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Granisetron

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Granisetron, Kytril, Sustol, Sancuso

  • See Also
  1. 5-HT3 Antagonist
  2. Ondansetron
  3. Palonosetron
  4. Dolasetron
  5. Nausea in Cancer
  • Indications
  1. Chemotherapy associated Nausea
  2. Radiation Therapy associated Nausea
  • Mechanism
  1. Blocks peripheral and central 5HT3 receptors
    1. Peripheral 5HT3 receptors at vagal nerve terminals
    2. Central 5HT3 receptors at ChemoreceptorTrigger Zone in Medulla (area postrema controls Vomiting)
  • Dosing
  1. Nausea with Chemotherapy (adult dosing unless otherwise specified)
    1. Intravenous (adults and children age >2 years)
      1. Give 10 mcg/kg IV over 5 minutes given 30 minutes before Chemotherapy
    2. SQ (Sustol)
      1. Give 10 mg SQ given 30 min prior to Chemotherapy
    3. Oral
      1. Take 2 mg orally once daily OR 1 mg orally twice daily given 1 hour before Chemotherapy
    4. Transdermal (Sancuso, 34 mg patch delivers 3.1 mg per 24 hours)
      1. Apply 1 patch to upper outer arm 24 to 48 hours before Chemotherapy
      2. Remove 24 hours after Chemotherapy (may use 1 patch continuously for up to 7 days)
      3. Avoid exposing patch to heat or sunlight
  2. Nausea with Radiation Therapy (adult)
    1. Dose: 2 mg orally 1 hour before each Radiation Therapy treatment
  • Adverse Effects
  1. See 5-HT3 Antagonist
  2. Serotonin Syndrome
    1. http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm351864.htm
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Resources
  1. Granisetron (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=02f350c9-b7d2-4906-af28-70ed4461ff23
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Aapro (2004) Oncologist 9(6):673-86 +PMID: 15561811