How is the drug Emend for post-op nausea?

Question

My Bariatric doctor recommended it since I always get violently ill whenever I've gone under General Anesthesia....hopefully this time I won't have that problem.

Answer 1

I've only ever seen Emend used for chemotherapy-related nausea and vomitting. This new use for Emend (aprepitant) with postoperative nausea and vomitting is great, it looks as if it is more effective than the classic ondansetron (aka Zofran) and may be longer-acting.

The only consideration that I can think of at this point is the length of your surgery. The research recommends aprepitant be given 3 hours before surgery, but that may need to be adjusted if you are undergoing a surgery longer than an hour, because Emend peaks at hour 4, so you would want to be waking up just as it was peaking.

Remember, you don't have to pick just one drug and stick with it. You might be able to combine ondansetron, metoclopramide, and emend. Talk to the anesthetist. Also, when you are waking up after surgery, talk to the recovery room nurses and tell them at the first glimmer of nausea so that they can help you get it under control before you're actually vomitting. This is especially important if your surgery involves your torso or abdomen, because violent, repeated vomitting can negatively impact the surgical site.

Finally, be sure to go over all the medications, herbal supplements, vitamins, etc you are already on, because the list of interactions for aprepitant is long-ish.

Good luck with your next procedure!