rolapitant
Brand names: Varubi
Varubi is a medicine that helps prevent nausea and vomiting caused by chemotherapy. It is used with other anti-nausea medicines.
What it does
Varubi is used to prevent delayed nausea and vomiting in adults.
Common side effects
Neutropenia (low white blood cell count), Hiccups, Abdominal pain
Key warnings
You should not take Varubi if you are taking thioridazine or pimozide.
How It Works
Varubi blocks a substance in your body called substance P/neurokinin 1 (NK1). This substance can cause nausea and vomiting. By blocking it, Varubi helps prevent these side effects from chemotherapy.
How to Take It
Take one 180 mg Varubi tablet by mouth within 2 hours before your chemotherapy starts. You will also take other anti-nausea medicines, including dexamethasone and a 5-HT3 receptor antagonist. You can take Varubi with or without food. Make sure to take Varubi before each chemotherapy cycle, but not more often than every 2 weeks.
Pregnancy & Breastfeeding
There is not enough information about Varubi use in pregnant women to know if it is safe. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Varubi passes into breast milk. Talk to your doctor if you are breastfeeding.
Missed Dose
If you miss a dose of Varubi, talk to your doctor or pharmacist right away. They will tell you what to do.
Storage
Store Varubi tablets at room temperature, between 68°F to 77°F.
Side Effects (from patient reports)
Based on 489 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 531 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2013–2025.
Total Reports
531
Death-Related Reports
161
Hospitalization Reports
114
Top Indication
Nausea
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DEATH | 141 |
| 2 | NAUSEA | 79 |
| 3 | FATIGUE | 50 |
| 4 | INFUSION RELATED REACTION | 40 |
| 5 | DYSPNOEA | 34 |
| 6 | DECREASED APPETITE | 33 |
| 7 | FLUSHING | 32 |
| 8 | DIARRHOEA | 29 |
| 9 | THROMBOCYTOPENIA | 29 |
| 10 | DEHYDRATION | 22 |
| 11 | VOMITING | 22 |
| 12 | CHEST DISCOMFORT | 21 |
| 13 | ANAEMIA | 20 |
| 14 | BACK PAIN | 19 |
| 15 | WEIGHT DECREASED | 17 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
You should not take Varubi if you are taking thioridazine or pimozide. These drugs can cause serious heart problems if taken with Varubi. Varubi can increase the levels of these drugs in your blood, leading to QT prolongation and Torsades de Pointes, which are dangerous heart rhythm problems.
Known Drug Interactions
Table 4: Clinically Relevant Interactions Affecting Drugs Co-Administered with VARUBI CYP2D6 Substrates Narrow Therapeutic Index Drugs (Thioridazine and Pimozide) Clinical Impact: Increased plasma concentrations of thioridazine and pimozide are associated with serious and/or life-threatening events of QT prolongation and Torsades de Pointes. Intervention: VARUBI is contraindicated in patients taking CYP2D6 substrates with a narrow therapeutic index such as thioridazine and pimozide. If patients require these drugs, use an alternative antiemetic to VARUBI or an alternative to thioridazine or...
Mechanism: Rolapitant blocks the body from breaking down pimozide, which can lead to dangerously high levels of the drug in the blood. This buildup can cause serious or life-threatening heart rhythm problems.
What to do: Do not take these two medications together. Your doctor should use a different medicine for your nausea or your heart condition.
Table 4: Clinically Relevant Interactions Affecting Drugs Co-Administered with VARUBI CYP2D6 Substrates Narrow Therapeutic Index Drugs (Thioridazine and Pimozide) Clinical Impact: Increased plasma concentrations of thioridazine and pimozide are associated with serious and/or life-threatening events of QT prolongation and Torsades de Pointes. Intervention: VARUBI is contraindicated in patients taking CYP2D6 substrates with a narrow therapeutic index such as thioridazine and pimozide. If patients require these drugs, use an alternative antiemetic to VARUBI or an alternative to thioridazine or...
Mechanism: Rolapitant prevents the body from processing thioridazine, causing it to build up to unsafe levels. High levels of this drug can cause life-threatening heart rhythm issues.
What to do: This combination must be avoided. Ask your doctor for a different treatment option for either your nausea or your mental health condition.
rifampin) Clinical Impact: Co-administration of VARUBI with rifampin can significantly reduce the plasma concentrations of rolapitant and decrease the efficacy of VARUBI [see Clinical Pharmacology (12.3) ] . Strong CYP3A4 Inducers (e.g., rifampin) : significantly reduced plasma concentrations of rolapitant can decrease the efficacy of VARUBI; avoid use of VARUBI in patients who require chronic administration of such drugs.
Mechanism: Rifampin significantly lowers the levels of rolapitant in your blood. This makes the medication much less effective at preventing nausea and vomiting.
What to do: Avoid using this combination if you are taking rifampin on a long-term basis. Your doctor will need to find a different medicine for you.
Use the lowest effective dose of rosuvastatin (see prescribing information for additional information on recommended dosing).
Mechanism: Rolapitant blocks a protein that helps clear rosuvastatin from your body, which can lead to higher levels of the statin in your blood.
What to do: Use the lowest dose of rosuvastatin that is effective for your condition.
Warfarin Clinical Impact: Although co-administration of intravenous rolapitant (VARBI is not approved for intravenous use), which has a higher C max than oral VARUBI, with warfarin did not substantially increase the systemic exposure to S-warfarin, the active enantiomer, the effects on INR and prothrombin time were not studied [see Clinical Pharmacology (12.3) ] . Intervention: Monitor INR and prothrombin time and adjust the dosage of warfarin, as needed with concomitant use of VARUBI, to maintain the target INR range. ( 7 ) Warfarin : Monitor for increased INR or prothrombin time; adjust t...
Mechanism: It is not clear exactly how these drugs interact, but taking them together might change how well your blood thins.
What to do: Your doctor should monitor your blood clotting tests closely and adjust your warfarin dose as needed.
Common Questions
Can I take Varubi if I am allergic to other anti-nausea medications?
Will Varubi interact with my other medications?
How long does Varubi stay in my system?
Can I drink alcohol while taking Varubi?
What should I do if I experience side effects from Varubi?
Does Varubi cure nausea and vomiting from chemotherapy?
Can I drive or operate machinery while taking Varubi?
Is Varubi safe for older adults?
How often will I take Varubi?
Can I split or crush the Varubi tablet?
What are the common side effects of rolapitant?
Does rolapitant interact with other medications?
What drug class is rolapitant?
Is rolapitant safe during pregnancy?
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for rolapitant
The FDA label for rolapitant (sold under brand names such as Varubi) classifies it as a prescription-only medication in the NK1 Receptor Antagonist (Antiemetic) class. Varubi is used to prevent delayed nausea and vomiting in adults. Official labeling lists 9 commonly reported side effects, including Neutropenia (low white blood cell count), Hiccups, Abdominal pain.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 489 voluntary reports. The database also lists 9 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. Acquisition-cost data is surveyed weekly by CMS and updated as manufacturers report changes.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: August 19, 2020
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages