Fosaprepitant Side Effects
Medically reviewed by Drugs.com. Last updated on Sep 20, 2024.
Applies to fosaprepitant: intravenous powder for solution.
Serious side effects of fosaprepitant
Along with its needed effects, fosaprepitant may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking fosaprepitant:
More common side effects
- black, tarry stools
- blurred vision
- chest tightness
- chills
- confusion
- cough
- decreased urination
- difficult or labored breathing
- dizziness
- dry mouth
- fainting
- fever
- increase in heart rate
- lightheadedness
- lower back or side pain
- nervousness
- pain, swelling, or redness at the injection site
- painful or difficult urination
- pale skin
- pounding in the ears
- rapid breathing
- slow or fast heartbeat
- sore throat
- sunken eyes
- tenderness, swelling, warmth, or skin discoloration at the injection site
- thirst
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual tiredness or weakness
- wrinkled skin
Less common side effects
- hard lump at the injection site
Rare side effects
- blood in the urine
- changes in patterns and rhythms of speech
- changes in skin color
- chest pain or discomfort
- fast, slow, irregular, pounding, or racing heartbeat or pulse
- general feeling of discomfort or illness
- headache
- increased sweating
- increased thirst
- lightheadedness, dizziness, or fainting
- loss of consciousness
- muscle pain or cramps
- nausea
- pain, tenderness, or swelling of the foot or leg
- seizures
- slurred speech
- swelling
- swelling of the face, ankles, or hands
- trouble with speaking
- trouble breathing
- vomiting
Incidence not known
- diarrhea
- difficulty with swallowing
- hives or welts, itching
- joint pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red skin lesions, often with a purple center
- red, irritated eyes
- redness of the skin
Other side effects of fosaprepitant
Some side effects of fosaprepitant may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common side effects
- belching
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- continuing ringing or buzzing or other unexplained noise in ears
- difficulty having a bowel movement
- dizziness
- feeling of indigestion
- hair loss or thinning of the hair
- hearing loss
- hiccups
- indigestion
- lack or loss of strength
- loss of appetite
- pain in the chest below the breastbone
- stomach discomfort, upset, or pain
- swelling or inflammation of the mouth
- weight loss
Less common side effects
- feeling of warmth
- pain or discomfort in chest, upper stomach, or throat
- redness of the face, neck, arms, and occasionally, upper chest
- sudden sweating
- unusually warm skin
Rare side effects
- abnormal dreams
- blemishes on the skin
- bumps on the skin
- burning, dry, or itching eyes
- change in taste
- change in walking and balance
- clumsiness or unsteadiness
- confusion about identity, place, and time
- difficulty with moving
- discharge, excessive tearing
- excess air or gas in the stomach
- extreme thirst
- false or unusual sense of well-being
- flushed, dry skin
- frequent urination
- fruit-like breath odor
- full feeling
- heartburn
- increased hunger
- increased sensitivity of the skin to sunlight
- increased urination
- increased volume of pale, dilute urine
- muscle ache, cramp, stiffness, or weakness
- oily skin
- passing gas
- pimples
- redness or other discoloration of the skin
- redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
- severe constipation
- severe sunburn
- sleepiness
- stomach distension
- sweating
- swollen joints
- trouble performing routine tasks
- trouble sleeping
- unexplained weight loss
- unusual drowsiness, dullness, or feeling of sluggishness
- weight gain
- white patches with diaper rash
For healthcare professionals
Applies to fosaprepitant: intravenous powder for injection, intravenous solution.
General adverse events
The most common side effects reported were fatigue, diarrhea, neutropenia, asthenia, anemia, peripheral neuropathy, leukopenia, dyspepsia, urinary tract infection, and pain in extremity.
Because fosaprepitant is converted to aprepitant, side effects associated with aprepitant may be expected to occur with this drug. The manufacturer product information for aprepitant should be consulted.[Ref]
Cardiovascular
- Uncommon (0.1% to 1%): Increased blood pressure, flushing, hot flush, palpitations, thrombophlebitis
- Frequency not reported: Hypotension
Aprepitant:
- Uncommon (0.1% to 1%): Palpitations, hot flush/flushing
- Rare (0.01% to 0.1%): Bradycardia, cardiovascular disorder
Dermatologic
- Uncommon (0.1% to 1%): Erythema
- Postmarketing reports: Pruritus, rash, urticaria, Stevens-Johnson syndrome/toxic epidermal necrolysis
Aprepitant:
- Uncommon (0.1% to 1%): Acne, rash
- Rare (0.01% to 0.1%): Hyperhidrosis, photosensitivity reaction, pruritic rash, seborrhea, skin lesion, Stevens-Johnson syndrome/toxic epidermal necrolysis
- Frequency not reported: Pruritus, urticaria, angioedema
Gastrointestinal
- Very common (10% or more): Diarrhea (up to 13%)
- Common (1% to 10%): Constipation, dyspepsia
- Uncommon (0.1% to 1%): Abdominal distention, abdominal pain, upper abdominal pain, oral candidiasis
Aprepitant:
- Common (1% to 10%): Constipation, dyspepsia, diarrhea, eructation
- Uncommon (0.1% to 1%): Abdominal pain, gastroesophageal reflux disease, nausea, vomiting, dry mouth, flatulence
- Rare (0.01% to 0.1%): Duodenal ulcer perforation, abdominal distension, hard feces, neutropenic colitis, stomatitis
- Frequency not reported: Upper abdominal pain, abnormal bowel sounds, stomach discomfort, subileus
Constipation and subileus occurred at higher doses of aprepitant.
Genitourinary
- Common (1% to 10%): Urinary tract infection
Aprepitant:
- Uncommon (0.1% to 1%): Dysuria
- Rare (0.01% to 0.1%): Glucose urine present, pollakiuria, RBCs urine positive, increased urine output
Hematologic
- Common (1% to 10%): Anemia, leukopenia, neutropenia
- Frequency not reported: Thrombocytopenia
Aprepitant:
- Common (1% to 10%): Decreased hemoglobin
- Uncommon (0.1% to 1%): Febrile neutropenia, anemia
- Rare (0.01% to 0.1%): Decreased neutrophil count
Hepatic
Aprepitant:
- Common (1% to 10%): Increased ALT, increased AST
- Frequency not reported: Increased blood bilirubin
Hypersensitivity
- Frequency not reported: Immediate hypersensitivity reactions (including flushing, erythema, dyspnea, anaphylactic reactions/anaphylactic shock)
- Postmarketing reports: Hypersensitivity reactions (including anaphylactic reactions/anaphylaxis, anaphylactic shock), immediate hypersensitivity/anaphylactic reactions during infusion (including flushing, erythema, rash, chest tightness, wheezing, dyspnea)
Local
- Common (1% to 10%): Infusion-site reactions, infusion site pain
- Uncommon (0.1% to 1%): Infusion-site erythema, infusion-site induration, infusion-site pruritus, infusion-site thrombophlebitis, injection-site irritation, vessel puncture-site pain
Infusion site reactions occurred in 2.2% of patients treated with this drug compared to 0.6% of patients treated with ondansetron and dexamethasone (standard therapy). These reactions included infusion-site pain, injection-site irritation, vessel puncture-site pain, and infusion-site thrombophlebitis.
Metabolic
- Uncommon (0.1% to 1%): Decreased appetite
Aprepitant:
- Common (1% to 10%): Decreased appetite
- Rare (0.01% to 0.1%): Polydipsia
- Frequency not reported: Increased blood glucose
Musculoskeletal
- Common (1% to 10%): Pain in extremity
Aprepitant:
Rare (0.01% to 0.1%) Muscular weakness, muscle spasms
Nervous system
- Common (1% to 10%): Peripheral neuropathy
- Frequency not reported: Syncope
- Postmarketing reports: Ifosfamide-induced neurotoxicity
Aprepitant:
- Common (1% to 10%): Headache
- Uncommon (0.1% to 1%): Dizziness, somnolence
- Rare (0.01% to 0.1%): Cognitive disorder, dysgeusia, lethargy, tinnitus
- Frequency not reported: Dysarthria, hypoesthesia, sensory disturbance
Ifosfamide-induced neurotoxicity has been reported after coadministration of this drug and ifosfamide.
Ocular
Aprepitant:
- Rare (0.01% to 0.1%): Conjunctivitis
- Frequency not reported: Miosis, reduced visual acuity
Other
- Very common (10% or more): Fatigue (up to 15%)
- Common (1% to 10%): Asthenia
Aprepitant:
- Common (1% to 10%): Asthenia, fatigue
- Uncommon (0.1% to 1%): Malaise, increased blood alkaline phosphatase
- Rare (0.01% to 0.1%): Candidiasis, staphylococcal infection, gait disturbance, decreased blood sodium, weight decreased, chest discomfort, edema
- Frequency not reported: Decreased blood albumin, decreased blood potassium
Psychiatric
Aprepitant:
- Uncommon (0.1% to 1%): Anxiety
- Rare (0.01% to 0.1%): Disorientation, euphoric mood
- Frequency not reported: Insomnia
Respiratory
- Uncommon (0.1% to 1%): Cough, oropharyngeal pain, throat irritation
- Frequency not reported: Dyspnea
Aprepitant:
- Common (1% to 10%): Hiccups
- Rare (0.01% to 0.1%): Postnasal drip, sneezing, oropharyngeal pain, cough, throat irritation
- Frequency not reported: Dyspnea, wheezing
References
1. (2022) "Product Information. Emend for Injection (fosaprepitant)." Merck Sharp & Dohme LLC, SUPPL-21
2. (2022) "Product Information. Emend IV (fosaprepitant)." Merck Sharp & Dohme (Australia) Pty Ltd
3. (2022) "Product Information. Ivemend (fosaprepitant)." Merck Sharp & Dohme (UK) Ltd
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Further information
Fosaprepitant side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.