Cinvanti
Cinvanti (aprepitant) is an injectable medication used to prevent nausea and vomiting caused by certain anti-cancer medications (chemotherapy). It's given by a healthcare provider intravenously (IV), which means the medication is delivered directly into your vein. Typically you'll only receive Cinvanti (aprepitant) on day 1 of your chemotherapy cycle. Common side effects include diarrhea and low energy. Rarely, Cinvanti (aprepitant) can also cause severe allergic reactions, such as swelling, itching, and rash. Your provider will monitor these symptoms during your treatment.
What is Cinvanti (aprepitant)?
What is Cinvanti (aprepitant) used for?
- Prevention of nausea and vomiting caused by certain anti-cancer (chemotherapy) medications
How Cinvanti (aprepitant) works
Cinvanti (aprepitant) is an antiemetic called NK1 receptor antagonists. It works by blocking certain chemicals in the brain that can cause nausea and vomiting. In doing so, Cinvanti (aprepitant) helps ease both acute and delayed nausea and vomiting.
Drug facts
| Common Brands | Cinvanti |
|---|---|
| Drug Class | NK1 receptor antagonist |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Cinvanti (aprepitant)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Tiredness (15%)
- Diarrhea (13%)
- Low white blood cell count (8%)
- Low energy (4%)
- Low red blood cell count (3%)
- Nerve pain (3%)
Please note: These side effects were reported by adults receiving fosaprepitant (a prodrug of aprepitant) along with ondansetron and dexamethasone.
Less Common Side Effects
- Pain in arms and legs
- Indigestion
- Urinary tract infection
- Infusion site reaction, including pain and skin irritation
Cinvanti (aprepitant) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: trouble breathing, rash, swelling of lips, tongue, or throat
The following Cinvanti (aprepitant) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Pain, tingling, or numbness in the hands or feet
- Unusual weakness or fatigue
- Upset stomach
Pros and cons of Cinvanti (aprepitant)
Pros
- Typically just need one dose per chemotherapy cycle
- Can use in people who have liver or kidney problems
- Might work well for people who didn’t see benefits with other antiemetics
- Can be taken together with other antiemetics (e.g., ondansetron)
Cons
- Only prevents nausea and vomiting, can't treat nausea and vomiting if you already have symptoms
- Not clear whether it's safe or works well in children
- Can't be taken with pimozide, a medication for Tourette syndrome
- Needs to be delivered into a vein, which can be less convenient than taking oral tablets
Pharmacist tips for Cinvanti (aprepitant)
- You'll typically receive Cinvanti (aprepitant) on day 1 of your chemotherapy, 30 minutes before your treatment.
- Cinvanti (aprepitant) can sometimes cause severe allergic reactions. Your provider will monitor you for symptoms such as trouble breathing, swelling of your face, flushing, rash, hives, and dizziness during and after injection.
- Watch out for injection site reactions such as pain, hardening, redness, or itching. In some cases, your injection site might also become swollen due to a blood clot. Tell your provider right away if you experience these symptoms.
- Don't use this medication if you're pregnant since it contains alcohol and can cause harm to your unborn baby. If you're pregnant or thinking of getting pregnant during treatment or chemotherapy, contact your provider.
- If you're taking hormonal birth control, make sure to also use non-hormonal birth control (e.g., condoms) as a backup method during treatment and for a month after the last dose of Cinvanti (aprepitant). This is because Cinvanti (aprepitant) can cause hormonal birth control to not work as well to prevent pregnancy.
- Cinvanti (aprepitant) can interact with many medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Cinvanti (aprepitant). Talk with your provider or pharmacist if you have any questions about interactions with this medication.
Risks and warnings for Cinvanti (aprepitant)
Cinvanti (aprepitant) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious allergic reaction
- Risk factor: Allergic to aprepitant
In some rare cases, Cinvanti (aprepitant) can cause allergic reactions, which can be life-threatening. Your risk is higher if you've been allergic to medications with aprepitant (e.g., Emend) in the past. Your provider will monitor you for serious allergic reactions during and after your infusion to make sure this medication is safe for you. Watch out for signs and symptoms, such as wheezing, eye swelling, flushing, itching, and rash. Let your provider know right away if you have any of these allergic reactions.
Interactions with other medications
Cinvanti (aprepitant) interacts with many medications. Before you receive it, make sure your provider is aware of all the other medications, vitamins, and supplements you're currently taking. They can help you check for any serious medication interactions.
Certain medications, like ketoconazole and diltiazem (Cardizem), can raise the amount of Cinvanti (aprepitant) in your body. Taking them together can make it more likely for you to experience Cinvanti (aprepitant) side effects, such as diarrhea and fatigue. On the other hand, taking certain medications like rifampin (Rifadin) can lower the amount of Cinvanti (aprepitant) in your body and cause the medication to not work as well.
Cinvanti (aprepitant) can also cause your body to absorb less warfarin (Coumadin), which can raise your risk of blood clots. Your provider will monitor your blood work (INR blood test), 7 to 10 days after your last treatment of Cinvanti (aprepitant), to make sure warfarin (Coumadin) is working well for you.
Finally, Cinvanti (aprepitant) might cause certain hormonal birth controls to work less well. If you're taking hormonal birth control, make sure to also use a back-up birth control, like condoms, during treatment and for at least a month after the last dose of Cinvanti (aprepitant) or oral aprepitant (Emend).
Cinvanti (aprepitant) dosage
Typical dosage for Cinvanti (aprepitant)
A healthcare provider will determine your dose of Cinvanti (aprepitant) based on the chemotherapy regimen you're getting and what other anti-nausea medications you're receiving.
The typical dose of Cinvanti (aprepitant) ranges from 100 mg to 130 mg injected through the veins on day 1 of your chemotherapy cycle. Cinvanti (aprepitant) is typically given 30 minutes before chemotherapy in a hospital or at an infusion center.
Cinvanti (aprepitant) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Cinvanti (aprepitant) will not be safe for you to take.
- Taking pimozide