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When using aprepitant, it's important to be aware of various interactions and precautions to ensure its safe and effective use. Here are key points to consider:

• Drug Interactions: Aprepitant's effectiveness can be influenced by other medications that affect its removal from the body. These include certain antifungals (e.g., itraconazole, ketoconazole), diltiazem, specific antibiotics like macrolides (e.g., clarithromycin, erythromycin), nefazodone, HIV protease inhibitors (e.g., nelfinavir), rifamycins (e.g., rifampin, rifabutin), ritonavir, St. John's wort, and some anti-seizure medications (e.g., carbamazepine, phenytoin). Additionally, aprepitant itself can alter the elimination of other drugs, potentially impacting their effectiveness. Examples of such drugs include elacestrant, flibanserin, lomitapide, and pimozide.

• Warfarin Monitoring: For individuals taking warfarin, aprepitant may affect its anticoagulant function. It is advised that blood testing be conducted during the two weeks following aprepitant treatment to ensure warfarin is working properly.

• Hormonal Birth Control: Aprepitant may reduce the effectiveness of hormonal contraceptives such as pills, patches, or rings, which could lead to an unintended pregnancy. It is crucial to discuss alternative or additional birth control methods with your doctor or pharmacist during treatment and for one month after the last dose. Report any unusual spotting or breakthrough bleeding, as these may indicate reduced contraceptive efficacy.

• Avoiding Similar Medications: Aprepitant is closely related to fosaprepitant. Do not use these medications concurrently.

By understanding these interactions and precautions, you can help ensure the safe use of aprepitant. Always consult with your healthcare provider for personalized advice and before making any changes to your medication regimen.

Aprepitant can interact with various medications by altering how they are processed in your body, which can impact their effectiveness. Drugs that can influence the removal of aprepitant include azole antifungals (such as Itraconazole and Ketoconazole), diltiazem, macrolide antibiotics (like Clarithromycin and Erythromycin), Nefazodone, HIV protease inhibitors (such as nelfinavir), rifamycins (including Rifampin and Rifabutin), Ritonavir, St. John's wort, and certain anti-seizure medications (such as Carbamazepine and Phenytoin).

Conversely, aprepitant can modify the way other medications are broken down, potentially affecting their action. Examples of these medications include elacestrant, Flibanserin, lomitapide, and Pimozide.

If you are taking Warfarin, aprepitant may influence its effectiveness, and your doctor should monitor your blood levels closely for two weeks following aprepitant treatment to ensure warfarin is working properly.

Additionally, aprepitant can reduce the effectiveness of hormonal birth control methods, such as pills, patches, or rings, increasing the risk of pregnancy. It is important to consult your doctor or pharmacist about using a reliable backup birth control method during treatment and for one month after the last dose. Inform your doctor if you experience any new spotting or breakthrough bleeding, as these could indicate reduced birth control effectiveness.

Finally, avoid using fosaprepitant concurrently with aprepitant, as they are very similar.