What is Em Ex?
Em Ex injection is used to prevent nausea and vomiting that may occur after treatment with cancer medicines (chemotherapy or radiation), including high-dose cisplatin. Em Ex is also used to prevent and treat nausea and vomiting that may happen after surgery.
Em Ex is a selective 5-HT3 receptor antagonist. It works in the stomach to block the signals to the brain that cause nausea and vomiting.
Em Ex is to be given only by or under the immediate supervision of your doctor.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, Em Ex injection is used in certain patients:
- To prevent the nausea and vomiting that may occur after cancer radiation treatment in patients undergoing bone marrow transplantation.
Em Ex indications
Em Ex Injection is a serotonin-3 (5-HT3) receptor antagonist indicated for:
- The prevention of nausea and/or vomiting associated with initial and repeat courses of emetogenic cancer therapy, including high-dose cisplatin.
- The prevention and treatment of postoperative nausea and vomiting in adults. As with other antiemetics, routine prophylaxis is not recommended in 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 during the postoperative period, Em Ex Injection is recommended even where the incidence of postoperative nausea and/or vomiting is low.
How should I use Em Ex?
Use Em Ex as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Em Ex. Talk to your pharmacist if you have questions about this information.
- Apply Em Ex 24 to 48 hours before your chemotherapy treatment, or as directed by your doctor.
- Em Ex should be applied to clean, healthy skin on the upper arm. Do not apply to cut, scraped, or irritated skin. Do not use creams, oils, lotions, powders, or any other products that could irritate the skin or prevent the patch from sticking well.
- To apply Em Ex, remove the patch from the sealed pouch. Do not cut or damage the patch. Remove the thin, clear, protective liner. Bend the patch in the middle and remove one-half of the rigid plastic film. Apply the exposed, sticky area of the patch to your skin. Remove the other half of the rigid plastic film and press the whole patch firmly in place against the skin.
- If the patch does not stick well, you may tape the edges with surgical bandages or medical adhesive tape. Do not completely cover the patch with bandages or tape. Do not wrap completely around your arm. Ask your health care provider if you are unsure of what type of dressing you can use.
- Wash your hands immediately after using Em Ex.
- You may shower or bathe normally while wearing the patch. You should avoid activities such as swimming, strenuous exercise, or using a sauna or whirlpool. It is unknown how these activities may affect Em Ex.
- Continue to wear the patch during your chemotherapy and for at least 24 hours after your treatment is completed. Em Ex may be worn for up to 7 days or as directed by your doctor.
- To remove the patch, gently peel it off of your skin and fold the sticky side together. Throw the used patch in the trash away from children and pets. Wash your hands after handling the patch.
- Gently wash the skin with soap and water where the patch was applied.
- If you miss a dose of Em Ex, contact your doctor immediately.
Ask your health care provider any questions you may have about how to use Em Ex.
Uses of Em Ex in details
Use: Labeled Indications
Chemotherapy-associated nausea and vomiting: Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy, including high-dose cisplatin (injection and tablets); prevention of nausea and vomiting associated with anthracycline/cyclophosphamide chemotherapy regimens; prevention of nausea and vomiting associated with moderately and/or highly emetogenic chemotherapy regimens of up to 5 consecutive days of duration (transdermal).
Radiation-associated nausea and vomiting: Prevention of nausea and vomiting associated with radiation therapy, including total body radiation and fractionated abdominal radiation (tablets).
Off Label Uses
Prevention of postoperative nausea and vomiting
Based on the Society for Ambulatory Anesthesia Consensus Guidelines for management of postoperative nausea and vomiting, Em Ex may administered prior to the end of surgery to prevent postoperative nausea and vomiting.
Em Ex description
Each mL of preservative-free aqueous solution contains 1.12 mg Em Ex hydrochloride equivalent to Em Ex 1 mg and sodium chloride 9 mg. The solution's pH ranges from 4-6.
Em Ex hydrochloride is an antinauseant and antiemetic agent. It is endo-N-(9-methyl-9-azabicyclo[3.3.1]non-3-yl)-1-methyl-1H-indazole-3-carboxamide hydrochloride with a molecular weight of 348.9 (312.4 free base). Its empirical formula is C18H24N4O·HCl.
Em Ex hydrochloride is a white to off-white solid that is readily soluble in water and normal saline at 20°C. Em Ex injection is a clear, colorless, sterile, nonpyrogenic, aqueous solution for IV administration.
Em Ex dosage
Em Ex Dosage
Generic name: Em Ex hydrochloride 1mg
Dosage form: tablet, film coated; oral solution
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Emetogenic Chemotherapy
The recommended adult dosage of oral Em Ex (Em Ex hydrochloride) is 2 mg once daily or 1 mg twice daily. In the 2 mg once-daily regimen, two 1 mg tablets or 10 mL of Em Ex
Oral Solution (2 teaspoonfuls, equivalent to 2 mg of Em Ex) are given up to 1 hour before chemotherapy. In the 1 mg twice-daily regimen, the first 1 mg tablet or one teaspoonful (5 mL) of Em Ex
Oral Solution is given up to 1 hour before chemotherapy, and the second tablet or second teaspoonful (5 mL) of Em Ex
Oral Solution, 12 hours after the first. Either regimen is administered only on the day(s) chemotherapy is given. Continued treatment, while not on chemotherapy, has not been found to be useful.
Use in the Elderly, Renal Failure Patients or Hepatically Impaired Patients
No dosage adjustment is recommended.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established.
Radiation (Either Total Body Irradiation or Fractionated Abdominal Radiation)
The recommended adult dosage of oral Em Ex is 2 mg once daily. Two 1 mg tablets or 10 mL of Em Ex
Oral Solution (2 teaspoonfuls, equivalent to 2 mg of Em Ex) are taken within 1 hour of radiation.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established.
Use in the Elderly
No dosage adjustment is recommended.
More about Em Ex (Em Ex)
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Images
- Drug Interactions
- Support Group
- 2 Reviews - Add your own review/rating
Consumer resources
- Em Ex
- Em Ex solution
- Em Ex tablets
- Em Ex (Advanced Reading)
- Other brands: Sancuso
Professional resources
- Em Ex (AHFS Monograph)
- Em Ex (FDA)
Related treatment guides
- Nausea/Vomiting, Chemotherapy Induced
- Nausea/Vomiting, Postoperative
- Nausea/Vomiting, Radiation Induced
Em Ex interactions
See also:
What other drugs will affect Em Ex?
Em Ex does not induce or inhibit the cytochrome P-450 drug-metabolizing enzyme system in vitro. There have been no definitive drug-drug interaction studies to examine pharmacokinetic or pharmacodynamic interaction with other drugs; however, in humans, Em Ex (Em Ex) Injection has been safely administered with drugs representing benzodiazepines, neuroleptics, and anti-ulcer medications commonly prescribed with antiemetic treatments. Em Ex (Em Ex) Injection also does not appear to interact with emetogenic cancer chemotherapies. Because Em Ex is metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes, inducers or inhibitors of these enzymes may change the clearance and, hence, the half-life of Em Ex. No specific interaction studies have been conducted in anesthetized patients. In addition, the activity of the cytochrome P-450 subfamily 3A4 (involved in the metabolism of some of the main narcotic analgesic agents) is not modified by Em Ex (Em Ex) in vitro.
In in vitro human microsomal studies, ketoconazole inhibited ring oxidation of Em Ex (Em Ex). However, the clinical significance of in vivo pharmacokinetic interactions with ketoconazole is not known. In a human pharmacokinetic study, hepatic enzyme induction with phenobarbital resulted in a 25% increase in total plasma clearance of intravenous Em Ex (Em Ex). The clinical significance of this change is not known.
QT prolongation has been reported with Em Ex (Em Ex). Use of Em Ex (Em Ex) in patients concurrently treated with drugs known to prolong the QT interval and/or are arrhythmogenic, this may result in clinical consequences.
Em Ex side effects
See also:
What are the possible side effects of Em Ex?
QT prolongation has been reported with Em Ex.
Chemotherapy-Induced Nausea and Vomiting
Over 3700 patients have received Em Ex (Em Ex) Tablets in clinical trials with emetogenic cancer therapies consisting primarily of cyclophosphamide or cisplatin regimens.
In patients receiving Em Ex (Em Ex) Tablets 1 mg bid for 1, 7 or 14 days, or 2 mg daily for 1 day, adverse experiences reported in more than 5% of the patients with comparator and placebo incidences are listed in Table 4.
Table 4 Principal Adverse Events in Clinical Trials Metoclopramide/dexamethasone and phenothiazines/dexamethasone
In the absence of a placebo group, there is uncertainty as to how many of these events should be attributed to Em Ex (Em Ex), except for headache, which was clearly more frequent than in comparison groups.
Radiation-Induced Nausea and Vomiting
In controlled clinical trials, the adverse events reported by patients receiving Em Ex (Em Ex) Tablets and concurrent radiation were similar to those reported by patients receiving Em Ex (Em Ex) Tablets prior to chemotherapy. The most frequently reported adverse events were diarrhea, asthenia, and constipation. Headache, however, was less prevalent in this patient population.
Postmarketing Experience
QT prolongation has been reported with Em Ex.
Em Ex contraindications
See also:
What is the most important information I should know about Em Ex?
You should not use this medication if you are allergic to Em Ex or to similar medicines such as dolasetron (Anzemet), ondansetron (Zofran), or palonosetron (Aloxi).
Before taking Em Ex, tell your doctor if you have liver disease, a heart rhythm disorder, an electrolyte imbalance (such as low levels of potassium or magnesium in your blood), or a personal or family history of Long QT syndrome.
Em Ex is usually started up to 1 hour before chemotherapy. Tell your doctor if you forget to take the medication within the specified amount of time before your procedure.
Active ingredient matches for Em Ex:
Granisetron in Egypt.
List of Em Ex substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Dialgyl (Greece) | |
| Emegar (Czech Republic, Slovakia) | |
| EMEGRAN (India) | |
| 1 mg x 1 mL x 3ml (Biochem) | $ 0.76 |
| Emegran 1mg x 1mL INJ / 3ml (Biochem) | $ 0.76 |
| EMEGRAN inj 1 mg x 1 mL x 3ml (Biochem) | $ 0.76 |
| Emegran 1mg x 1mL INJ / 3ml (Biochem) | $ 0.76 |
| EMEGRAN 3 | |
| EMEGRAN 3 1MG INJECTION 1 vial / 3 ML injection each (Biochem Pharmaceutical Industries) | $ 0.74 |
| Emetril (Turkey) | |
| Eumetic (Argentina) | |
| Frezitron (Philippines) | |
| G Setron (Egypt) | |
| Ge Nai Ya (China) | |
| Ge Ou Shu (China) | |
| Ge Rui Tong (China) | |
| Gestranol (Georgia) | |
| Gomsetron (Vietnam) | |
| Gomsetron 1 mg/1 mL x 5 tube x 1 mL | |
| Gomsetron 3 mg/3 mL x 5 tube x 3 mL | |
| Graftor (Croatia (Hrvatska)) | |
| GRAITIC (India) | |
| 1 mg x 15ml (Alpha Aromatic) | $ 0.28 |
| Graitic 1mg SYR / 15ml (Alpha Aromatic) | $ 0.28 |
| GRAITIC syr 1 mg x 15ml (Alpha Aromatic) | $ 0.28 |
| Graitic 1mg SYR / 15ml (Alpha Aromatic) | $ 0.28 |
| Gramet (Indonesia) | |
| Grandem | |
| Grandem 1mg SYR / 10ml (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| 1 mg x 10ml (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| 1 mg x 1 mL x 1's (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| 1 mg x 6's (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.34 |
| Grandem 2 mg Tablet (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.12 |
| Grandem 3 mg Injection (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.18 |
| Grandem 10 ml Syrup (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.12 |
| Grandem 1 mg Tablet (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.06 |
| Grandem 5 mg Injection (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.22 |
| Grandem 1mg x 1mL AMP / 1 (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| Grandem 1mg FC-TAB / 6 (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.34 |
| GRANDEM 1 MG/ML INJECTION 1 vial / 3 ML injection each (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.81 |
| GRANDEM 1 MG SYRUP 1 bottle / 10 ML syrup each (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.35 |
| GRANDEM 1 MG TABLET 1 strip / 6 tablets each (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.41 |
| GRANDEM 1 MG TABLET MD 1 strip / 6 tablet mds each (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.45 |
| GRANDEM syr 1 mg x 10ml (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| GRANDEM inj 1 mg x 1 mL x 1ml (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.23 |
| GRANDEM film-coated tab 1 mg x 6's (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.34 |
| GRANDEM inj 1 mg x 1 mL x 3ml (Aristo Pharmaceuticals Pvt Ltd.) | $ 0.54 |
See 531 substitutes for Em Ex | |
References
- DailyMed. "GRANISETRON: 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).
- PubChem. "granisetron". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "granisetron". http://www.drugbank.ca/drugs/DB00889 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Em Ex are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Em Ex. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
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There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
