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• cobicistat
Emend (aprepitant)

+

cobicistat

1 interaction

Avoid/Use Alternative

aprepitant + cobicistat

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• cobimetinib
Emend (aprepitant)

+

cobimetinib

1 interaction

Avoid/Use Alternative

aprepitant + cobimetinib

if aprepitant 3-day regimen, avoid combo or decr. cobimetinib dose to 20 mg/day and D/C aprepitant w/in 14 days; aprepitant single dose-regimen OK: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metab. inhibited)

• codeine
Emend (aprepitant)

+

codeine

1 interaction

Avoid/Use Alternative

aprepitant + codeine

if aprepitant 3-day regimen, use alternative or monitor resp. rate; consider decr. codeine dose; aprepitant single dose-regimen OK: combo may incr. codeine and active metabolite morphine levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite morphine)

• colchicine
Emend (aprepitant)

+

colchicine

1 interaction

Avoid/Use Alternative

aprepitant + colchicine

if aprepitant 3-day regimen, CV RISK: avoid combo if renal or hepatic impairment; otherwise, monitor CK, myopathy s/sx; GOUT or FMF: use alternative or decr. colchicine dose during and x14 days after aprepitant use: GOUT PROPHYLAXIS: give colchicine 0.3-0.6 mg/day divided qd-bid; ACUTE GOUT TX: avoid combo if already receiving colchicine for gout prophylaxis; otherwise, give colchicine 1.2 mg x1 only; FMF: decr. max colchicine dose to 1.2 mg/day divided qd-bid; aprepitant single dose-regimen OK: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (hepatic metab. inhibited)

• conivaptan
Emend (aprepitant)

+

conivaptan

1 interaction

Avoid/Use Alternative

aprepitant + conivaptan

avoid combo w/ oral aprepitant during and x7 days after conivaptan tx; IV aprepitant use OK: combo may incr. levels of both drugs, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metab. inhibited)

• crizotinib
Emend (aprepitant)

+

crizotinib

1 interaction

Avoid/Use Alternative

aprepitant + crizotinib

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• cyclosporine
Emend (aprepitant)

+

cyclosporine

1 interaction

Avoid/Use Alternative

aprepitant + cyclosporine

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of serious infection, nephrotoxicity, other adverse effects (hepatic metab. inhibited)

• dabrafenib
Emend (aprepitant)

+

dabrafenib

1 interaction

Avoid/Use Alternative

aprepitant + dabrafenib

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• danazol
Emend (aprepitant)

+

danazol

1 interaction

Avoid/Use Alternative

aprepitant + danazol

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• darunavir
Emend (aprepitant)

+

darunavir

1 interaction

Avoid/Use Alternative

aprepitant + darunavir

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• desogestrel (contraceptive)
Emend (aprepitant)

+

desogestrel (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + desogestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. desogestrel levels, contraceptive efficacy (hepatic metab. induced)

• dienogest (contraceptive)
Emend (aprepitant)

+

dienogest (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + dienogest (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. dienogest levels, contraceptive efficacy (hepatic metab. induced)

• dihydrocodeine
Emend (aprepitant)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

aprepitant + dihydrocodeine

if aprepitant 3-day regimen, use alternative or monitor resp. rate, consider decr. dihydrocodeine dose; aprepitant single dose-regimen OK: combo may incr. dihydrocodeine and active metabolite dihydromorphine levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite dihydromorphine)

• dihydroergotamine
Emend (aprepitant)

+

dihydroergotamine

1 interaction

Avoid/Use Alternative

aprepitant + dihydroergotamine

if aprepitant 3-day regimen, use alternative; aprepitant single dose-regimen OK: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• diltiazem
Emend (aprepitant)

+

diltiazem

1 interaction

Avoid/Use Alternative

aprepitant + diltiazem

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• disopyramide
Emend (aprepitant)

+

disopyramide

1 interaction

Avoid/Use Alternative

aprepitant + disopyramide

if aprepitant 3-day regimen, use alternative or monitor disopyramide levels, ECG; aprepitant single dose-regimen OK: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• domperidone
Emend (aprepitant)

+

domperidone

1 interaction

Avoid/Use Alternative

aprepitant + domperidone

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• doxorubicin
Emend (aprepitant)

+

doxorubicin

1 interaction

Avoid/Use Alternative

aprepitant + doxorubicin

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. doxorubicin levels, risk serious infection, myelosuppression, cardiotoxicity, other adverse effects (hepatic metab. inhibited)

• dronedarone
Emend (aprepitant)

+

dronedarone

1 interaction

Avoid/Use Alternative

aprepitant + dronedarone

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• drospirenone (contraceptive)
Emend (aprepitant)

+

drospirenone (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + drospirenone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. hormonal contraceptive levels, efficacy (hepatic metab. induced)

• duvelisib
Emend (aprepitant)

+

duvelisib

1 interaction

Avoid/Use Alternative

aprepitant + duvelisib

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• efavirenz
Emend (aprepitant)

+

efavirenz

1 interaction

Avoid/Use Alternative

aprepitant + efavirenz

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• elacestrant
Emend (aprepitant)

+

elacestrant

1 interaction

Avoid/Use Alternative

aprepitant + elacestrant

avoid combo: combo may incr. elacestrant levels, risk of adverse effects (hepatic metab. inhibited)

• encorafenib
Emend (aprepitant)

+

encorafenib

1 interaction

Avoid/Use Alternative

aprepitant + encorafenib

avoid combo: combo may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• ensartinib
Emend (aprepitant)

+

ensartinib

1 interaction

Avoid/Use Alternative

aprepitant + ensartinib

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (hepatic metab. possibly inhibited)

• entrectinib
Emend (aprepitant)

+

entrectinib

1 interaction

Avoid/Use Alternative

aprepitant + entrectinib

if aprepitant 3-day regimen, PEDS PTS w/ ENTRECTINIB START DOSE <200 mg/day: avoid combo; ADULT AND PEDS PTS >2yo: use alternative or monitor ECG, CBC, limit coadmin. to 14 days or less and decr. entrectinib dose as follows: if entrectinib start dose 200 mg qd, decr. to 50 mg qd; if entrectinib start dose 300 mg qd, decr. to 100 mg qd; if entrectinib start dose 400 or 600 mg qd, decr. to 200 mg qd; aprepitant single dose-regimen OK: combo may incr. entrectinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• enzalutamide
Emend (aprepitant)

+

enzalutamide

1 interaction

Avoid/Use Alternative

aprepitant + enzalutamide

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ergotamine
Emend (aprepitant)

+

ergotamine

1 interaction

Avoid/Use Alternative

aprepitant + ergotamine

if aprepitant 3-day regimen, use alternative; aprepitant single dose-regimen OK: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• erythromycin
Emend (aprepitant)

+

erythromycin

1 interaction

Avoid/Use Alternative

aprepitant + erythromycin

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• estradiol (contraceptive)
Emend (aprepitant)

+

estradiol (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + estradiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx; monitor thrombosis s/sx: combo may decr. estradiol levels, contraceptive efficacy; may initially incr. estradiol levels, risk of thromboembolism, other adverse effects (hepatic metab. induced; hepatic metab. inhibited)

• ethinyl estradiol (contraceptive)
Emend (aprepitant)

+

ethinyl estradiol (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + ethinyl estradiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx; monitor thrombosis s/sx, especially if oral ethinyl estradiol dose >35 mcg/day: combo may decr. ethinyl estradiol levels, contraceptive efficacy; may initially incr. ethinyl estradiol levels, risk of thromboembolism, other adverse effects (hepatic metab. induced; hepatic metab. inhibited)

• ethynodiol (contraceptive)
Emend (aprepitant)

+

ethynodiol (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + ethynodiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. ethynodiol and active metabolite levels, contraceptive efficacy (hepatic metab. induced)

• etonogestrel (contraceptive)
Emend (aprepitant)

+

etonogestrel (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + etonogestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. etonogestrel levels, contraceptive efficacy (hepatic metab. induced)

• etrasimod
Emend (aprepitant)

+

etrasimod

1 interaction

Avoid/Use Alternative

aprepitant + etrasimod

aprepitant 3-day regimen: if CYP2C9 poor metabolizer or if also combined w/ moderate or strong CYP2C9 inhibitor, avoid combo; otherwise, caution advised; aprepitant single dose-regimen OK: combo may incr. etrasimod levels, risk of AV block, bradycardia, QT prolongation, cardiac arrhythmias, serious infection, other adverse effects (hepatic metab. inhibited)

• etravirine
Emend (aprepitant)

+

etravirine

1 interaction

Avoid/Use Alternative

aprepitant + etravirine

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• fedratinib
Emend (aprepitant)

+

fedratinib

1 interaction

Avoid/Use Alternative

aprepitant + fedratinib

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of myelosuppression, hepatotoxicity, other adverse effects (hepatic metab. inhibited)

• fentanyl
Emend (aprepitant)

+

fentanyl

1 interaction

Avoid/Use Alternative

aprepitant + fentanyl

if aprepitant 3-day regimen, use alternative or monitor resp. rate, consider decr. fentanyl dose; aprepitant single dose-regimen OK: combo may incr. fentanyl levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• fexinidazole
Emend (aprepitant)

+

fexinidazole

1 interaction

Avoid/Use Alternative

aprepitant + fexinidazole

avoid combo: combo may decr. aprepitant levels, efficacy; may decr. fexinidazole active metabolite levels, efficacy (hepatic metab. induced; hepatic metab. inhibited, decr. conversion to active metabolites)

• fluconazole
Emend (aprepitant)

+

fluconazole

1 interaction

Avoid/Use Alternative

aprepitant + fluconazole

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• fosamprenavir
Emend (aprepitant)

+

fosamprenavir

1 interaction

Avoid/Use Alternative

aprepitant + fosamprenavir

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• fosphenytoin
Emend (aprepitant)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

aprepitant + fosphenytoin

avoid combo: combo may decr. levels, efficacy of both drugs (hepatic metab. induced)

• grapefruit
Emend (aprepitant)

+

grapefruit

1 interaction

Avoid/Use Alternative

aprepitant + grapefruit

avoid grapefruit juice w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (GI metab. inhibited)

• hydrocodone
Emend (aprepitant)

+

hydrocodone

1 interaction

Avoid/Use Alternative

aprepitant + hydrocodone

if aprepitant 3-day regimen, use alternative or monitor resp. rate, ECG, consider decr. (benz)hydrocodone dose; aprepitant single dose-regimen OK: combo may incr. hydrocodone levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• idelalisib
Emend (aprepitant)

+

idelalisib

1 interaction

Avoid/Use Alternative

aprepitant + idelalisib

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• imatinib
Emend (aprepitant)

+

imatinib

1 interaction

Avoid/Use Alternative

aprepitant + imatinib

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• infigratinib
Emend (aprepitant)

+

infigratinib

1 interaction

Avoid/Use Alternative

aprepitant + infigratinib

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. infigratinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• isavuconazonium
Emend (aprepitant)

+

isavuconazonium

1 interaction

Avoid/Use Alternative

aprepitant + isavuconazonium

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• itraconazole
Emend (aprepitant)

+

itraconazole

1 interaction

Avoid/Use Alternative

aprepitant + itraconazole

avoid combo during and x2wk after itraconazole tx: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• ivabradine
Emend (aprepitant)

+

ivabradine

1 interaction

Avoid/Use Alternative

aprepitant + ivabradine

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• ivacaftor
Emend (aprepitant)

+

ivacaftor

1 interaction

Avoid/Use Alternative

aprepitant + ivacaftor

if aprepitant 3-day regimen, pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd; aprepitant single dose-regimen OK: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• ivosidenib
Emend (aprepitant)

+

ivosidenib

1 interaction

Avoid/Use Alternative

aprepitant + ivosidenib

avoid combo: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• ixabepilone
Emend (aprepitant)

+

ixabepilone

1 interaction

Avoid/Use Alternative

aprepitant + ixabepilone

if aprepitant 3-day regimen, consider alternative or monitor CBC; aprepitant single dose-regimen OK: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other toxicity (hepatic metab. inhibited)

• ketoconazole
Emend (aprepitant)

+

ketoconazole

1 interaction

Avoid/Use Alternative

aprepitant + ketoconazole

avoid combo during and up to 1wk after ketoconazole tx: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• lefamulin
Emend (aprepitant)

+

lefamulin

1 interaction

Avoid/Use Alternative

aprepitant + lefamulin

ORAL LEFAMULIN: avoid combo w/ oral aprepitant; IV lefamulin and IV aprepitant use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lemborexant
Emend (aprepitant)

+

lemborexant

1 interaction

Avoid/Use Alternative

aprepitant + lemborexant

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• lenacapavir
Emend (aprepitant)

+

lenacapavir

1 interaction

Avoid/Use Alternative

aprepitant + lenacapavir

avoid combo w/ oral aprepitant during and x9mo after lenacapavir tx; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• letermovir
Emend (aprepitant)

+

letermovir

1 interaction

Avoid/Use Alternative

aprepitant + letermovir

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• levoketoconazole
Emend (aprepitant)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

aprepitant + levoketoconazole

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• levonorgestrel (contraceptive)
Emend (aprepitant)

+

levonorgestrel (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + levonorgestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. levonorgestrel levels, contraceptive efficacy (hepatic metab. induced)

• levonorgestrel (post-coital contraceptive)
Emend (aprepitant)

+

levonorgestrel (post-coital contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + levonorgestrel (post-coital contraceptive)

consider alternative: combo may decr. levonorgestrel levels, post-coital contraceptive efficacy (hepatic metab. induced)

• lonafarnib
Emend (aprepitant)

+

lonafarnib

1 interaction

Avoid/Use Alternative

aprepitant + lonafarnib

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lopinavir/ritonavir
Emend (aprepitant)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

aprepitant + lopinavir/ ritonavir

avoid combo: combo may incr. or decr. aprepitant levels, incr. risk of adverse effects or decr. efficacy (hepatic metab. altered)

• lorlatinib
Emend (aprepitant)

+

lorlatinib

1 interaction

Avoid/Use Alternative

aprepitant + lorlatinib

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• lovastatin
Emend (aprepitant)

+

lovastatin

1 interaction

Avoid/Use Alternative

aprepitant + lovastatin

if aprepitant 3-day regimen, use alternative or monitor CK, myopathy sx; adjust lovastatin max dose to 20 mg/day; aprepitant single dose-regimen OK: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lumacaftor/ivacaftor
Emend (aprepitant)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

aprepitant + lumacaftor/ ivacaftor

avoid combo: combo may decr. aprepitant levels, efficacy; may incr. ivacaftor levels, risk of adverse effects (hepatic metab. induced; hepatic metab. inhibited)

• lurbinectedin
Emend (aprepitant)

+

lurbinectedin

1 interaction

Avoid/Use Alternative

aprepitant + lurbinectedin

if aprepitant 3-day regimen, use alternative or monitor CBC and consider decr. lurbinectedin dose; aprepitant single dose-regimen OK: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• macitentan
Emend (aprepitant)

+

macitentan

1 interaction

Avoid/Use Alternative

aprepitant + macitentan

if aprepitant 3-day regimen and if also combined w/ strong-mod CYP2C9 inhibitor, avoid combo; otherwise, caution advised; aprepitant single dose-regimen OK: combo may incr. macitentan levels, risk of adverse effects (hepatic metab. inhibited)

• mavacamten
Emend (aprepitant)

+

mavacamten

1 interaction

Avoid/Use Alternative

aprepitant + mavacamten

avoid combo: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• medroxyprogesterone (contraceptive)
Emend (aprepitant)

+

medroxyprogesterone (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + medroxyprogesterone (contraceptive)

use additional non-hormonal or alternative contraception: combo may decr. hormonal contraceptive levels, efficacy (hepatic metab. induced)

• meperidine
Emend (aprepitant)

+

meperidine

1 interaction

Avoid/Use Alternative

aprepitant + meperidine

if aprepitant 3-day regimen, use alternative or monitor resp. rate, ECG; consider decr. meperidine dose; aprepitant single dose-regimen OK: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• methadone
Emend (aprepitant)

+

methadone

1 interaction

Avoid/Use Alternative

aprepitant + methadone

if aprepitant 3-day regimen, use alternative or monitor resp. rate, ECG, consider decr. methadone dose; otherwise caution advised: combo may incr. or decr. methadone levels, incr. risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy (hepatic metab. altered)

• methylergonovine
Emend (aprepitant)

+

methylergonovine

1 interaction

Avoid/Use Alternative

aprepitant + methylergonovine

if aprepitant 3-day regimen, use alternative; aprepitant single dose-regimen OK: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• midazolam
Emend (aprepitant)

+

midazolam

1 interaction

Avoid/Use Alternative

aprepitant + midazolam

if aprepitant 3-day regimen, avoid combo w/ midazolam nasal; monitor resp. rate, consider decr. midazolam dose w/ other midazolam dosage forms; aprepitant single dose-regimen OK: combo may incr. midazolam and active metabolite levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• mifepristone
Emend (aprepitant)

+

mifepristone

1 interaction

Avoid/Use Alternative

aprepitant + mifepristone

avoid combo w/in 14 days of daily mifepristone use: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• mitapivat
Emend (aprepitant)

+

mitapivat

1 interaction

Avoid/Use Alternative

aprepitant + mitapivat

avoid combo: combo may incr. mitapivat levels, risk of adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• mitotane
Emend (aprepitant)

+

mitotane

1 interaction

Avoid/Use Alternative

aprepitant + mitotane

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• mobocertinib
Emend (aprepitant)

+

mobocertinib

1 interaction

Avoid/Use Alternative

aprepitant + mobocertinib

if aprepitant 3-day regimen, use alternative or monitor ECG; decr. mobocertinib dose as follows: if taking 160 mg, decr. dose to 80 mg; if taking 120 mg, decr. dose to 40 mg, if taking 80 mg, decr. dose to 40 mg; otherwise, caution advised: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• modafinil
Emend (aprepitant)

+

modafinil

1 interaction

Avoid/Use Alternative

aprepitant + modafinil

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• nafcillin
Emend (aprepitant)

+

nafcillin

1 interaction

Avoid/Use Alternative

aprepitant + nafcillin

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• naloxegol
Emend (aprepitant)

+

naloxegol

1 interaction

Avoid/Use Alternative

aprepitant + naloxegol

if aprepitant 3-day regimen, use alternative or decr. naloxegol dose to 12.5 mg/day; aprepitant single dose-regimen OK: combo may incr. naloxegol levels, risk of adverse effects (hepatic metab. inhibited)

• nefazodone
Emend (aprepitant)

+

nefazodone

1 interaction

Avoid/Use Alternative

aprepitant + nefazodone

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• nelfinavir
Emend (aprepitant)

+

nelfinavir

1 interaction

Avoid/Use Alternative

aprepitant + nelfinavir

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• neratinib
Emend (aprepitant)

+

neratinib

1 interaction

Avoid/Use Alternative

aprepitant + neratinib

if aprepitant 3-day regimen, avoid combo if also combined w/ P-gp inhibitor; otherwise, caution advised; aprepitant single dose-regimen OK: combo may incr. neratinib levels, risk of adverse effects (hepatic metab. inhibited)

• nilotinib
Emend (aprepitant)

+

nilotinib

1 interaction

Avoid/Use Alternative

aprepitant + nilotinib

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• nirogacestat
Emend (aprepitant)

+

nirogacestat

1 interaction

Avoid/Use Alternative

aprepitant + nirogacestat

avoid combo: combo may incr. levels of both drugs, risk of hypophosphatemia, other adverse effects (hepatic metab. inhibited)

• nisoldipine
Emend (aprepitant)

+

nisoldipine

1 interaction

Avoid/Use Alternative

aprepitant + nisoldipine

if aprepitant 3-day regimen, consider alternative or monitor BP; aprepitant single dose-regimen OK: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• norelgestromin (contraceptive)
Emend (aprepitant)

+

norelgestromin (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + norelgestromin (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. hormonal contraceptive levels, efficacy (hepatic metab. induced)

• norethindrone (contraceptive)
Emend (aprepitant)

+

norethindrone (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + norethindrone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. norethindrone levels, contraceptive efficacy (hepatic metab. induced)

• norgestimate (contraceptive)
Emend (aprepitant)

+

norgestimate (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + norgestimate (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. norgestimate and active metabolites levels, contraceptive efficacy (hepatic metab. induced)

• norgestrel (contraceptive)
Emend (aprepitant)

+

norgestrel (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + norgestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. norgestrel levels, contraceptive efficacy (hepatic metab. induced)

• olaparib
Emend (aprepitant)

+

olaparib

1 interaction

Avoid/Use Alternative

aprepitant + olaparib

if aprepitant 3-day regimen, use alternative or decr. olaparib dose to 150 mg bid; monitor CBC; aprepitant single dose-regimen OK: combo may incr. olaparib levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• oliceridine
Emend (aprepitant)

+

oliceridine

1 interaction

Avoid/Use Alternative

aprepitant + oliceridine

if aprepitant 3-day regimen, use alternative or monitor resp. rate, ECG; consider decr. oliceridine frequency; aprepitant single dose-regimen OK: combo may incr. oliceridine levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• omaveloxolone
Emend (aprepitant)

+

omaveloxolone

1 interaction

Avoid/Use Alternative

aprepitant + omaveloxolone

if aprepitant 3-day regimen, use alternative or decr. omaveloxolone dose to 100 mg/day; otherwise, caution advised: combo may incr. omaveloxolone levels, risk of adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• oxycodone
Emend (aprepitant)

+

oxycodone

1 interaction

Avoid/Use Alternative

aprepitant + oxycodone

if aprepitant 3-day regimen, use alternative or monitor resp. rate; consider decr. oxycodone dose; aprepitant single dose-regimen OK: combo may incr. oxycodone levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• pacritinib
Emend (aprepitant)

+

pacritinib

1 interaction

Avoid/Use Alternative

aprepitant + pacritinib

avoid combo: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (incl. life-threatening), other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• palovarotene
Emend (aprepitant)

+

palovarotene

1 interaction

Avoid/Use Alternative

aprepitant + palovarotene

if aprepitant 3-day regimen, use alternative or decr. palovarotene dose as follows: wt 10-19.9 kg maint. dose 1 mg daily, flare dose 5 mg daily wk 1-4, then 2.5 mg daily wk 5-12; wt 20-39.9 kg maint. dose 1.5 mg daily, flare dose 6 mg daily wk 1-4, then 3 mg daily wk 5-12; wt 40-59.9 kg maint. dose 2 mg daily, flare dose 7.5 mg daily wk 1-4, then 4 mg daily wk 5-12; wt 60 kg and greater or 14 yo and older maint. dose 2.5 mg daily, flare dose 10 mg daily wk 1-4, then 5 mg daily wk 5-12: combo may incr. palovarotene levels, risk of adverse effects (hepatic metab. inhibited)

• pemigatinib
Emend (aprepitant)

+

pemigatinib

1 interaction

Avoid/Use Alternative

aprepitant + pemigatinib

if aprepitant 3-day regimen, use alternative or monitor phosphate and decr. pemigatinib dose as follows: if on pemigatinib 13.5 mg qd, decr. to 9 mg qd; if on pemigatinib 9 mg qd, decr. to 4.5 mg qd; aprepitant single dose-regimen OK: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• pentobarbital
Emend (aprepitant)

+

pentobarbital

1 interaction

Avoid/Use Alternative

aprepitant + pentobarbital

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• pexidartinib
Emend (aprepitant)

+

pexidartinib

1 interaction

Avoid/Use Alternative

aprepitant + pexidartinib

avoid combo: combo may decr. aprepitant levels, efficacy; may incr. pexidartinib levels, risk of hepatotoxicity, other adverse effects (hepatic metab. induced; hepatic metab. inhibited)

• phenobarbital
Emend (aprepitant)

+

phenobarbital

1 interaction

Avoid/Use Alternative

aprepitant + phenobarbital

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• phenytoin
Emend (aprepitant)

+

phenytoin

1 interaction

Avoid/Use Alternative

aprepitant + phenytoin

avoid combo: combo may decr. levels, efficacy of both drugs (hepatic metab. induced)

• posaconazole
Emend (aprepitant)

+

posaconazole

1 interaction

Avoid/Use Alternative

aprepitant + posaconazole

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• pralsetinib
Emend (aprepitant)

+

pralsetinib

1 interaction

Avoid/Use Alternative

aprepitant + pralsetinib

if aprepitant 3-day regimen, use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd; aprepitant single dose-regimen OK: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• primidone
Emend (aprepitant)

+

primidone

1 interaction

Avoid/Use Alternative

aprepitant + primidone

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• propafenone
Emend (aprepitant)

+

propafenone

1 interaction

Avoid/Use Alternative

aprepitant + propafenone

if CYP2D6 poor metabolizer or if also combined w/ CYP2D6 inhibitor, avoid combo w/ aprepitant 3-day regimen; otherwise, monitor ECG, BP; aprepitant single dose-regimen OK: combo may incr. propafenone levels, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (hepatic metab. inhibited)

• repotrectinib
Emend (aprepitant)

+

repotrectinib

1 interaction

Avoid/Use Alternative

aprepitant + repotrectinib

avoid combo; D/C aprepitant 3-5 half-lives prior to repotrectinib tx: combo may incr. repotrectinib levels, risk of adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• ribociclib
Emend (aprepitant)

+

ribociclib

1 interaction

Avoid/Use Alternative

aprepitant + ribociclib

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• rifabutin
Emend (aprepitant)

+

rifabutin

1 interaction

Avoid/Use Alternative

aprepitant + rifabutin

avoid combo: combo may incr. rifabutin levels, risk of myelosuppression, uveitis, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• rifampin
Emend (aprepitant)

+

rifampin

1 interaction

Avoid/Use Alternative

aprepitant + rifampin

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• rifapentine
Emend (aprepitant)

+

rifapentine

1 interaction

Avoid/Use Alternative

aprepitant + rifapentine

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ritonavir
Emend (aprepitant)

+

ritonavir

1 interaction

Avoid/Use Alternative

aprepitant + ritonavir

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• rivaroxaban
Emend (aprepitant)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

aprepitant + rivaroxaban

if aprepitant 3-day regimen, use alternative if CrCl <80 and combined w/ P-gp inhibitor; otherwise, monitor bleeding s/sx; aprepitant single dose-regimen OK: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (hepatic metab. inhibited)

• segesterone (contraceptive)
Emend (aprepitant)

+

segesterone (contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + segesterone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after aprepitant tx: combo may decr. segesterone levels, contraceptive efficacy (hepatic metab. induced)

• selpercatinib
Emend (aprepitant)

+

selpercatinib

1 interaction

Avoid/Use Alternative

aprepitant + selpercatinib

if aprepitant 3-day regimen, use alternative or monitor ECG, electrolytes; decr. selpercatinib dose as follows: if on selpercatinib 40 mg tid, decr. to 40 mg qd; if on selpercatinib 80 mg bid, decr. to 40 mg bid; if on selpercatinib 120 mg bid, decr. to 80 mg bid; if on selpercatinib 160 mg bid, decr. to 120 mg bid; aprepitant single dose-regimen OK: combo may incr. selpercatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• selumetinib
Emend (aprepitant)

+

selumetinib

1 interaction

Avoid/Use Alternative

aprepitant + selumetinib

if aprepitant 3-day regimen, use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments; aprepitant single dose-regimen OK: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• simvastatin
Emend (aprepitant)

+

simvastatin

1 interaction

Avoid/Use Alternative

aprepitant + simvastatin

if aprepitant 3-day regimen, use alternative or monitor CK, myopathy sx; adjust max simvastatin dose to 10 mg/day; aprepitant single dose-regimen OK: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• siponimod
Emend (aprepitant)

+

siponimod

1 interaction

Avoid/Use Alternative

aprepitant + siponimod

if aprepitant 3-day regimen and if also combined w/ moderate or strong CYP2C9 inhibitor, avoid combo; otherwise, caution advised; aprepitant single dose-regimen OK: combo may incr. siponimod levels, risk of adverse effects (hepatic metab. inhibited)

• sonidegib
Emend (aprepitant)

+

sonidegib

1 interaction

Avoid/Use Alternative

aprepitant + sonidegib

if aprepitant 3-day regimen, avoid combo; aprepitant single dose-regimen OK: combo may incr. sonidegib levels, risk of adverse effects (hepatic metab. inhibited)

• sotorasib
Emend (aprepitant)

+

sotorasib

1 interaction

Avoid/Use Alternative

aprepitant + sotorasib

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• St. John's wort
Emend (aprepitant)

+

St. John's wort

1 interaction

Avoid/Use Alternative

aprepitant + St. John's wort

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• sufentanil
Emend (aprepitant)

+

sufentanil

1 interaction

Avoid/Use Alternative

aprepitant + sufentanil

if aprepitant 3-day regimen, consider alternative or monitor resp. rate, consider decr. sufentanil dose or frequency; aprepitant single dose-regimen OK: combo may incr. sufentanil levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• tazemetostat
Emend (aprepitant)

+

tazemetostat

1 interaction

Avoid/Use Alternative

aprepitant + tazemetostat

if aprepitant 3-day regimen, use alternative or monitor ECG, CBC; decr. tazemetostat dose as follows: if taking 800 mg bid, decr. tazemetostat dose to 400 mg bid; if taking 600 mg bid, decr. tazemetostat dose to 400 mg qam plus 200 mg qpm; if taking 400 mg bid, decr. tazemetostat dose to 200 mg bid; aprepitant single dose-regimen OK: combo may incr. tazemetostat levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• tipranavir
Emend (aprepitant)

+

tipranavir

1 interaction

Avoid/Use Alternative

aprepitant + tipranavir

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• tolvaptan
Emend (aprepitant)

+

tolvaptan

1 interaction

Avoid/Use Alternative

aprepitant + tolvaptan

if aprepitant 3-day regimen and HYPONATREMIA USE: avoid combo; AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DZ USE: decr. tolvaptan total daily dose by 50% as follows: if taking 60 mg/day, decr. to 15 mg qam and 15 mg qpm; if taking 90 mg/day, decr. to 30 mg qam and 15 mg qpm; if taking 120 mg/day, decr. to 45 mg qam and 15 mg qpm; aprepitant single dose-regimen OK: combo may incr. tolvaptan levels, risk of adverse effects (hepatic metab. inhibited)

• tramadol
Emend (aprepitant)

+

tramadol

1 interaction

Avoid/Use Alternative

aprepitant + tramadol

if aprepitant 3-day regimen, use alternative or monitor resp. rate, ECG, consider decr. tramadol dose; aprepitant single dose-regimen OK: combo may incr. tramadol and active metabolite levels, risk of CNS and resp. depression, psychomotor impairment, seizures, serotonin syndrome, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite)

• triazolam
Emend (aprepitant)

+

triazolam

1 interaction

Avoid/Use Alternative

aprepitant + triazolam

if aprepitant 3-day regimen, use alternative or consider decr. triazolam dose; aprepitant single dose-regimen OK: combo may incr. triazolam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• tucatinib
Emend (aprepitant)

+

tucatinib

1 interaction

Avoid/Use Alternative

aprepitant + tucatinib

avoid combo: combo may incr. aprepitant levels, risk of adverse effects (hepatic metab. inhibited)

• ulipristal (post-coital contraceptive)
Emend (aprepitant)

+

ulipristal (post-coital contraceptive)

1 interaction

Avoid/Use Alternative

aprepitant + ulipristal (post-coital contraceptive)

avoid combo: combo may decr. ulipristal levels, post-coital contraceptive efficacy (hepatic metab. induced)

• vardenafil
Emend (aprepitant)

+

vardenafil

1 interaction

Avoid/Use Alternative

aprepitant + vardenafil

if aprepitant 3-day regimen, max vardenafil dose 5 mg/24h; avoid combo w/ ODT form; aprepitant single dose-regimen OK: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• venetoclax
Emend (aprepitant)

+

venetoclax

1 interaction

Avoid/Use Alternative

aprepitant + venetoclax

if aprepitant 3-day regimen, monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50%; AML: decr. venetoclax dose by at least 50%; aprepitant single dose-regimen OK: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metab. inhibited)

• verapamil
Emend (aprepitant)

+

verapamil

1 interaction

Avoid/Use Alternative

aprepitant + verapamil

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of hypotension, bradycardia, AV block, other adverse effects; may decr. verapamil levels, efficacy (hepatic metab. altered)

• voriconazole
Emend (aprepitant)

+

voriconazole

1 interaction

Avoid/Use Alternative

aprepitant + voriconazole

avoid combo: combo may incr. aprepitant levels, risk of adverse effects; may decr. voriconazole levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

Monitor/Modify Tx

• abemaciclib
Emend (aprepitant)

+

abemaciclib

1 interaction

Monitor/Modify Tx

aprepitant + abemaciclib

if aprepitant 3-day regimen, consider decr. abemaciclib 200 mg bid dose to 150 mg bid, abemaciclib 150 mg bid dose to 100 mg bid, abemaciclib 100 mg bid dose to 50 mg bid; monitor CBC; aprepitant single dose-regimen OK: combo may incr. abemaciclib levels, risk of serious infection, myelosuppression, thrombosis risk, other adverse effects (hepatic metab. inhibited)

• acalabrutinib
Emend (aprepitant)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

aprepitant + acalabrutinib

if aprepitant 3-day regimen, decr. acalabrutinib dose to 100 mg qd; monitor CBC; aprepitant single dose-regimen OK: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• alfuzosin
Emend (aprepitant)

+

alfuzosin

1 interaction

Monitor/Modify Tx

aprepitant + alfuzosin

if aprepitant 3-day regimen, monitor BP, ECG; aprepitant single dose-regimen OK: combo may incr. alfuzosin levels, risk of QT prolongation, cardiac arrhythmias, hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• apixaban
Emend (aprepitant)

+

apixaban

1 interaction

Monitor/Modify Tx

aprepitant + apixaban

if aprepitant 3-day regimen, monitor bleeding s/sx; if also combined w/ P-gp inhibitor, consider decr. apixaban dose; aprepitant single dose-regimen OK: combo may incr. apixaban levels, risk of bleeding, other adverse effects (hepatic metab. inhibited)

• aripiprazole oral
Emend (aprepitant)

+

aripiprazole oral

1 interaction

Monitor/Modify Tx

aprepitant + aripiprazole oral

consider decr. PO aripiprazole dose; if also CYP2D6 PM or if also combined w/ strong CYP2D6 inhibitor, consider decr. PO aripiprazole dose up to 75%; no dose adjustment if depression adjunct tx use: combo w/ aprepitant 3-day regimen may incr. aripiprazole levels, risk of adverse effects; aprepitant single dose-regimen OK (hepatic metab. inhibited)

• artemether/lumefantrine
Emend (aprepitant)

+

artemether/ lumefantrine

1 interaction

Monitor/Modify Tx

aprepitant + artemether/ lumefantrine

if aprepitant 3-day regimen, monitor ECG; otherwise; caution advised: combo may incr. artemether/lumefantrine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• atorvastatin
Emend (aprepitant)

+

atorvastatin

1 interaction

Monitor/Modify Tx

aprepitant + atorvastatin

if aprepitant 3-day regimen, monitor CK, myopathy sx; aprepitant single dose-regimen OK: combo may incr. atorvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• avanafil
Emend (aprepitant)

+

avanafil

1 interaction

Monitor/Modify Tx

aprepitant + avanafil

if aprepitant 3-day regimen, monitor BP and adjust max avanafil dose to 50 mg/24h; aprepitant single dose-regimen OK: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• avatrombopag
Emend (aprepitant)

+

avatrombopag

1 interaction

Monitor/Modify Tx

aprepitant + avatrombopag

CHRONIC IMMUNE THROMBOCYTOPENIA: if aprepitant 3-day regimen also combined w/ a mod-strong CYP2C9 inhibitor, decr. start dose to 20 mg 3x/wk and monitor platelets, thrombosis s/sx; otherwise, monitor platelets, thrombosis s/sx; CHRONIC LIVER DZ: if aprepitant 3-day regimen, monitor platelets, thrombosis s/sx; aprepitant single dose-regimen OK: combo may incr. avatrombopag levels, risk of thromboembolism, other adverse effects (hepatic metab. inhibited)

• axitinib
Emend (aprepitant)

+

axitinib

1 interaction

Monitor/Modify Tx

aprepitant + axitinib

if aprepitant 3-day regimen, consider decr. axitinib dose; aprepitant single dose-regimen OK: combo may incr. axitinib levels, risk of adverse effects (hepatic metab. inhibited)

• brexpiprazole
Emend (aprepitant)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

aprepitant + brexpiprazole

if aprepitant 3-day regimen, decr. brexpiprazole dose 75% if CYP2D6 poor metabolizer or if also combined w/ moderate or strong CYP2D6 inhibitor; aprepitant single dose-regimen OK: combo may incr. brexpiprazole levels, risk of adverse effects (hepatic metab. inhibited)

• bromocriptine
Emend (aprepitant)

+

bromocriptine

1 interaction

Monitor/Modify Tx

aprepitant + bromocriptine

if aprepitant 3-day regimen, limit bromocriptine max dose to 1.6 mg/day if diabetes tx; otherwise, caution advised; aprepitant single dose-regimen OK: combo may incr. bromocriptine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• budesonide
Emend (aprepitant)

+

budesonide

1 interaction

Monitor/Modify Tx

aprepitant + budesonide

if aprepitant 3-day regimen, monitor hypercorticism s/sx; aprepitant single dose-regimen OK: combo may incr. budesonide levels, risk of systemic corticosteroid effects, incl. Cushing syndrome, adrenal suppression, serious infection, other adverse effects (hepatic metab. inhibited)

• butorphanol
Emend (aprepitant)

+

butorphanol

1 interaction

Monitor/Modify Tx

aprepitant + butorphanol

if aprepitant 3-day regimen, monitor resp. rate, consider decr. butorphanol dose; aprepitant single dose-regimen OK: combo may incr. butorphanol levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• cabozantinib
Emend (aprepitant)

+

cabozantinib

1 interaction

Monitor/Modify Tx

aprepitant + cabozantinib

if aprepitant 3-day regimen, monitor ECG, BP, bleeding s/sx; aprepitant single dose-regimen OK: combo may incr. cabozantinib levels, risk of QT prolongation, cardiac arrhythmias, HTN, GI or other bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• capivasertib
Emend (aprepitant)

+

capivasertib

1 interaction

Monitor/Modify Tx

aprepitant + capivasertib

if aprepitant 3-day regimen, monitor glucose and decr. capivasertib dose to 320 mg bid x4 days followed by 3 days off; aprepitant single dose-regimen OK: combo may incr. capivasertib levels, risk of severe hyperglycemia, other adverse effects (hepatic metab. inhibited)

• cariprazine
Emend (aprepitant)

+

cariprazine

1 interaction

Monitor/Modify Tx

aprepitant + cariprazine

aprepitant single dose OK; for aprepitant 3-day regimen: if starting cariprazine tx, adjust dose as follows: SCHIZOPHRENIA/BIPOLAR MANIA: start cariprazine 1.5 mg qod, then may incr. to 1.5 mg qd; BIPOLAR DEPRESSION/DEPRESSION ADJUNCT: start cariprazine 1.5 mg qod; if on stable cariprazine tx and starting aprepitant, adjust cariprazine dose as follows: ALL INDICATIONS: if on cariprazine 1.5 mg or 3 mg qd, decr. dose to 1.5 mg qod; if on cariprazine 4.5 mg or 6 mg qd, decr. dose to 1.5 mg qd: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metab. inhibited)

• cilostazol
Emend (aprepitant)

+

cilostazol

1 interaction

Monitor/Modify Tx

aprepitant + cilostazol

if aprepitant 3-day regimen, decr. cilostazol dose to 50 mg bid; aprepitant single dose-regimen OK: combo may incr. cilostazol levels, risk of adverse effects (hepatic metab. inhibited)

• clonazepam
Emend (aprepitant)

+

clonazepam

1 interaction

Monitor/Modify Tx

aprepitant + clonazepam

if aprepitant 3-day regimen, monitor resp. rate; aprepitant single dose-regimen OK: combo may incr. clonazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• clozapine
Emend (aprepitant)

+

clozapine

1 interaction

Monitor/Modify Tx

aprepitant + clozapine

if aprepitant 3-day regimen, monitor ECG, BP, HR; consider decr. clozapine dose; aprepitant single dose-regimen OK: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (hepatic metab. inhibited)

• copanlisib
Emend (aprepitant)

+

copanlisib

1 interaction

Monitor/Modify Tx

aprepitant + copanlisib

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. copanlisib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• daridorexant
Emend (aprepitant)

+

daridorexant

1 interaction

Monitor/Modify Tx

aprepitant + daridorexant

if aprepitant 3-day regimen, adjust max daridorexant dose to 25 mg/day; aprepitant single dose-regimen OK: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• dasatinib
Emend (aprepitant)

+

dasatinib

1 interaction

Monitor/Modify Tx

aprepitant + dasatinib

if aprepitant 3-day regimen, monitor ECG, CBC; aprepitant single dose-regimen OK: combo may incr. dasatinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• deflazacort
Emend (aprepitant)

+

deflazacort

1 interaction

Monitor/Modify Tx

aprepitant + deflazacort

if aprepitant 3-day regimen, decr. deflazacort to 1/3 usual dose; aprepitant single dose-regimen OK: combo may incr. deflazacort active metabolite levels, risk of systemic corticosteroid effects incl. Cushing syndrome and adrenal suppression (hepatic metab. inhibited)

• dexamethasone
Emend (aprepitant)

+

dexamethasone

1 interaction

Monitor/Modify Tx

aprepitant + dexamethasone

if aprepitant 3-day regimen, decr. dexamethasone PO dose 50%; aprepitant single dose-regimen OK: combo may incr. dexamethasone levels, risk of systemic corticosteroid effects incl. Cushing syndrome and adrenal suppression, serious infection, other adverse effects (hepatic metab. inhibited)

• dofetilide
Emend (aprepitant)

+

dofetilide

1 interaction

Monitor/Modify Tx

aprepitant + dofetilide

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• elexacaftor/tezacaftor/ivacaftor
Emend (aprepitant)

+

elexacaftor/ tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

aprepitant + elexacaftor/ tezacaftor/ ivacaftor

if aprepitant 3-day regimen, adjust elexacaftor/tezacaftor/ivacaftor dose as follows; aprepitant single dose-regimen OK: 2-5 YO: decr. dose by alternating one elexacaftor/tezacaftor/ivacaftor packet or one ivacaftor packet at each morning dose, no evening doses; 6 YO AND OLDER: decr. dose by alternating two elexacaftor/tezacaftor/ivacaftor tabs or one ivacaftor tab at each morning dose, no evening doses: combo may incr. elexacaftor/tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• eplerenone
Emend (aprepitant)

+

eplerenone

1 interaction

Monitor/Modify Tx

aprepitant + eplerenone

if aprepitant 3-day regimen, monitor potassium, Cr in 3-7 days after tx start; in post-MI CHF pts, max eplerenone dose 25 mg/day; in HTN pts, start eplerenone 25 mg qd, max dose 50 mg/day; aprepitant single dose-regimen OK: combo may incr. eplerenone levels, risk of hyperkalemia, serious arrhythmias, other adverse effects (hepatic metab. inhibited)

• erdafitinib
Emend (aprepitant)

+

erdafitinib

1 interaction

Monitor/Modify Tx

aprepitant + erdafitinib

if aprepitant 3-day regimen, monitor phosphate; aprepitant single dose-regimen OK: combo may incr. erdafitinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• estazolam
Emend (aprepitant)

+

estazolam

1 interaction

Monitor/Modify Tx

aprepitant + estazolam

if aprepitant 3-day regimen, monitor resp. rate; consider decr. estazolam dose; aprepitant single dose-regimen OK: combo may incr. estazolam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• everolimus
Emend (aprepitant)

+

everolimus

1 interaction

Monitor/Modify Tx

aprepitant + everolimus

BREAST CA, PNET, RENAL CELL CA, or RENAL ANGIOMYOLIPOMA w/ TSC: if also combined w/ P-gp inhibitor, decr. everolimus to 2.5 mg/day, may incr. to 5 mg/day if tolerated, monitor CBC; otherwise, monitor CBC; TSC-ASSOC. SEGA or TSC-ASSOC. PARTIAL-ONSET SEIZURES: if also combined w/ P-gp inhibitor, monitor everolimus levels, CBC and decr. everolimus 50%; give every other day if already on lowest available dose; otherwise, monitor everolimus levels, CBC; TRANSPLANT: monitor everolimus levels, CBC: combo w/ aprepitant 3-day regimen may incr. everolimus levels, risk of serious infection, myelosuppression, other adverse effects; aprepitant single dose-regimen OK (hepatic metab. inhibited)

• felodipine
Emend (aprepitant)

+

felodipine

1 interaction

Monitor/Modify Tx

aprepitant + felodipine

if aprepitant 3-day regimen, monitor BP, HR; aprepitant single dose-regimen OK: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (hepatic metab. inhibited)

• finerenone
Emend (aprepitant)

+

finerenone

1 interaction

Monitor/Modify Tx

aprepitant + finerenone

if aprepitant 3-day regimen, monitor potassium; aprepitant single dose-regimen OK: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (hepatic metab. inhibited)

• futibatinib
Emend (aprepitant)

+

futibatinib

1 interaction

Monitor/Modify Tx

aprepitant + futibatinib

if aprepitant 3-day regimen, monitor phosphate; aprepitant single dose-regimen OK: combo may incr. futibatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• gepirone
Emend (aprepitant)

+

gepirone

1 interaction

Monitor/Modify Tx

aprepitant + gepirone

if aprepitant 3-day regimen, monitor ECG, electrolytes; decr. gepirone dose 50%; aprepitant single dose-regimen OK: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• gilteritinib
Emend (aprepitant)

+

gilteritinib

1 interaction

Monitor/Modify Tx

aprepitant + gilteritinib

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. gilteritinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• glasdegib
Emend (aprepitant)

+

glasdegib

1 interaction

Monitor/Modify Tx

aprepitant + glasdegib

if aprepitant 3-day regimen, monitor CBC, ECG; aprepitant single dose-regimen OK: combo may incr. glasdegib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• guanfacine
Emend (aprepitant)

+

guanfacine

1 interaction

Monitor/Modify Tx

aprepitant + guanfacine

if aprepitant 3-day regimen, decr. guanfacine ER dose 50%, consider decr. dose for immed.-release form; aprepitant single dose-regimen OK: combo may incr. guanfacine levels, risk of adverse effects (hepatic metab. inhibited)

• hydrocortisone
Emend (aprepitant)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

aprepitant + hydrocortisone

if aprepitant 3-day regimen, consider decr. hydrocortisone dose; aprepitant single dose-regimen OK: combo may incr. hydrocortisone levels, risk of systemic corticosteroid effects, incl. Cushing syndrome and adrenal suppression, other adverse effects (hepatic metab. inhibited)

• ibrutinib
Emend (aprepitant)

+

ibrutinib

1 interaction

Monitor/Modify Tx

aprepitant + ibrutinib

if aprepitant 3-day regimen and B-CELL MALIGNANCIES: decr. ibrutinib dose to 280 mg qd; CHRONIC GVHD: consider decr. ibrutinib dose; aprepitant single dose-regimen OK: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• ifosfamide
Emend (aprepitant)

+

ifosfamide

1 interaction

Monitor/Modify Tx

aprepitant + ifosfamide

monitor CBC, renal, cardiac fxn; consider ifosfamide dose adjustment: combo may incr. ifosfamide active and toxic metabolite levels or decr. ifosfamide active metabolite levels, incr. risk of myelosuppression, serious infection, encephalopathy, nephrotoxicity, cardiotoxicity, other toxicities or decr. efficacy (hepatic metab. altered, incr. or decr. active metabolite formation)

• iloperidone
Emend (aprepitant)

+

iloperidone

1 interaction

Monitor/Modify Tx

aprepitant + iloperidone

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. iloperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• irinotecan
Emend (aprepitant)

+

irinotecan

1 interaction

Monitor/Modify Tx

aprepitant + irinotecan

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• lapatinib
Emend (aprepitant)

+

lapatinib

1 interaction

Monitor/Modify Tx

aprepitant + lapatinib

if aprepitant 3-day regimen, monitor ECG; consider decr. lapatinib dose; aprepitant single dose-regimen OK: combo may incr. lapatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lidocaine
Emend (aprepitant)

+

lidocaine

1 interaction

Monitor/Modify Tx

aprepitant + lidocaine

if aprepitant 3-day regimen, monitor lidocaine levels if lidocaine antiarrhythmic use; otherwise, monitor BP, HR; aprepitant single dose-regimen OK: combo may incr. lidocaine levels, risk of hypotension, bradycardia, other adverse effects; risk may be higher w/ continuous infusion or higher doses for local anesthesia (hepatic metab. inhibited)

• lumateperone
Emend (aprepitant)

+

lumateperone

1 interaction

Monitor/Modify Tx

aprepitant + lumateperone

if aprepitant 3-day regimen, monitor ECG; decr. lumateperone dose to 21 mg qd; aprepitant single dose-regimen OK: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lurasidone
Emend (aprepitant)

+

lurasidone

1 interaction

Monitor/Modify Tx

aprepitant + lurasidone

if aprepitant 3-day regimen, monitor ECG; decr. lurasidone start dose to 20 mg or decr. usual lurasidone dose 50%, max 80 mg/day; aprepitant single dose-regimen OK: combo may incr. lurasidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• mavorixafor
Emend (aprepitant)

+

mavorixafor

1 interaction

Monitor/Modify Tx

aprepitant + mavorixafor

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. mavorixafor levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• mefloquine
Emend (aprepitant)

+

mefloquine

1 interaction

Monitor/Modify Tx

aprepitant + mefloquine

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. mefloquine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• methylprednisolone
Emend (aprepitant)

+

methylprednisolone

1 interaction

Monitor/Modify Tx

aprepitant + methylprednisolone

if aprepitant 3-day regimen, decr. methylprednisolone IV dose 25%, PO dose 50%; aprepitant single dose-regimen OK: combo may incr. methylprednisolone levels, risk of systemic corticosteroid effects incl. Cushing syndrome and adrenal suppression (hepatic metab. inhibited)

• midostaurin
Emend (aprepitant)

+

midostaurin

1 interaction

Monitor/Modify Tx

aprepitant + midostaurin

if aprepitant 3-day regimen, monitor ECG, CBC; aprepitant single dose-regimen OK: combo may incr. midostaurin levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• nifedipine
Emend (aprepitant)

+

nifedipine

1 interaction

Monitor/Modify Tx

aprepitant + nifedipine

if aprepitant 3-day regimen, monitor BP, consider lowest nifedipine start dose; aprepitant single dose-regimen OK: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• nimodipine
Emend (aprepitant)

+

nimodipine

1 interaction

Monitor/Modify Tx

aprepitant + nimodipine

monitor BP: combo may incr. or decr. nimodipine levels, incr. risk of hypotension, other adverse effects or decr. efficacy (hepatic metab. altered)

• nortriptyline
Emend (aprepitant)

+

nortriptyline

1 interaction

Monitor/Modify Tx

aprepitant + nortriptyline

if aprepitant 3-day regimen, monitor nortriptyline levels; aprepitant single dose-regimen OK: combo may incr. nortriptyline levels, risk of adverse effects (hepatic metab. inhibited)

• osilodrostat
Emend (aprepitant)

+

osilodrostat

1 interaction

Monitor/Modify Tx

aprepitant + osilodrostat

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. osilodrostat levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• palbociclib
Emend (aprepitant)

+

palbociclib

1 interaction

Monitor/Modify Tx

aprepitant + palbociclib

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. palbociclib levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• panobinostat
Emend (aprepitant)

+

panobinostat

1 interaction

Monitor/Modify Tx

aprepitant + panobinostat

if aprepitant 3-day regimen, monitor ECG, CBC; aprepitant single dose-regimen OK: combo may incr. panobinostat levels, risk of QT prolongation, cardiac arrhythmias, serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• pazopanib
Emend (aprepitant)

+

pazopanib

1 interaction

Monitor/Modify Tx

aprepitant + pazopanib

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. pazopanib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• pimavanserin
Emend (aprepitant)

+

pimavanserin

1 interaction

Monitor/Modify Tx

aprepitant + pimavanserin

if aprepitant 3-day regimen, consider monitoring ECG; aprepitant single dose-regimen OK: combo may incr. pimavanserin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• pirtobrutinib
Emend (aprepitant)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

aprepitant + pirtobrutinib

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. pirtobrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• ponatinib
Emend (aprepitant)

+

ponatinib

1 interaction

Monitor/Modify Tx

aprepitant + ponatinib

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. ponatinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• quetiapine
Emend (aprepitant)

+

quetiapine

1 interaction

Monitor/Modify Tx

aprepitant + quetiapine

if aprepitant 3-day regimen, monitor ECG; consider decr. quetiapine dose; aprepitant single dose-regimen OK: combo may incr. quetiapine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quinidine (antiarrhythmic)
Emend (aprepitant)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

aprepitant + quinidine (antiarrhythmic)

if aprepitant 3-day regimen, monitor quinidine levels, ECG; aprepitant single dose-regimen OK: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quinidine (CYP2D6 inhibitor)
Emend (aprepitant)

+

quinidine (CYP2D6 inhibitor)

1 interaction

Monitor/Modify Tx

aprepitant + quinidine (CYP2D6 inhibitor)

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quinine
Emend (aprepitant)

+

quinine

1 interaction

Monitor/Modify Tx

aprepitant + quinine

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. quinine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quizartinib
Emend (aprepitant)

+

quizartinib

1 interaction

Monitor/Modify Tx

aprepitant + quizartinib

if aprepitant 3-day regimen, monitor ECG, electrolytes; aprepitant single-dose regimen OK: combo may incr. quizartinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• ranolazine
Emend (aprepitant)

+

ranolazine

1 interaction

Monitor/Modify Tx

aprepitant + ranolazine

if aprepitant 3-day regimen, adjust ranolazine max dose to 1000 mg/day; aprepitant single dose-regimen OK: combo may incr. ranolazine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• red yeast rice
Emend (aprepitant)

+

red yeast rice

1 interaction

Monitor/Modify Tx

aprepitant + red yeast rice

if aprepitant 3-day regimen, monitor CK, myopathy sx w/ large amounts of red yeast rice; aprepitant single dose-regimen OK: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, red yeast rice contains varying amounts of lovastatin)

• repaglinide
Emend (aprepitant)

+

repaglinide

1 interaction

Monitor/Modify Tx

aprepitant + repaglinide

if aprepitant 3-day regimen, monitor glucose; aprepitant single dose-regimen OK: combo may incr. repaglinide levels, risk of hypoglycemia, other adverse effects (hepatic metab. inhibited)

• rimegepant
Emend (aprepitant)

+

rimegepant

1 interaction

Monitor/Modify Tx

aprepitant + rimegepant

if aprepitant 3-day regimen, separate rimegepant doses by at least 48h; aprepitant single dose-regimen OK: combo may incr. rimegepant levels, risk of adverse effects (hepatic metab. inhibited)

• riociguat
Emend (aprepitant)

+

riociguat

1 interaction

Monitor/Modify Tx

aprepitant + riociguat

if aprepitant 3-day regimen, monitor BP; aprepitant single dose-regimen OK: combo may incr. riociguat levels, risk of severe hypotension, other adverse effects (hepatic metab. inhibited)

• ruxolitinib
Emend (aprepitant)

+

ruxolitinib

1 interaction

Monitor/Modify Tx

aprepitant + ruxolitinib

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• ruxolitinib topical
Emend (aprepitant)

+

ruxolitinib topical

1 interaction

Monitor/Modify Tx

aprepitant + ruxolitinib topical

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• sertraline
Emend (aprepitant)

+

sertraline

1 interaction

Monitor/Modify Tx

aprepitant + sertraline

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. sertraline levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• sirolimus
Emend (aprepitant)

+

sirolimus

1 interaction

Monitor/Modify Tx

aprepitant + sirolimus

if aprepitant 3-day regimen, monitor sirolimus levels; aprepitant single dose-regimen OK: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (hepatic metab. inhibited)

• sirolimus albumin-bound
Emend (aprepitant)

+

sirolimus albumin-bound

1 interaction

Monitor/Modify Tx

aprepitant + sirolimus albumin-bound

if aprepitant 3-day regimen, decr. sirolimus albumin-bound dose to 56 mg/m2; monitor CBC, bleeding s/sx; aprepitant single dose-regimen OK: combo may incr. sirolimus albumin-bound levels, risk of serious infection, myelosuppression, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• sparsentan
Emend (aprepitant)

+

sparsentan

1 interaction

Monitor/Modify Tx

aprepitant + sparsentan

if aprepitant 3-day regimen, monitor BP, potassium, renal fxn; aprepitant single dose-regimen OK: combo may incr. sparsentan levels, risk of hypotension (incl. orthostasis, syncope), hyperkalemia, edema, nephrotoxicity, other adverse effects (hepatic metab. inhibited)

• sunitinib
Emend (aprepitant)

+

sunitinib

1 interaction

Monitor/Modify Tx

aprepitant + sunitinib

if aprepitant 3-day regimen, consider monitoring ECG, electrolytes; aprepitant single dose-regimen OK: combo may incr. sunitinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• suvorexant
Emend (aprepitant)

+

suvorexant

1 interaction

Monitor/Modify Tx

aprepitant + suvorexant

if aprepitant 3-day regimen, decr. suvorexant dose to 5 mg, max 10 mg/day; aprepitant single dose-regimen OK: combo may incr. suvorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• suzetrigine
Emend (aprepitant)

+

suzetrigine

1 interaction

Monitor/Modify Tx

aprepitant + suzetrigine

if aprepitant 3-day regimen, start suzetrigine 100 mg x1 at least 1h before or 2h after food, after 12h give 50 mg q12h x3 doses, then after 12h give 50mg q24h; aprepitant single dose-regimen OK: combo may incr. suzetrigine and active metabolite levels, risk of adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• tacrolimus
Emend (aprepitant)

+

tacrolimus

1 interaction

Monitor/Modify Tx

aprepitant + tacrolimus

if aprepitant 3-day regimen, monitor tacrolimus levels, ECG, renal fxn; aprepitant single dose-regimen OK: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, other adverse effects (hepatic metab. inhibited)

• tadalafil
Emend (aprepitant)

+

tadalafil

1 interaction

Monitor/Modify Tx

aprepitant + tadalafil

if aprepitant 3-day regimen, monitor BP; aprepitant single dose-regimen OK: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• tamsulosin
Emend (aprepitant)

+

tamsulosin

1 interaction

Monitor/Modify Tx

aprepitant + tamsulosin

if aprepitant 3-day regimen, monitor BP, especially w/ tamsulosin dose >0.4 mg; aprepitant single dose-regimen OK: combo may incr. tamsulosin levels, risk of hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• temsirolimus
Emend (aprepitant)

+

temsirolimus

1 interaction

Monitor/Modify Tx

aprepitant + temsirolimus

if aprepitant 3-day regimen, monitor CBC; consider decr. temsirolimus dose; aprepitant single dose-regimen OK: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• tezacaftor/ivacaftor
Emend (aprepitant)

+

tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

aprepitant + tezacaftor/ ivacaftor

if aprepitant 3-day regimen, decr. dose by alternating tezacaftor/ivacaftor tab and ivacaftor tab at morning dose, no evening doses; aprepitant single dose-regimen OK: combo may incr. tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• tofacitinib
Emend (aprepitant)

+

tofacitinib

1 interaction

Monitor/Modify Tx

aprepitant + tofacitinib

monitor CBC; if also combined w/ strong CYP2C19 inhibitor, adjust tofacitinib dose as follows: RHEUMATOID or PSORIATIC ARTHRITIS: decr. tofacitinib dose to 5 mg qd; ULCERATIVE COLITIS: decr. tofacitinib 22 mg qd dose to 11 mg qd; decr. tofacitinib 11 mg qd dose to 5 mg qd; decr. tofacitinib 10 mg bid dose to 5 mg bid; decr. tofacitinib 5 mg bid dose to 5 mg qd; JUVENILE IDIOPATHIC ARTHRITIS: decr. usual tofacitinib bid dose to qd: combo w/ aprepitant 3-day regimen may incr. tofacitinib levels, risk of serious infection, myelosuppression, other adverse effects; aprepitant single dose-regimen OK (hepatic metab. inhibited)

• toremifene
Emend (aprepitant)

+

toremifene

1 interaction

Monitor/Modify Tx

aprepitant + toremifene

if aprepitant 3-day regimen, monitor ECG; aprepitant single dose-regimen OK: combo may incr. toremifene levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• trabectedin
Emend (aprepitant)

+

trabectedin

1 interaction

Monitor/Modify Tx

aprepitant + trabectedin

if aprepitant 3-day regimen, monitor CBC, cardiac fxn, LFTs; aprepitant single dose-regimen OK: combo may incr. trabectedin levels, risk of myelosuppression, cardiotoxicity, hepatotoxicity, other adverse effects (hepatic metab. inhibited)

• trazodone
Emend (aprepitant)

+

trazodone

1 interaction

Monitor/Modify Tx

aprepitant + trazodone

if aprepitant 3-day regimen, monitor ECG, BP; aprepitant single dose-regimen OK: combo may incr. trazodone levels, risk of QT prolongation, cardiac arrhythmias, hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• ubrogepant
Emend (aprepitant)

+

ubrogepant

1 interaction

Monitor/Modify Tx

aprepitant + ubrogepant

if aprepitant 3-day regimen, limit ubrogepant dose to 50 mg, may give second 50 mg dose after 24h if needed; aprepitant single dose-regimen OK: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metab. inhibited)

• upadacitinib
Emend (aprepitant)

+

upadacitinib

1 interaction

Monitor/Modify Tx

aprepitant + upadacitinib

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. upadacitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• vanzacaftor/tezacaftor/deutivacaftor
Emend (aprepitant)

+

vanzacaftor/ tezacaftor/ deutivacaftor

1 interaction

Monitor/Modify Tx

aprepitant + vanzacaftor/ tezacaftor/ deutivacaftor

if aprepitant 3-day regimen, adjust vanzacaftor/tezacaftor/deutivacaftor as follows; aprepitant single dose-regimen OK: 6-11 YO AND WT <40 KG: decr. vanzacaftor/tezacaftor/deutivacaftor dose to two tablets (4 mg/20 mg/50 mg each) qod; 6-11 YO AND WT 40 KG AND ABOVE: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod; 12 YO AND OLDER: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod: combo may incr. vanzacaftor/tezacaftor/deutivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• vemurafenib
Emend (aprepitant)

+

vemurafenib

1 interaction

Monitor/Modify Tx

aprepitant + vemurafenib

if aprepitant 3-day regimen, monitor ECG; otherwise, caution advised: combo may incr. vemurafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• vinblastine
Emend (aprepitant)

+

vinblastine

1 interaction

Monitor/Modify Tx

aprepitant + vinblastine

if aprepitant 3-day regimen, monitor CBC; otherwise, caution advised: combo may incr. vinblastine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• vincristine
Emend (aprepitant)

+

vincristine

1 interaction

Monitor/Modify Tx

aprepitant + vincristine

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. vincristine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metab. inhibited)

• voclosporin
Emend (aprepitant)

+

voclosporin

1 interaction

Monitor/Modify Tx

aprepitant + voclosporin

if aprepitant 3-day regimen, monitor ECG, renal fxn; decr. voclosporin morning dose to 15.8 mg and evening dose to 7.9 mg; aprepitant single dose-regimen OK: combo may incr. voclosporin levels, risk of QT prolongation, cardiac arrhythmias, serious infection, nephrotoxicity, other adverse effects (hepatic metab. inhibited)

• warfarin
Emend (aprepitant)

+

warfarin

1 interaction

Monitor/Modify Tx

aprepitant + warfarin

monitor INR 7-10 days after aprepitant tx: combo may decr. warfarin levels, efficacy (hepatic metab. induced)

• zanubrutinib
Emend (aprepitant)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

aprepitant + zanubrutinib

if aprepitant 3-day regimen, decr. zanubrutinib dose to 80 mg bid; monitor CBC; otherwise, caution advised: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects; may decr. aprepitant levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

Caution Advised

• aliskiren
Emend (aprepitant)

+

aliskiren

1 interaction

Caution Advised

aprepitant + aliskiren

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. aliskiren levels, risk of adverse effects (hepatic metab. inhibited)

• armodafinil
Emend (aprepitant)

+

armodafinil

1 interaction

Caution Advised

aprepitant + armodafinil

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• belzutifan
Emend (aprepitant)

+

belzutifan

1 interaction

Caution Advised

aprepitant + belzutifan

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• bexarotene
Emend (aprepitant)

+

bexarotene

1 interaction

Caution Advised

aprepitant + bexarotene

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• budesonide rectal
Emend (aprepitant)

+

budesonide rectal

1 interaction

Caution Advised

aprepitant + budesonide rectal

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. budesonide levels, risk of systemic corticosteroid effects incl. Cushing syndrome and adrenal suppression, serious infection, other adverse effects (hepatic metab. inhibited)

• clobazam
Emend (aprepitant)

+

clobazam

1 interaction

Caution Advised

aprepitant + clobazam

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• cyclophosphamide
Emend (aprepitant)

+

cyclophosphamide

1 interaction

Caution Advised

aprepitant + cyclophosphamide

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may decr. cyclophosphamide active metabolite levels, efficacy (hepatic metab. possibly inhibited, decr. conversion to active metabolite)

• danshen
Emend (aprepitant)

+

danshen

1 interaction

Caution Advised

aprepitant + danshen

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• darifenacin
Emend (aprepitant)

+

darifenacin

1 interaction

Caution Advised

aprepitant + darifenacin

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. darifenacin levels, risk of adverse effects (hepatic metab. inhibited)

• darolutamide
Emend (aprepitant)

+

darolutamide

1 interaction

Caution Advised

aprepitant + darolutamide

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• deferasirox
Emend (aprepitant)

+

deferasirox

1 interaction

Caution Advised

aprepitant + deferasirox

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• dicloxacillin
Emend (aprepitant)

+

dicloxacillin

1 interaction

Caution Advised

aprepitant + dicloxacillin

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• echinacea
Emend (aprepitant)

+

echinacea

1 interaction

Caution Advised

aprepitant + echinacea

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• elafibranor
Emend (aprepitant)

+

elafibranor

1 interaction

Caution Advised

aprepitant + elafibranor

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• elagolix
Emend (aprepitant)

+

elagolix

1 interaction

Caution Advised

aprepitant + elagolix

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• eletriptan
Emend (aprepitant)

+

eletriptan

1 interaction

Caution Advised

aprepitant + eletriptan

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. eletriptan levels, risk of adverse effects (hepatic metab. inhibited)

• enasidenib
Emend (aprepitant)

+

enasidenib

1 interaction

Caution Advised

aprepitant + enasidenib

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• erlotinib
Emend (aprepitant)

+

erlotinib

1 interaction

Caution Advised

aprepitant + erlotinib

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. erlotinib levels, risk of adverse effects (hepatic metab. inhibited)

• eslicarbazepine acetate
Emend (aprepitant)

+

eslicarbazepine acetate

1 interaction

Caution Advised

aprepitant + eslicarbazepine acetate

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• felbamate
Emend (aprepitant)

+

felbamate

1 interaction

Caution Advised

aprepitant + felbamate

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• garlic
Emend (aprepitant)

+

garlic

1 interaction

Caution Advised

aprepitant + garlic

caution advised w/ supplemental garlic; dietary intake OK: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ginkgo
Emend (aprepitant)

+

ginkgo

1 interaction

Caution Advised

aprepitant + ginkgo

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ginseng, Asian
Emend (aprepitant)

+

ginseng, Asian

1 interaction

Caution Advised

aprepitant + ginseng, Asian

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• glycerol phenylbutyrate
Emend (aprepitant)

+

glycerol phenylbutyrate

1 interaction

Caution Advised

aprepitant + glycerol phenylbutyrate

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• grazoprevir
Emend (aprepitant)

+

grazoprevir

1 interaction

Caution Advised

aprepitant + grazoprevir

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. grazoprevir levels, risk of adverse effects (hepatic metab. inhibited)

• griseofulvin
Emend (aprepitant)

+

griseofulvin

1 interaction

Caution Advised

aprepitant + griseofulvin

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• istradefylline
Emend (aprepitant)

+

istradefylline

1 interaction

Caution Advised

aprepitant + istradefylline

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. istradefylline levels, risk of adverse effects (hepatic metab. inhibited)

• larotrectinib
Emend (aprepitant)

+

larotrectinib

1 interaction

Caution Advised

aprepitant + larotrectinib

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. larotrectinib levels, risk of adverse effects (hepatic metab. inhibited)

• levonorgestrel intrauterine device (contraceptive)
Emend (aprepitant)

+

levonorgestrel intrauterine device (contraceptive)

1 interaction

Caution Advised

aprepitant + levonorgestrel intrauterine device (contraceptive)

caution advised: combo may decr. hormonal contraceptive levels, efficacy (hepatic metab. induced)

• maraviroc
Emend (aprepitant)

+

maraviroc

1 interaction

Caution Advised

aprepitant + maraviroc

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. maraviroc levels, risk of adverse effects (hepatic metab. inhibited)

• meropenem
Emend (aprepitant)

+

meropenem

1 interaction

Caution Advised

aprepitant + meropenem

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)

• naldemedine
Emend (aprepitant)

+

naldemedine

1 interaction

Caution Advised

aprepitant + naldemedine

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. naldemedine levels, risk of adverse effects (hepatic metab. inhibited)

• nevirapine
Emend (aprepitant)

+

nevirapine

1 interaction

Caution Advised

aprepitant + nevirapine

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• odevixibat
Emend (aprepitant)

+

odevixibat

1 interaction

Caution Advised

aprepitant + odevixibat

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• olutasidenib
Emend (aprepitant)

+

olutasidenib

1 interaction

Caution Advised

aprepitant + olutasidenib

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)

• ospemifene
Emend (aprepitant)

+

ospemifene

1 interaction

Caution Advised

aprepitant + ospemifene

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. ospemifene levels, risk of adverse effects (hepatic metab. inhibited)

• oxcarbazepine
Emend (aprepitant)

+

oxcarbazepine

1 interaction

Caution Advised

aprepitant + oxcarbazepine

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• perampanel
Emend (aprepitant)

+

perampanel

1 interaction

Caution Advised

aprepitant + perampanel

caution advised if on perampanel 12 mg/day: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• pioglitazone
Emend (aprepitant)

+

pioglitazone

1 interaction

Caution Advised

aprepitant + pioglitazone

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• prednisone
Emend (aprepitant)

+

prednisone

1 interaction

Caution Advised

aprepitant + prednisone

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• roflumilast
Emend (aprepitant)

+

roflumilast

1 interaction

Caution Advised

aprepitant + roflumilast

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. roflumilast levels, risk of adverse effects (hepatic metab. inhibited)

• roflumilast topical
Emend (aprepitant)

+

roflumilast topical

1 interaction

Caution Advised

aprepitant + roflumilast topical

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. roflumilast levels, risk of adverse effects (hepatic metab. inhibited)

• rufinamide
Emend (aprepitant)

+

rufinamide

1 interaction

Caution Advised

aprepitant + rufinamide

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• sarilumab
Emend (aprepitant)

+

sarilumab

1 interaction

Caution Advised

aprepitant + sarilumab

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. altered; sarilumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)

• saxagliptin
Emend (aprepitant)

+

saxagliptin

1 interaction

Caution Advised

aprepitant + saxagliptin

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. saxagliptin levels, risk of adverse effects (hepatic metab. inhibited)

• seladelpar
Emend (aprepitant)

+

seladelpar

1 interaction

Caution Advised

aprepitant + seladelpar

caution advised if aprepitant 3-day regimen and if CYP2C9 poor metabolizer or if also combined w/ moderate CYP2C9 inhibitor; aprepitant single dose-regimen OK: combo may incr. seladelpar levels, risk of adverse effects (hepatic metab. inhibited)

• sildenafil
Emend (aprepitant)

+

sildenafil

1 interaction

Caution Advised

aprepitant + sildenafil

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. sildenafil levels, risk of hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• silodosin
Emend (aprepitant)

+

silodosin

1 interaction

Caution Advised

aprepitant + silodosin

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. silodosin levels, risk of adverse effects (hepatic metab. inhibited)

• sirolimus topical
Emend (aprepitant)

+

sirolimus topical

1 interaction

Caution Advised

aprepitant + sirolimus topical

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. sirolimus levels, risk of adverse effects (hepatic metab. inhibited)

• somatropin
Emend (aprepitant)

+

somatropin

1 interaction

Caution Advised

aprepitant + somatropin

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• stiripentol
Emend (aprepitant)

+

stiripentol

1 interaction

Caution Advised

aprepitant + stiripentol

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)

• tecovirimat
Emend (aprepitant)

+

tecovirimat

1 interaction

Caution Advised

aprepitant + tecovirimat

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• telotristat ethyl
Emend (aprepitant)

+

telotristat ethyl

1 interaction

Caution Advised

aprepitant + telotristat ethyl

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• ticagrelor
Emend (aprepitant)

+

ticagrelor

1 interaction

Caution Advised

aprepitant + ticagrelor

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. ticagrelor levels, risk of dyspnea, bleeding, other adverse effects (hepatic metab. inhibited)

• tocilizumab
Emend (aprepitant)

+

tocilizumab

1 interaction

Caution Advised

aprepitant + tocilizumab

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. altered; tocilizumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes)

• topiramate
Emend (aprepitant)

+

topiramate

1 interaction

Caution Advised

aprepitant + topiramate

caution advised especially w/ topiramate doses >200 mg/day: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• tovorafenib
Emend (aprepitant)

+

tovorafenib

1 interaction

Caution Advised

aprepitant + tovorafenib

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• tretinoin
Emend (aprepitant)

+

tretinoin

1 interaction

Caution Advised

aprepitant + tretinoin

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. tretinoin levels, risk of adverse effects (hepatic metab. inhibited)

• vaborbactam
Emend (aprepitant)

+

vaborbactam

1 interaction

Caution Advised

aprepitant + vaborbactam

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)

• vamorolone
Emend (aprepitant)

+

vamorolone

1 interaction

Caution Advised

aprepitant + vamorolone

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)

• vilazodone
Emend (aprepitant)

+

vilazodone

1 interaction

Caution Advised

aprepitant + vilazodone

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. vilazodone levels, risk of adverse effects (hepatic metab. inhibited)

• vorasidenib
Emend (aprepitant)

+

vorasidenib

1 interaction

Caution Advised

aprepitant + vorasidenib

caution advised: combo may decr. aprepitant levels, efficacy (hepatic metab. possibly induced)