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Varubi (rolapitant) is a medication used to prevent delayed nausea and vomiting associated with chemotherapy. While effective, it carries certain risks that patients should be aware of.

One significant risk is the potential for serious allergic reactions, including anaphylaxis and anaphylactic shock. These reactions have occurred during or shortly after the administration of Varubi, particularly in its injectable form. Symptoms can include difficulty breathing, swelling of the face or throat, hives, itching, abdominal pain, vomiting, back or chest pain, low blood pressure, or shock. Most reactions have been reported within the first few minutes of administration.

Patients with known allergies to soybean oil, legumes, or related allergens should exercise caution, as Varubi contains soybean oil, which may trigger hypersensitivity reactions. Healthcare providers are advised to assess patients for potential allergies to any component of the product before administration.

In the event of an allergic reaction, the administration of Varubi should be stopped immediately, and appropriate medical treatment should be initiated. Patients should inform their healthcare provider of any known allergies and report any unusual symptoms during or after receiving Varubi.

Varubi (rolapitant) is a medication prescribed to prevent delayed nausea and vomiting associated with chemotherapy. While it is generally well-tolerated, some patients may experience side effects. Common Side Effects:

• Neutropenia: A decrease in white blood cells, which can increase the risk of infections.
• Hiccups: Involuntary contractions of the diaphragm.
• Abdominal Pain: Discomfort or pain in the stomach area.
• Decreased Appetite: Reduced desire to eat.
• Dizziness: Feeling lightheaded or unsteady.
• Dyspepsia: Indigestion or upset stomach.
• Urinary Tract Infection: Infection in any part of the urinary system.
• Stomatitis: Inflammation inside the mouth.
• Anemia: A condition where there aren't enough healthy red blood cells to carry adequate oxygen to the body's tissues. Serious Side Effects: Although rare, serious allergic reactions can occur. Seek immediate medical attention if you experience:
• Swelling of the face, lips, tongue, or throat.
• Difficulty breathing or swallowing.
• Severe rash or hives. It's important to inform your healthcare provider about any side effects you experience while taking Varubi. They can provide guidance on managing side effects and determine if any adjustments to your treatment are necessary.

When taking Varubi (rolapitant) at a 180 mg dose, it's important to be aware of potential interactions with other medications:

• CYP2D6 Substrates: Varubi can moderately inhibit the enzyme CYP2D6, leading to increased levels of drugs metabolized by this enzyme. This effect can last for at least 28 days after a single dose. Medications such as Thioridazine and Pimozide, which rely on CYP2D6 for metabolism, may reach higher concentrations in the blood, increasing the risk of serious heart-related side effects like QT prolongation and Torsades de Pointes. Therefore, Varubi should not be used with these drugs. For other CYP2D6-metabolized medications, consult your healthcare provider to assess potential interactions.

• Strong CYP3A4 Inducers: Drugs that strongly induce the enzyme CYP3A4, such as Rifampin, can significantly reduce the effectiveness of Varubi by lowering its blood levels. It's advisable to avoid using Varubi if you're on long-term treatment with strong CYP3A4 inducers.

• BCRP and P-gp Substrates: Varubi inhibits transport proteins like BCRP and P-glycoprotein (P-gp), which can lead to increased levels of certain medications in the blood. For example, drugs like Methotrexate, topotecan, irinotecan, and Digoxin may have elevated concentrations when taken with Varubi, potentially causing adverse effects. If avoiding these combinations isn't possible, your doctor may monitor drug levels and adjust dosages accordingly.

• Warfarin: While Varubi doesn't significantly change the blood levels of warfarin, its effect on blood clotting time (INR) hasn't been thoroughly studied. If you're taking warfarin, your healthcare provider may monitor your INR more closely and adjust your warfarin dose as needed when starting or stopping Varubi.

Always inform your healthcare provider about all medications and supplements you're taking to ensure safe and effective use of Varubi.