Emend. Is it really a magic pill?

We have used Emend to reduce postoperative nausea for several years with excellent results. Our anesthesiologist recommend it to be taken the morning of surgery with tiny sip of water to reduce nausea 

Emend (apripitant) is a new class of anti nausea medications that acts within the brain to affect nausea pathways directly. It was developed for patients undergoing chemotherapy. In my cosmetic surgery practice, it has revolutionized postoperative nausea. The single pill provides 72 hours of coverage, and in the last 4 years of our practice prescribing it for cosmetic cases, we have only had one patient (out of multiple hundreds) vomit after surgery. That is a substantial improvement. It is expensive, for sure, but it is probably 1-3% of the cost of your cosmetic procedure. It is expensive because your insurance will not cover the cost since you are not undergoing chemotherapy. It is more effective than standard anti nausea medications such as zofran or phenergan. Ginger is mildly effective for nausea, but in my experience, it is minimally effective against the more powerful nausea that can occur after anesthesia Or narcotic pain medication. My advice: buy the pill. When you feel no nausea after surgery, you will feel it is worth it. Good luck!

 There are many treatments for nausea and vomiting. In our practice we have found Emend to be far too expensive to use routinely. There are many alternatives such as a scopolamine patch,  ondansetron and some medications that can be given through the  IV during the time of surgery. The good news is nausea and vomiting that can occur  is usually very short-lived after the procedure, and is related to swallowing blood  down the back of the nose and into the stomach

Emend is a great medication for post op nausea, but my office has used several other options that may or may not be more affordable. I would ask your surgeon for advice on an alternative. I do think that having an anti-emetic to help you through the post op period can be priceless. Not only for your comfort, but you would not want to retch and do something to mess up your surgical results. 

I have my patients use Emend when they give my anesthetist a history of severe reaction to anesthesias from previous surgery(s).  It is about 75% effective in these difficult cases (which is very good).  Ask your doctor's office to seek a source for better pricing since that sounds exorbitant to me.  If you've not had severe nausea in the past and don't tend to get seasick readily, your doctor can consider less expensive more readily available alternatives such as Zofran, Bonine, etc. for you.