• Emeset indications
• Uses of Emeset in details
• Emeset description
• Emeset dosage
• Emeset interactions
• Emeset side effects
• Emeset contraindications

What is Emeset?

Emeset blocks the actions of chemicals in the body that can trigger nausea and vomiting.

Emeset is used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy or radiation).

Emeset is not for preventing nausea or vomiting that is caused by factors other than cancer treatment or surgery.

Emeset may be used for purposes not listed in this medication guide.

Emeset indications

Prevention of Nausea and Vomiting Associated with Highly Emetogenic Cancer Chemotherapy

Emeset (Emeset) oral soluble film is indicated for the prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin ≥50 mg/m2.

Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Cancer Chemotherapy

Emeset is indicated for the prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy.

Prevention of Nausea and Vomiting Associated with Radiotherapy

Emeset is indicated for the prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen.

Prevention of Postoperative Nausea and/or Vomiting

Emeset is indicated for the prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, Emeset is recommended even where the incidence of postoperative nausea and/or vomiting is low.

How should I use Emeset?

Use Emeset soluble film as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Emeset soluble film. Talk to your pharmacist if you have questions about this information.
• Do not remove the film strip from the foil pouch until you are ready to take Emeset soluble film. Use the film strip immediately after opening the pouch. Do not store the removed film strip for future use.
• Make sure that your hands are dry when you open the foil pouch.
• To use Emeset soluble film, fold the pouch along the dotted line and tear it along the edge. Remove the film strip and place it on the top of your tongue. Once the strip dissolves, it can be swallowed with saliva. Emeset soluble film may be taken with or without liquid.
• Do not chew or swallow Emeset soluble film whole.
• Wash your hands after you use Emeset soluble film.
• It is important to take Emeset soluble film as directed to prevent nausea and vomiting. If you forget to take a dose of Emeset soluble film, take it when you remember as directed by your doctor. If you are not sure what to do, contact your doctor or pharmacist.

Ask your health care provider any questions you may have about how to use Emeset soluble film.

Uses of Emeset in details

Emeset is used for preventing nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy or radiation).

Emeset description

A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and has reported anxiolytic and neuroleptic properties. [PubChem]

Emeset dosage

Emeset Dosage

Generic name: Emeset 4mg in 5mL

Dosage form: tablets, orally disintegrating tablets, oral solution

See also:

• Emeset ODT

  Orally Disintegrating Tablets

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Instructions for Use/Handling Emeset ODT

Orally Disintegrating Tablets:

Do not attempt to push Emeset ODT Tablets through the foil backing. With dry hands, PEEL BACK the foil backing of 1 blister and GENTLY remove the tablet. IMMEDIATELY place the Emeset ODT Tablet on top of the tongue where it will dissolve in seconds, then swallow with saliva. Administration with liquid is not necessary.

Prevention of Nausea and Vomiting Associated with Highly Emetogenic Cancer Chemotherapy:

The recommended adult oral dosage of Emeset is 24 mg given as three 8-mg tablets administered 30 minutes before the start of single-day highly emetogenic chemotherapy, including cisplatin ≥50 mg/m2. Multiday, single-dose administration of a 24-mg dosage has not been studied.

Pediatric Use:

There is no experience with the use of a 24-mg dosage in pediatric patients.

Geriatric Use:

The dosage recommendation is the same as for the general population.

Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Cancer Chemotherapy:

The recommended adult oral dosage is one 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution given twice a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose. One 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution should be administered twice a day (every 12 hours) for 1 to 2 days after completion of chemotherapy.

Pediatric Use:

For pediatric patients aged 12 years and older, the dosage is the same as for adults. For pediatric patients aged 4 through 11 years, the dosage is one 4-mg Emeset Tablet or one 4-mg Emeset ODT Tablet or 5 mL (1 teaspoonful equivalent to 4 mg of Emeset) of Emeset

Oral Solution given 3 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with subsequent doses 4 and 8 hours after the first dose. One 4-mg Emeset Tablet or one 4-mg Emeset ODT Tablet or 5 mL (1 teaspoonful equivalent to 4 mg of Emeset) of Emeset

Oral Solution should be administered 3 times a day (every 8 hours) for 1 to 2 days after completion of chemotherapy.

Geriatric Use:

The dosage is the same as for the general population.

Prevention of Nausea and Vomiting Associated with Radiotherapy, Either Total Body Irradiation, or Single High-dose Fraction or Daily Fractions to the Abdomen:

The recommended oral dosage is one 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution given 3 times a day.

For total body irradiation, one 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution should be administered 1 to 2 hours before each fraction of radiotherapy administered each day.

For single high-dose fraction radiotherapy to the abdomen, one 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy.

For daily fractionated radiotherapy to the abdomen, one 8-mg Emeset Tablet or one 8-mg Emeset ODT Tablet or 10 mL (2 teaspoonfuls equivalent to 8 mg of Emeset) of Emeset

Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.

Pediatric Use:

There is no experience with the use of Emeset Tablets, Emeset ODT Tablets, or Emeset

Oral Solution in the prevention of radiation-induced nausea and vomiting in pediatric patients.

Geriatric Use:

The dosage recommendation is the same as for the general population.

Postoperative Nausea and Vomiting:

The recommended dosage is 16 mg given as two 8-mg Emeset Tablets or two 8-mg Emeset ODT Tablets or 20 mL (4 teaspoonfuls equivalent to 16 mg of Emeset) of Emeset

Oral Solution 1 hour before induction of anesthesia.

Pediatric Use:

There is no experience with the use of Emeset Tablets, Emeset ODT Tablets, or Emeset

Oral Solution in the prevention of postoperative nausea and vomiting in pediatric patients.

Geriatric Use:

The dosage is the same as for the general population.

Dosage Adjustment for Patients with Impaired Renal Function:

The dosage recommendation is the same as for the general population. There is no experience beyond first-day administration of Emeset.

Dosage Adjustment for Patients with Impaired Hepatic Function:

In patients with severe hepatic impairment (Child-Pugh2 score of 10 or greater), clearance is reduced and apparent volume of distribution is increased with a resultant increase in plasma half-life. In such patients, a total daily dose of 8 mg should not be exceeded.

More about Emeset (Emeset)

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Consumer resources

• Emeset
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• Emeset (Advanced Reading)
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• Other brands: Emeset

Professional resources

• Emeset (AHFS Monograph)
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Other formulations

• Emeset ODT

Related treatment guides

• Nausea/Vomiting
• Gastroenteritis
• Nausea/Vomiting, Postoperative
• Alcohol Dependence
• Nausea/Vomiting, Chemotherapy Induced
• More (4) »

Emeset interactions

See also:
What other drugs will affect Emeset?

Emeset does not itself appear to induce or inhibit the cytochrome P-450 drug-metabolizing enzyme system of the liver. Because Emeset is metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes (CYP3A4, CYP2D6, CYP1A2), inducers or inhibitors of these enzymes may change the clearance and, hence, the half-life of Emeset. On the basis of available data, no dosage adjustment is recommended for patients on these drugs.

Apomorphine

Based on reports of profound hypotension and loss of consciousness when apomorphine was administered with Emeset, concomitant use of apomorphine with Emeset is contraindicated.

Phenytoin, Carbamazepine, and Rifampicin

In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampicin), the clearance of Emeset was significantly increased and Emeset blood concentrations were decreased. However, on the basis of available data, no dosage adjustment for Emeset is recommended for patients on these drugs.

Chemotherapy

Tumor response to chemotherapy in the P-388 mouse leukemia model is not affected by Emeset. In humans, carmustine, etoposide, and cisplatin do not affect the pharmacokinetics of Emeset.

In a crossover study in 76 pediatric patients, I.V. Emeset did not increase blood levels of high-dose methotrexate.

Use In Surgical Patients

The coadministration of Emeset had no effect on the pharmacokinetics and pharmacodynamics of temazepam.

Emeset side effects

See also:
What are the possible side effects of Emeset?

The following have been reported as adverse events in clinical trials of patients treated with Emeset, the active ingredient of Emeset. A causal relationship to therapy with Emeset has been unclear in many cases.

Chemotherapy-Induced Nausea and Vomiting

The adverse events in Table 5 have been reported in ≥ 5% of adult patients receiving a single 24-mg Emeset Tablet in 2 trials. These patients were receiving concurrent highly emetogenic cisplatin-based chemotherapy regimens (cisplatin dose ≥ 50 mg/m ).

Table 5: Principal Adverse Events in US Trials: Single Day Therapy With 24-mg Emeset Tablets (Highly Emetogenic Chemotherapy)

The adverse events in Table 6 have been reported in ≥ 5% of adults receiving either 8 mg of Emeset Tablets 2 or 3 times a day for 3 days or placebo in 4 trials. These patients were receiving concurrent moderately emetogenic chemotherapy, primarily cyclophosphamide-based regimens.

Table 6: Principal Adverse Events in US Trials: 3 Days of Therapy With 8-mg Emeset Tablets (Moderately Emetogenic Chemotherapy)

Central Nervous System: There have been rare reports consistent with, but not diagnostic of, extrapyramidal reactions in patients receiving Emeset.

Hepatic: In 723 patients receiving cyclophosphamide-based chemotherapy in US clinical trials, AST and/or ALT values have been reported to exceed twice the upper limit of normal in approximately 1% to 2% of patients receiving Emeset Tablets. The increases were transient and did not appear to be related to dose or duration of therapy. On repeat exposure, similar transient elevations in transaminase values occurred in some courses, but symptomatic hepatic disease did not occur. The role of cancer chemotherapy in these biochemical changes cannot be clearly determined.

There have been reports of liver failure and death in patients with cancer receiving concurrent medications including potentially hepatotoxic cytotoxic chemotherapy and antibiotics. The etiology of the liver failure is unclear.

Integumentary: Rash has occurred in approximately 1% of patients receiving Emeset.

Other: Rare cases of anaphylaxis, bronchospasm, tachycardia, angina (chest pain), hypokalemia, electrocardiographic alterations, vascular occlusive events, and grand mal seizures have been reported. Except for bronchospasm and anaphylaxis, the relationship to Emeset was unclear.

Radiation-Induced Nausea and Vomiting

The adverse events reported in patients receiving Emeset Tablets and concurrent radiotherapy were similar to those reported in patients receiving Emeset Tablets and concurrent chemotherapy. The most frequently reported adverse events were headache, constipation, and diarrhea.

Postoperative Nausea and Vomiting

The adverse events in Table 7 have been reported in ≥ 5% of patients receiving Emeset Tablets at a dosage of 16 mg orally in clinical trials. With the exception of headache, rates of these events were not significantly different in the Emeset and placebo groups. These patients were receiving multiple concomitant perioperative and postoperative medications.

Table 7: Frequency of Adverse Events From Controlled Studies With Emeset Tablets (Postoperative Nausea and Vomiting)

Preliminary observations in a small number of subjects suggest a higher incidence of headache when Emeset ODT

Orally Disintegrating Tablets are taken with water, when compared to without water.

Observed During Clinical Practice

In addition to adverse events reported from clinical trials, the following events have been identified during post-approval use of oral formulations of Emeset. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to Emeset.

Cardiovascular: Rarely and predominantly with intravenous Emeset, transient ECG changes including QT interval prolongation have been reported.

General: Flushing. Rare cases of hypersensitivity reactions, sometimes severe (e.g., anaphylaxis/anaphylactoid reactions, angioedema, bronchospasm, shortness of breath, hypotension, laryngeal edema, stridor) have also been reported. Laryngospasm, shock, and cardiopulmonary arrest have occurred during allergic reactions in patients receiving injectable Emeset.

Hepatobiliary: Liver enzyme abnormalities

Lower Respiratory: Hiccups

Neurology: Oculogyric crisis, appearing alone, as well as with other dystonic reactions

Skin: Urticaria, Stevens-Johnson syndrome, and toxic epidermal necrolysis.

Special Senses: Eye Disorders: Cases of transient blindness, predominantly during intravenous administration, have been reported. These cases of transient blindness were reported to resolve within a few minutes up to 48 hours.

Drug Abuse And Dependence

Animal studies have shown that Emeset is not discriminated as a benzodiazepine nor does it substitute for benzodiazepines in direct addiction studies.

Emeset contraindications

See also:
What is the most important information I should know about Emeset?

You should not use this medication if you are allergic to Emeset or to similar medicines such as dolasetron (Anzemet), granisetron (Kytril), or palonosetron (Aloxi). Do not take Emeset if you are also using apomorphine (Apokyn).

Before taking Emeset, tell your doctor if you have liver disease, or a personal or family history of Long QT syndrome.

Emeset may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).

The serious side effects of this medication include blurred vision or temporary vision loss (lasting from only a few minutes to several hours), slow heart rate, trouble breathing, anxiety, agitation, shivering, feeling like you might pass out, and urinating less than usual or not at all. Stop taking Emeset and call your doctor at once if you have any of these side effects.

Emeset may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Active ingredient matches for Emeset:

Ondansetron in Czech Republic, India, Latvia, Romania, Sri Lanka, Venezuela, Vietnam.

Ondansetron HCl dihydrate in Thailand.

Ondansetron hydrochloride in Thailand, India, Czech Republic, Venezuela, Romania.

References

1. DailyMed. "ONDANSETRON: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "ondansetron". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. DrugBank. "ondansetron". http://www.drugbank.ca/drugs/DB00904 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology