Full Prescribing Information Important Safety Information

Realize the operational advantages of IV Push

CINVANTI 2-minute IV Push
(aprepitant) injectable emulsion*1-3
Fosaprepitant for injection†2-4
Reduces need for materials such as tubing and bags Yes NO
Requires no dilution Yes NO
Requires no reconstitution Yes NO
Two-minute administration time for patients Yes NO
60-day room temperature stability in the vial Yes NO
  Emend IV is included for illustrative purposes only; products should not be compared directly.
* CINVANTI is also available as a 30-minute infusion.
Includes generic fosaprepitant and Emend® IV (fosaprepitant) for injection.

2-minute IV Push provides operational advantages over longer IV infusions by:

  • REDUCING preparation and administration time1,5,6
    • Decreases pharmacy workload, requires fewer preparation steps, and allows for storage in automated dispensing devices
  • REDUCING use of infusion supplies1-3
    • Eliminates the need for materials such as tubing and IV solution bags
  • REDUCING patient time required for treatment6,7
    • Gives patients time back in their day

IV Push administration requires fewer supplies and materials vs IV infusion2,3,8-10

IV Push administration materials2,8 IV infusion administration materials2,3,9,10
  • 1 Pair of gloves
  • 1 Needle
  • 1 Syringe
  • 2 Alcohol swabs
  • 2 Saline syringes and a disinfectant cap to flush the line
  • 2 Pairs of gloves and other protective equipment
  • 1 Needle
  • 1 Syringe
  • 3 Alcohol swabs
  • 1 Infusion bag
  • 1 Infusion pump
  • 1 Seal
  • 1 Administration set
  • 1 IV pole
  • 1 Compounding hood
  • 2 Saline syringes and a disinfectant cap to flush the line



CINVANTI is a substance P/neurokinin-1 (NK1) receptor antagonist, indicated in adults, in combination with other antiemetic agents, for the prevention of: acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (HEC) including high-dose cisplatin as a single-dose regimen; delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy (MEC) as a single-dose regimen; and nausea and vomiting associated with initial and repeat courses of MEC as a 3-day regimen.

Limitations of Use: CINVANTI has not been studied for treatment of established nausea and vomiting.

Important Safety Information


CINVANTI is contraindicated in patients with hypersensitivity to any of the components of CINVANTI.

Concurrent use of pimozide with CINVANTI is contraindicated.

Warnings and Precautions

Clinically Significant CYP3A4 Drug Interactions

Aprepitant is a substrate, weak-to-moderate (dose-dependent) inhibitor, and an inducer of CYP3A4.

  • Use of CINVANTI with other drugs that are CYP3A4 substrates may result in increased plasma concentration of the concomitant drug.
    • Use of pimozide with CINVANTI is contraindicated due to the risk of significantly increased plasma concentrations of pimozide, potentially resulting in prolongation of the QT interval, a known adverse reaction of pimozide.
  • Use of CINVANTI with strong or moderate CYP3A4 inhibitors (e.g., ketoconazole, diltiazem) may increase plasma concentrations of aprepitant and result in an increased risk of adverse reactions related to CINVANTI.
  • Use of CINVANTI with strong CYP3A4 inducers (e.g., rifampin) may result in a reduction in aprepitant plasma concentrations and decreased efficacy of CINVANTI.

Hypersensitivity Reactions

Serious hypersensitivity reactions, including anaphylaxis, during or soon after administration of CINVANTI have occurred. Symptoms including dyspnea, eye swelling, flushing, pruritus, and wheezing have been reported. If hypersensitivity reactions occur, discontinue CINVANTI. Do not reinitiate CINVANTI in patients who experience these symptoms with previous use.

Decrease in INR with Concomitant Warfarin

Co-administration of CINVANTI with warfarin, a CYP2C9 substrate, may result in a clinically significant decrease in the International Normalized Ratio (INR) of prothrombin time. Monitor the INR in patients on chronic warfarin therapy in the 2-week period, particularly at 7 to 10 days, following initiation of CINVANTI with each chemotherapy cycle.

Risk of Reduced Efficacy of Hormonal Contraceptives

The efficacy of hormonal contraceptives may be reduced during administration of and for 28 days following the last dose of CINVANTI. Advise patients to use effective alternative or back-up methods of non-hormonal contraception during treatment with CINVANTI and for 1 month following administration of CINVANTI or oral aprepitant, whichever is administered last.

Use in Specific Populations

Avoid use of CINVANTI in pregnant women as alcohol is an inactive ingredient for CINVANTI. There is no safe level of alcohol exposure in pregnancy.

Adverse Reactions

The most common adverse reactions are:

  • Single-dose fosaprepitant with MEC (≥2%): fatigue, diarrhea, neutropenia, asthenia, anemia, peripheral neuropathy, leukopenia, dyspepsia, urinary tract infection, pain in extremity.
  • 3-day oral aprepitant with MEC (≥1% and greater than standard therapy): fatigue and eructation.
  • Single-dose fosaprepitant with HEC: generally similar to 3-day oral aprepitant. In addition, infusion site reactions (3%) occurred.
  • Single-dose CINVANTI (≥2%): headache and fatigue. The safety profile of CINVANTI in healthy subjects who received a single 2-minute injection was similar to that seen with a 30-minute infusion.

Report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. Report side effects to Heron at 1-844-437-6611.

For more information about CINVANTI, please see full Prescribing Information.

  1. CINVANTI [prescribing information]. Heron Therapeutics, Inc., San Diego, CA; March 2022.
  2. Intermountain Healthcare. Fact sheet for patients and families. Accessed October 2, 2019. https://intermountainhealthcare.org/ext/Dcmnt?ncid=520977298.
  3. DeBernardo, Christina. Medication administration via intravenous piggyback (IVPB). KLA Education Services. Accessed October 2, 2019. https://www.ivyleaguenurse.com/courses/IVPB.pdf.
  4. Emend IV [prescribing information]. Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ; April 2020.
  5. Grissinger M. Some IV medications are diluted unnecessarily in patient-care areas, creating undue risk. PT. 2017;42(8):490-508.
  6. Tsao NW, Lo C, Babich M, Shah K, Bansback NJ. Decentralized automated dispensing devices: systematic review of clinical and economic impacts in hospitals. Can J Hosp Pharm. 2014;67(2):138-148.
  7. Raajasekar AKA, Barola S, Tehrani L, Chandra AB. To push or not to push: the benefit of administering anti-emetics by intravenous push. Blood. 2015;126(23):3314.
  8. Doyle GR, McCutcheon JA. Parental Medication Administration: parental medications and preparing medications from ampules and vials. Clinical procedures for safer patient care. British Columbia Institute of Technology. https://opentextbc.ca/clinicalskills/chapter/safe-injection-administration-and-preparing-medication-from-ampules-and-vials/. Accessed October 2, 2019.
  9. ASHP Media. Practice basics—Chapter 16: Aseptic technique, sterile compounding, and IV admixture programs. http://www.ashpmedia.org/bookstore/P2074/Chpt-16.ppt. Accessed October 2, 2019.
  10. Study.com. Pharmaceutical compounding: equipment & supplies. https://study.com/academy/lesson/pharmaceutical-compounding-equipment-supplies.html. Accessed October 2, 2019.