Varubi
Varubi (rolapitant) is an antiemetic medication that belongs to the drug class called neurokinin-1 (NK-1) receptor antagonists. It's used for adults to prevent nausea and vomiting caused by certain anticancer medications (chemotherapy). Varubi (rolapitant) is used with two other medications, dexamethasone and a serotonin receptor antagonist. Varubi (rolapitant) is typically given only on day 1 of your chemotherapy cycle. Side effects include low appetite and dizziness.
What is Varubi (rolapitant)?
What is Varubi (rolapitant) used for?
- Prevention of nausea and vomiting caused by certain chemotherapy when used together with dexamethasone and a serotonin receptor antagonist
How Varubi (rolapitant) works
Varubi (rolapitant) is a neurokinin-1 (NK-1) receptor antagonist. It blocks a chemical called substance P from attaching to NK-1 receptors in the brain that control nausea and vomiting. This helps prevent nausea and vomiting from chemotherapy.
Drug facts
Side effects of Varubi (rolapitant)
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
- Low appetite (9%)
- Dizziness (6%)
- Indigestion (4%)
- Urinary tract infection (UTI, 4%)
- Inflamed and sore mouth (4%)
Less Common Side Effects
- Hiccups
- Stomach pain
The following Varubi (rolapitant) 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 to your care team if they continue or are bothersome):
- Dizziness
- Hiccups
- Loss of appetite
- Stomach pain
- Upset stomach
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Pros and cons of Varubi (rolapitant)
Pros
- Good option for preventing nausea and vomiting from chemotherapy
- Only need to take once per chemotherapy cycle
- Can take with or without food
Cons
- Only used to prevent nausea and vomiting, not treat it
- Can interact with many medications (e.g., dextromethorphan (Delsym), methotrexate)
- Might not be a good option for people with severe liver problems
Pharmacist tips for Varubi (rolapitant)
- Make sure you understand when you should take Varubi (rolapitant). You should take Varubi (rolapitant) within 2 hours before your chemotherapy on day 1 of your chemotherapy cycle. This timing helps you get the most benefit from the medication to prevent nausea and vomiting from your chemotherapy.
- Swallow Varubi (rolapitant) whole. Don't crush or chew the tablets. Talk to your provider if you're having trouble swallowing the tablets whole.
- Don't take Varubi (rolapitant) any more often than once every 2 weeks. Ask your provider about other options if you're still feeling nauseous even after taking Varubi (rolapitant).
- Varubi (rolapitant) can interact with many medications, such as digoxin (Lanoxin), dextromethorphan (Delsym), and methotrexate. Tell your provider about all the medications you take before you start Varubi (rolapitant). Also, don't start any new medications while you're taking Varubi (rolapitant) without talking to your provider first. Your provider can check that all your medications are safe for you to take.
Common questions about Varubi (rolapitant)
Take Varubi (rolapitant) within 2 hours of starting chemotherapy on day 1 of your chemotherapy cycle. You should only take the medication once during each chemotherapy cycle. You can take Varubi (rolapitant) again when it's time for your next chemotherapy cycle. But don't take Varubi (rolapitant) more than one time every 2 weeks.
Varubi (rolapitant) is a long-lasting medication. It takes about 35 days for most of Varubi (rolapitant) to leave your body after a single dose. This time frame is estimated based on the half-life of Varubi (rolapitant). This is why you typically only need a single dose of Varubi (rolapitant) before each chemotherapy cycle and why you shouldn't take the medication any sooner than every 2 weeks. Talk to your provider if you feel Varubi (rolapitant) isn't working well enough to help prevent nausea and vomiting.
Studies didn't report anyone having a severe allergic reaction to Varubi (rolapitant) tablets. But it's still a possibility just like with any other medication. Go to the hospital right away if you have symptoms of an allergic reaction after you take Varubi (rolapitant). These symptoms can include rash; hives; shortness of breath; or a swollen throat, tongue, or face.
Yes, Varubi (rolapitant) can safely be used for people with a soybean oil allergy. Varubi (rolapitant) tablets don't contain any soybean oil.
No, Varubi (rolapitant) is currently only available as a tablet. The medication used to be available as an intravenous (IV) injection, but the IV form was discontinued. In January 2018, the FDA and the manufacturer issued a warning stating that some people who were given the IV form of Varubi (rolapitant) had serious allergic reactions, including anaphylaxis and other allergic reactions that needed hospitalization. These reactions happened during or very soon after people got their Varubi (rolapitant) infusion.
It's not known if Varubi (rolapitant) is safe or or if it works well in children younger than 18 years old. Varubi (rolapitant) shouldn't be used for children under 2 years old because the medication affected the sexual development and fertility (ability to have babies) of young rats in animal studies. Ask your child's provider for other options to prevent nausea and vomiting from chemotherapy for your child.
Talk to your provider to see if Varubi (rolapitant) is right for you if you're pregnant or thinking of getting pregnant. Your provider will discuss your options with you. There haven't been enough studies looking at how the medication affects mothers and babies during pregnancy. Because of this, it's not known if Varubi (rolapitant) is safe to use during pregnancy. In studies done on animals, Varubi (rolapitant) didn't cause harm to unborn babies, but it affected the ability to have babies in female rats. Note that what happens in animals doesn't always mean that it'll happen in humans.
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Risks and warnings for Varubi (rolapitant)
Varubi (rolapitant) 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.
Interactions with other medications
Varubi (rolapitant) interacts with many medications. It can change the level of other medications in your blood. This can lead to serious side effects. Some medications, like pimozide (Orap) and thioridazine, can't be used at all with Varubi (rolapitant). Other medications will need to have their dose adjusted; you'll also need to watch more closely for side effects if you have to take them with Varubi (rolapitant).
Make sure to tell your provider about all the medications you're taking before you take Varubi (rolapitant). Don't start any new medications while you're taking Varubi (rolapitant) without talking to your provider or pharmacist first.
Varubi (rolapitant) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 90mg | 2 tablets | $642.53 | $321.27 |
Typical dosage for Varubi (rolapitant)
The typical dose is 180 mg by mouth within 2 hours before starting chemotherapy on day 1 of each chemotherapy cycle. Varubi (rolapitant) shouldn't be taken any sooner than every 2 weeks.
How much does Varubi (rolapitant) cost?
$642.53
Varubi (rolapitant) 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 Varubi (rolapitant) will not be safe for you to take.
- Take pimozide (Orap) or thioridazine
- Children younger than 2 years old
What are alternatives to Varubi (rolapitant)?
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