Indications for VARUBI:
In combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy.
Give Varubi before starting each cycle, but at no less than 2 week intervals. Highly emetogenic cisplatin-based chemotherapy: 180mg within 2hrs prior to chemotherapy with dexamethasone 20mg given 30mins prior to chemotherapy and a 5-HT3 receptor antagonist (see drug's full labeling for appropriate dosing) on Day 1, then dexamethasone 8mg twice daily on Days 2–4. Moderately emetogenic chemotherapy and combinations of anthracycline and cyclophosphamide: 180mg within 2hrs prior to chemotherapy with dexamethasone 20mg given 30mins prior to chemotherapy on Day 1 and a 5-HT3 receptor antagonist (see drug's full labeling for appropriate dosing) on Days 1–4.
Not established: see Contraindications.
Concomitant CYP2D6 substrates with narrow therapeutic index (eg, thioridazine, pimozide): may result in QT prolongation and Torsades de pointes; consider alternatives if use required. Pediatric patients <2yrs of age (due to irreversible impairment of sexual development and fertility).
Consider interactions with CYP2D6 substrates before starting treatment. Avoid in severe hepatic impairment; monitor if use cannot be avoided. Advise females of reproductive potential regarding possible infertility. Pregnancy. Nursing mothers.
Substance P/NK1 receptor antagonist.
See Contraindications. Potentiates CYP2D6 substrates (eg, dextromethorphan) and possibly others; see full labeling. Potentiates BCRP substrates (eg, methotrexate, topotecan, irinotecan) and P-gp substrates (eg, digoxin) with narrow therapeutic index; monitor if use cannot be avoided. Use lowest effective dose of rosuvastatin (see drug's full labeling for dosing). Antagonized by strong CYP3A4 inducers (eg, rifampin); avoid. Monitor INR and PT with concomitant warfarin; adjust dose as needed.
Neutropenia, hiccups, abdominal pain, decreased appetite, dizziness, dyspepsia, UTI, stomatitis, anemia.
Generic Drug Availability:
Single dose wallet—1 (4 x 90mg tabs)