Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Aprepitant may slow down how quickly your liver processes your antianxiety (or sleep) medicine.
What might happen:
The blood levels of your antianxiety (or sleep) medicine may increase and cause side effects.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know you are taking these medicines together. If you experience excess drowsiness, confusion, or loss of coordination, contact your healthcare professional. Your doctor may want to adjust the dose of your medicine or change to an antianxiety/sleep medicine not affected by your antinausea medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Emend (aprepitant) US prescribing information. Merck & Co., Inc. August, 2014.
2.Emend (aprepitant) Australian prescribing information. MSD April 5, 2004.
3.Emend (aprepitant) UK summary of product characteristics. Merck Sharp & Dohme Limited January 10. 2005.
4.Akynzeo (netupitant and palonsetron). Eisai Inc. October, 2014.
5.Majumdar AK, McCrea JB, Panebianco DL, Hesney M, Dru J, Constanzer M, Goldberg MR, Murphy G, Gottesdiener KM, Lines CR, Petty KJ, Blum RA. Effects of aprepitant on cytochrome P450 3A4 activity using midazolam as a probe. Clin Pharmacol Ther 2003 Sep;74(2):150-6.
6.Shadle CR, Lee Y, Majumdar AK, Petty KJ, Gargano C, Bradstreet TE, Evans JK, Blum RA. Evaluation of potential inductive effects of aprepitant on cytochrome P450 3A4 and 2C9 activity. J Clin Pharmacol 2004 Apr; 44(3):215-23.