Aprepitant Mylan 125 mg and 80 mg hard capsules – patient leaflet, side effects, dosage

1. What Aprepitant is and what it is used for

Aprepitant contains the active substance aprepitant and belongs to a group of medicines called "neurokinin 1 (NK₁) receptor antagonists". The brain has a specific area that controls nausea and vomiting. Aprepitant works by blocking signals to that area, thereby reducing nausea and

vomiting. Aprepitant capsules are used in adults and adolescents from the age of 12 years in combination with other medicines to prevent nausea and vomiting caused by chemotherapy (cancer treatment) that are strong and moderate triggers of nausea and vomiting (such as cisplatin, cyclophosphamide, doxorubicin or epirubicin).

2. What you need to know before you take or give Aprepitant

Do not take Aprepitant:

• if you or the child is allergic to aprepitant or any of the other ingredients of this medicine (listed in section 6).

• with medicines containing pimozide

  (used to treat psychiatric illnesses), terfenadine and astemizole (used for hay fever and other allergic conditions), cisapride (used for treating digestive problems). Tell the doctor if you or the child is taking these medicines since the treatment must be modified before you or the child start taking Aprepitant.

Warnings and precautions

Talk to the doctor, pharmacist or nurse before you take Aprepitant or give this medicine to the child.

Before treatment with Aprepitant, tell the doctor if you or the child have liver disease because the liver is important in breaking down the medicine in the body. The doctor may therefore have to monitor the condition of your or the child’s liver.

Children and adolescents

Do not give Aprepitant capsules to children under 12 years of age, because the capsules have not been studied in this population.

Other medicines and Aprepitant

Aprepitant can affect other medicines both during and after treatment with Aprepitant. There are some medicines that should not be taken with Aprepitant (such as pimozide, terfenadine, astemizole, and cisapride) or that require a dose adjustment (see also ‘Do not take Aprepitant’).

• corticosteroids (such

  as dexamethasone and

  methylprednisolone),

• anti-anxiety medicines (such as

  alprazolam),

• tolbutamide (a medicine used to

  treat diabetes)

Tell the doctor or pharmacist if you or the child are taking, have recently taken, or might take any other medicines.

Pregnancy and breast-feeding

This medicine should not be used during pregnancy unless clearly necessary. If you or the child are pregnant or breast-feeding may be pregnant or are planning to have a baby, ask the doctor for advice before taking this medicine.

For information regarding birth control, see ‘Other medicines and Aprepitant’.

It is not known whether Aprepitant is excreted in human milk; therefore, breast-feeding is not recommended during treatment with this medicine. It is important to tell the doctor if you or the child are breast-feeding or are planning to breast-feed before taking this medicine.

Driving and using machines

It should be taken into account that some people feel dizzy and sleepy after taking Aprepitant. If you or the child feels dizzy or sleepy, avoid driving, riding a bicycle or using machines or tools after taking this medicine (see ‘Possible side effects’).

Aprepitant contains sucrose and sodium

Aprepitant capsules contain sucrose. If you or the child have been told by your doctor that you or the child have an intolerance to some sugars, contact the doctor before taking this medicine.

This medicine contains less than 1 mmol sodium (23 mg) per capsule, that is to say is essentially ‘sodium-free’.

3. How to take Aprepitant

Always take this medicine or give this medicine to the child exactly as the

3

2

doctor, pharmacist or nurse has told you. You should check with the doctor, pharmacist or nurse if you are not sure. Always take Aprepitant together with other medicines, to prevent nausea and vomiting. After treatment with Aprepitant, the doctor may ask you or the child to continue taking other medicines including a corticosteroid (such as dexamethasone) and a ‘5HT₃ antagonist’ (such as ondansetron) for preventing nausea and vomiting. Check with the doctor, pharmacist or nurse if you are not sure.

The recommended oral dose of Aprepitant is

Day 1:

• one 125 mg capsule 1 hour before

  you start your chemotherapy session and

Days 2 and 3:

• one 80 mg capsule each day

• If no chemotherapy is given, take

  Aprepitant in the morning

• If chemotherapy is given, take

  Aprepitant 1 hour before you start your chemotherapy session.

Aprepitant can be taken with or without food.

Swallow the capsule whole with some liquid.

If you take more Aprepitant than you should

Do not take more capsules than the doctor recommends. If you or the child has taken too many capsules, contact your doctor immediately.

If you forget to take Aprepitant

If you or the child has missed a dose, contact your doctor for advice.

If you have any further questions on the use of this medicine, ask the doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Stop taking Aprepitant and see a doctor immediately if you or the child notice any of the following side

effects, which may be serious, and

for which you or the child may need urgent medical treatment:

• Hives, rash, itching, difficulty breathing or swallowing (frequency not known, cannot be estimated from the available data); these are signs of an allergic reaction.

Other side effects that have been reported are listed below:

Common side effects (may affect up to 1 in 10 people) are:

• constipation, indigestion,
• headache,
• tiredness,
• loss of appetite,
• hiccups,
• increased amount of liver enzymes in your blood.

Uncommon side effects (may affect up to 1 in 100 people) are:

• dizziness, sleepiness,
• acne, rash,
• anxiousness,
• burping, nausea, vomiting, heartburn, stomach pain, dry mouth, passing wind,
• increased painful or burning urination,
• weakness, generally feeling unwell,
• hot flush/reddening of the face or skin,
• fast or irregular heartbeats,
• fever with increased risk of infection, lowering of red blood cells.

Rare side effects (may affect up to

1 in 1,000 people) are:

• difficulty thinking, lack of energy, taste disturbance,
• sensitivity of the skin to sun, excessive sweating, oily skin, sores on skin, itching rash, Stevens-Johnson syndrome/toxic epidermal necrolysis (rare severe skin reaction),
• euphoria (feeling of extreme happiness), disorientation,
• bacterial infection, fungal infection,
• severe constipation, stomach ulcer, inflammation of the small intestine and colon, sores in mouth, bloating,
• frequent urination, passing more urine than normal, presence of sugar or blood in urine,
• chest discomfort, swelling, change in the manner of walking,
• cough, mucus in back of throat, throat irritation, sneezing, sore throat, The effects of Aprepitant or other medicines might be influenced if you or the child take Aprepitant together with other medicines including those listed below. Please talk to the doctor or pharmacist if you or the child is taking any of the following medicines:

• birth control medicines which can

  include birth control pills, skin patches, implants, and certain Intrauterine devices (IUDs) that release hormones may not work adequately when taken together with Aprepitant. Another or additional non-hormonal form of birth control should be used during treatment with Aprepitant and for up to 2 months after using this medicine,

• cyclosporine, tacrolimus, sirolimus,

  everolimus (immunosuppressants),

• alfentanil, fentanyl (used to treat

  pain),

• quinidine (used to treat an irregular

  heart beat),

• irinotecan, etoposide, vinorelbine,

  ifosfamide (medicines used to treat cancer),

• medicines containing ergot alkaloid

  derivatives such as ergotamine and diergotamine (used for treating migraines),

• warfarin, acenocoumarol (blood

  thinners; blood tests may be required),

• rifampicin, clarithromycin,

  telithromycin (antibiotics used to treat infections),

• phenytoin (a medicine used to treat

  seizures),

• carbamazepine (used to treat

  depression and epilepsy),

• midazolam, triazolam, phenobarbital

  (medicines used to produce calmness or help you sleep),

• St. John’s Wort (an herbal preparation

  used to treat depression),

• protease inhibitors (used to treat HIV

  infections),

• ketoconazole (except shampoo)

  (used to treat Cushing’s syndrome - when the body produces an excess of cortisol),

• itraconazole, voriconazole,

  posaconazole (antifungals),

• nefazodone (used to treat

  depression),

• eye discharge and itching,
• ringing in the ear,
• muscle spasms, muscle weakness,
• excessive thirst,

• slow heartbeat, heart and blood

  vessel disease,

• lowering of white blood cells, low

  sodium levels in the blood, weight loss.

Reporting of side effects

If you or the child gets any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Aprepitant

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

This medicine does not require any special storage conditions.

Do not remove the capsule from its blister until you are ready to take it.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Aprepitant contains

The active substance is aprepitant. Each capsule contains 80 mg or 125 mg of aprepitant.

The other ingredients are:

Capsule content:

hydroxypropylcellulose, sodium laurilsulfate, sucrose, cellulose microcrystalline. Printing ink: shellac, ammonia solution (concentrated),

propylene glycol, potassium hydroxide, black iron oxide (E 172). Capsule shell: titanium dioxide (E 171), gelatin. The 125 mg capsule also contains red iron oxide (E 172).

What Aprepitant looks like and contents of the pack

The 80 mg capsule is size 2 capsule and has an opaque white cap and an opaque white body with “80 mg” printed in black ink.

The 125 mg capsule is size 1 capsule and has an opaque pink cap and an opaque white body, printed with “125 mg” in black ink.

Aprepitant 80 mg capsules are supplied in perforated unit dose blisters of 1x1, 2x1 or 5x1 capsules. Aprepitant 125 mg capsules are supplied in perforated unit dose blisters of 1x1 or 5x1 capsules. Aprepitant 125 mg / 80 mg capsules are supplied in a 3-day treatment pack in perforated unit dose blisters of 1x1 (125 mg) and 2x1 (80 mg) capsules.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Mylan,

Station Close,

Potters Bar,

Hertfordshire,

EN6 1TL,

United Kingdom.

Manufacturer

Ethypharm

Chemin de la Poudrière

76120 Le Grand Quevilly

France

Ethypharm

Z.I. de Saint Arnoult

28170 Châteauneuf en Thymerais France

This leaflet was last revised in

4 1

TBC

2274535

Date: Time:

23 SEP 2020 14:05