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A new drug helps reduce nausea and vomiting associated with chemotherapy, according to the U.S. Food and Drug Administration (FDA) who approved aprepitant (brand name, Emend) in March 2003 for use in combination with other anti-nausea drugs. The approval came after research showed that aprepitant significantly reduced immediate and delayed nausea and vomiting (up to five days) in patients who received a strong form of chemotherapy. Because chemotherapy is a systemic treatment—affecting the entire body, both normal and cancerous cells—side effects are possible. These side effects vary significantly depending on several factors, including the types of drugs used, their dosages, and the duration of treatment. For example, some chemotherapy drugs may irritate the lining of the stomach or intestines. Drugs that may be more likely to cause nausea or vomiting include cisplatin, cyclophosphamide, doxorubicin, etoposide (high doses), etc. Sometimes, nausea and vomiting occur within a few minutes of or after treatment. At times, patients may experience "anticipatory" nausea, in which symptoms develop before a treatment due to psychological associations. Other common side effects of chemotherapy include hair loss (alopecia) and fatigue. In a recent issue of the journal, Cancer, Sergio Poli-Bigelli, MD of the Instituto de Oncologia Hematologia at the Universidad Central de Venezuela and colleagues from Brazil and Pennsylvania added the drug aprepitant to other commonly used anti-nausea treatments (ondansetron and dexamethasone) to determine whether aprepitant could further reduce nausea and vomiting resulting from chemotherapy with drugs such as cisplatin. The study was funded by Merck, the maker of aprepitant. Two hundred eighty-six chemotherapy patients were given standard anti-nausea drugs during chemotherapy while 283 patients received aprepitant in addition to the standard drugs. The results of the study showed that 47% of patients on aprepitant experienced vomiting and 37% experienced nausea within five days of treatment. This is compared to patients in the group who received only the standard anti-nausea drugs: 57% of those patients experienced vomiting and 60% experienced nausea. "Nausea and vomiting are two common complications of cancer chemotherapy and can lead to considerable distress and disruption in patients' lives," said Scott Reines, MD., PhD, Vice President, Clinical Research, Merck Research Laboratories, in a company news release. "Emend [generic name, aprepitant] is a new medicine that will help more patients to avoid symptoms of nausea and vomiting for up to five days after their chemotherapy treatment." Aprepitant is the first medicine that is FDA approved to treat delayed symptoms of nausea. Sometimes, nausea and vomiting can begin after the first day of chemotherapy and last for several days after treatment. Patients take aprepitant once a day for three days. The drug is not approved to be taken continuously since its effect can change. Despite the side effects that can occur with chemotherapy, it can be highly effective at treating cancer or reducing the risk that cancer will recur in the future. Furthermore, most of these side effects are temporary and go away after treatment is completed. In most cases, the benefits of treating cancer with chemotherapy far outweighs the risks or inconveniences of any side effects.
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