Emend(TM) (aprepitant), New Antiemetic Medicine to Help Prevent Nausea and Vomiting in Chemotherapy Patients, Now Available in Canada

    - Emend(TM) is the first in a new class approved to prevent both acute
    and delayed nausea and vomiting triggered by chemotherapy -

    TORONTO, Oct. 16 /CNW/ - Cancer patients now have a new, highly effective
oral medicine available to help protect them, in combination with existing
therapy(1), from the nausea and vomiting triggered by highly and moderately
emetogenic chemotherapy. Discovered and developed by Merck, Emend(TM)
(aprepitant) is a new Neurokinin-1 (NK-1) receptor antagonist that is added to
other anti-vomiting and nausea medicines to help protect patients from acute
and delayed symptoms. Emend(TM) is the first in a new class of medicines
indicated for the prevention of acute and delayed nausea and vomiting
triggered by chemotherapy.
    "The nausea and vomiting I experienced with chemotherapy were so
debilitating that I couldn't go to work, take care of my children, or even get
out of bed," says Andrea Jacobs, breast cancer survivor and former
chemotherapy patient. "These symptoms not only made my life unbearable for
four days after chemotherapy, but they also made me very anxious and nervous
about future treatments."
    Previous research has shown there remains a significant need to better
control both the acute and delayed symptoms that patients experience, despite
their use of antiemetic medicines prior to receiving chemotherapy.(2) Although
physicians and nurses accurately estimated the prevalence of acute episodes
experienced by their patients, many more patients reported delayed nausea and
vomiting symptoms than was predicted by their healthcare provider.(3)
    "Delayed Nausea and vomiting are two common complications of cancer
chemotherapy and are often underestimated in patients," said Dr. David Warr,
medical oncologist and associate professor, department of medicine at the
University of Toronto. "The good news is that aprepitant is now approved for
use with another antiemetic to help patients prevent these worrisome and
challenging side effects of chemotherapy before they occur."
    Beginning on the first day of the first cycle of chemotherapy, Emend(TM)
is added to an antiemetic regimen that includes a corticosteroid and a 5-HT(3)
receptor antagonist in patients receiving highly and moderately emetogenic
chemotherapy.(4) Highly emetogenic chemotherapy is therapy that causes most
patients to vomit if they do not receive antiemetic medicine prior to their
treatment. Antiemetic therapy is therapy that is given to prevent nausea and
vomiting prior to the administration of chemotherapy.

    Nausea and vomiting remain a significant burden for cancer patients

    "Nausea and vomiting are among the top concerns that people have when
they receive chemotherapy," said Sean Hopkins, Clinical Pharmacy Specialist,
Breast Cancer, at the Ottawa Hospital Cancer Centre. "Approximately half of
all patients receiving highly emetogenic chemotherapy experience delayed
nausea and vomiting despite the use of currently available antiemetic
    The prevalence of these symptoms was demonstrated in an observational,
multinational study of 300 cancer chemotherapy patients and their healthcare
providers (physician or nurse).(5) The majority of patients in the study
(97 per cent) received a 5-HT(3) receptor antagonist for a duration of 3 days.
Many (78 per cent) received also a corticosteroid. Practitioners were asked to
estimate the incidence of acute and delayed symptoms in their patients using a
questionnaire prior to the enrollment of patients. Patients were asked to
complete a 5-day diary, recording emetic events and nausea incidences.

    Emend(TM) offers a new mechanism of action

    Multiple neurotransmitters (chemical substances that transmit nerve
impulses) are implicated in nausea and vomiting. Emend(TM) is believed to work
through a novel mechanism which blocks the nausea and vomiting signals
transmitted by the neurotransmitter, Substance P, in the brain. This mechanism
is distinct from how current anti-vomiting medicines work.
    Therefore, by blocking the actions of multiple neurotransmitters, a
regimen of Emend(TM) added to other antiemetic medicines works to provide
improved prevention against acute as well as delayed nausea and vomiting
caused by chemotherapy.

    Emend(TM) is now available

    Emend(TM) is available as a convenient three-dose tri-pack containing the
dose that is specific for each day of treatment: one 125-mg capsule
(white/pink) and two 80-mg capsules (white). Other packaging options include
hospital unit doses of 125 mg capsules and a package of 2 x 80 mg capsules.
    Emend(TM) (aprepitant), in combination with a 5-HT(3) antagonist class of
antiemetics and dexamethasone, is indicated for the prevention of acute and
delayed nausea and vomiting due to highly emetogenic cancer chemotherapy and
the prevention of nausea and vomiting in women due to treatment with
moderately emetogenic cancer chemotherapy consisting of cyclophosphamide and

    Important information about Emend(TM)

    Emend(TM) is available as an oral capsule. The recommended dosing regimen
is Emend(TM) 125 mg orally 1 hour prior to chemotherapy treatment (Day 1) and
80 mg once daily in the morning on Days 2 and 3. Emend(TM) may be taken with
or without food. Chronic continuous use of Emend(TM) for prevention of nausea
and vomiting is not recommended because it has not been studied and because
the drug interaction profile may change during chronic continuous use.
    Emend(TM) is a prescription medicine and should not be taken with
pimozide, terfenadine, astemizole, and cisapride. Emend(TM) should not be used
by patients who are allergic to any ingredient of the product.
    Patients should talk to their doctor about all the other medications they
are taking. Emend(TM) may cause serious life-threatening reactions if used
with certain medicines. It can be affected by some medicines. Emend(TM) may
also affect some medicines, including chemotherapy, causing them to work
differently in the body.
    Doctors may check to make sure their patients' other medicines are
working properly, while they are taking Emend(TM). Patients taking warfarin
therapy should be monitored more closely after each 3-day regimen of Emend(TM)
to check their blood clotting time.
    Patients should talk to their doctor about all the other medicines they
are taking, or if they are pregnant or plan to become pregnant, or are
breast-feeding or have liver problems.
    Women using birth control pills while taking Emend(TM) should also use a
back-up method of contraception to avoid pregnancy.
    Patients should read the patient information before starting therapy with
Emend(TM) and reread it each time the prescription is renewed in case any
information has changed.
    Emend(TM) is not used to treat nausea and vomiting that patients already
have. Complete information about precautions and drug interactions with
Emend(TM) can be found in the attached product circular.

    About Merck Frosst Canada Ltd.

    At Merck Frosst, patients come first. Merck Frosst Canada Ltd. is a
research-driven pharmaceutical company discovering, developing and marketing a
broad range of innovative medicines and vaccines to improve human health. The
Merck Frosst Centre for Therapeutic Research, one of the largest biomedical
research facilities in Canada, has the mandate to discover new therapies for
the treatment of respiratory diseases, inflammatory diseases, diabetes,
osteoporosis and hypertension. Merck Frosst is one of the top 20 R&D investors
in Canada, with an investment of $114 million in 2006. More information about
Merck Frosst is available at http://www.merckfrosst.com.

    Forward-Looking Statement

    This press release contains "forward-looking statements" as that term is
defined in the Private Securities Litigation Reform Act of 1995. These
statements are based on management's current expectations and involve risks
and uncertainties, which may cause results to differ materially from those set
forth in the statements. The forward-looking statements may include statements
regarding product development, product potential or financial performance. No
forward-looking statement can be guaranteed, and actual results may differ
materially from those projected. Merck undertakes no obligation to publicly
update any forward-looking statement, whether as a result of new information,
future events, or otherwise. Forward-looking statements in this press release
should be evaluated together with the many uncertainties that affect Merck's
business, particularly those mentioned in the cautionary statements in Item 1
of Merck's Form 10-K for the year ended Dec. 31, 2006, and in its periodic
reports on Form 10-Q and Form 8-K, which the Company incorporates by

    B-roll available via satellite:

    10:30 - 11: 00 firm EST, Tuesday, October 16, 2007
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    (1) A 5 HT3 class of antiemetic and dexamethasme.
    (2) Grunberg SM, Deuson RR, et al. Incidence of chemotherapy-induced
        nausea and emesis after modern antiemetics. Cancer 2004 May 15; 100
    (3) Grunberg SM, Deuson RR, et al. Incidence of chemotherapy-induced
        nausea and emesis after modern antiemetics. Cancer 2004 May 15; 100
    (4) Or in women receiving moderately emetogenic chemotherapy consisting
        of an anthracycline cyclophosphamide.
    (5) Grunberg SM, Deuson RR, et al. Incidence of chemotherapy-induced
        nausea and emesis after modern antiemetics. Cancer 2004 May 15; 100

    Emend(TM) is a trademark of Merck & Co., Inc., Whitehouse Station, N.J.,

For further information:

For further information: Media Contact: Jennifer Goode, Edelman, (416)
979-1120 ext. 230; Marlene Gauthier, Merck Frosst Canada Ltd., (514) 726-3057

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