Granisetron

Granisetron is used to prevent nausea and vomiting caused by chemotherapy treatment lasting up to 5 days.

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Pharmacist Trey Robinson, PharmD summarizes the uses, common side effects, and warnings for the 5HT3 blockers class of medications
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Pharmacist Trey Robinson, PharmD summarizes the uses, common side effects, and warnings for the Antiemetics class of medications

Granisetron Overview

Reviewed: July 11, 2013
Updated: 

Granisetron is a prescription medication used to prevent nausea and vomiting caused by chemotherapy, radiation, or surgery. Granisetron belongs to a group of drugs called serotonin 5-HT3 antagonists, which block serotonin, a natural chemical in the body, from causing nausea and vomiting.

This medication comes in tablet form, a patch, and in an intravenous (IV) form. The tablet is taken 1 hour before chemotherapy or radiation, and in the case of chemotherapy, may be taken again 12 hours later. The patch is appled 24 to 48 hours before your scheduled chemotherapy treatment. The injectable form of granisetron can be given by IV within 30 minutes before chemotherapy.

Common side effects include headache, constipation, and diarrhea. Granisetron can cause drowsiness. Do not drive or operate heavy machinery until you know how it affects you.

How was your experience with Granisetron?

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What are you taking Granisetron for?

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  • Other
  • Nausea
  • Vomiting

How long have you been taking it?

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  • Less than a week
  • A couple weeks
  • A month or so
  • A few months
  • A year or so
  • Two years or more

How well did Granisetron work for you?

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Uses of Granisetron

Granisetron is a prescription medication used to prevent nausea and vomiting caused by cancer chemotherapy and radiation therapy. The injectable form is also used to prevent nausea and vomiting related to surgery.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Granisetron Brand Names

Granisetron may be found in some form under the following brand names:

Granisetron Drug Class

Granisetron is part of the drug class:

Side Effects of Granisetron

Granisetron can cause serious side effects. See "Drug Precautions" section.

Common side effects include:

  • weakness
  • headache
  • stomach pain
  • constipation
  • diarrhea
  • drowsiness
  • insomnia

This is not a complete list of granisetron side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Granisetron Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • medications that block a protein in the body (CYPA4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone

  • medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin, St John's wort, and nimodipine (Nimotop)

  • medications that could lead to serotonin syndrome such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), desvenlafaxine (Pristiq), nefazodone (Serzone), paroxetine (Paxil, Pexeva), sertraline (Zoloft), venlafaxine (Effexor), trimipramine (Surmontil), isocarboxazid (Marplan), amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), protriptyline (Vivactil), and clomipramine (Anafranil), and linezolid (Zyvox)

This is not a complete list of granisetron drug interactions. Ask your doctor or pharmacist for more information.

Granisetron Precautions

Serious side effects have been reported with granisetron including:

  • A painful blockage of the intestine or bloating of the stomach. Using Sancuso may make it harder to identify certain stomach and bowel problems that are from other causes. Tell your healthcare provider if you have any stomach area (abdominal) pain or swelling while using Sancuso.
  • Skin reactions such as an allergic rash. Skin reactions can happen just at the patch application site or outside the patch application site. Tell your healthcare provider if you get any redness, rashes, bumps, blisters or itching at the patch application site, and especially if they spread outside the place where the patch was or if they appear outside the patch application site. You may need to stop using Sancuso.
  • Serotonin syndrome. Tell your healthcare provider right away if you have some or all of the symptoms of serotonin syndrome.
    • agitation
    • hallucinations
    • delirium
    • coma
    • increased heart rate
    • dizziness
    • sweating
    • flushing
    • muscle tremor and rigidity
    • seizures
  • Benzyl alcohol, a component of granisetron 1 mg/mL (an injectable form of granisetron) has been associated with serious adverse reactions and death, particularly in newborn babies (neonates).

Do not take granisetron if you:

  • are allergic to granisetron or any inactive ingredient in granisetron
  • have long QT syndrome (condition that increases the risk of developing an irregular heartbeat that may cause fainting or sudden death)

Granisetron can cause drowsiness. Do not drive or operate heavy machinery until you know how granisetron affects you.

Granisetron Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of granisetron, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before taking granisetron, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • or anyone in your family has or has ever had long QT syndrome (a condition that increases the risk of developing an irregular heartbeat that may cause fainting or sudden death)
  • have heart disease
  • have liver disease
  • have an electrolyte imbalance
  • have pain or swelling in your stomach area (abdomen)
  • are allergic to medical adhesive tape, adhesive dressings or other skin patches (for the patch formulation only)
  • are breastfeeding or plan to breastfeed. It is not known if Sancuso passes into your breast milk.
  • are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Granisetron and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Granisetron falls into category B. There are no good studies that have been done in humans with granisetron. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Granisetron and Lactation

It is not known if granisetron crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using granisetron.

Granisetron Usage

  • Take granisetron exactly as prescribed.
  • Granisetron comes in tablet form, a patch, and in an injectable (IV) form.
  • The oral form is usually taken one hour before cancer chemotherapy or radiation. It can be taken twice daily if used for cancer chemotherapy.
  • Apply granisetron patch 24 to 48 hours before your scheduled chemotherapy treatment.
    • Wear the patch all the time during your chemotherapy. Granisetron patch may be worn for up to 7 days, depending on how long your chemotherapy treatment lasts (up to 5 days).
    • Wait to remove the patch at least 1 day (24 hours) after your chemotherapy is finished.
  • The injectable form of granisetron can be given by IV within 30 minutes before chemotherapy.
  • Granisetron tablets can be taken with or without food. Take it on an empty stomach if your doctor tells you to do so.

Granisetron Dosage

Take granisetron exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Cancer Chemotherapy

The recommended granisetron dose for the prevention of nausea and vomiting due to chemotherapy is 2 mg once daily or 1 mg twice daily on the days of chemotherapy. granisetron should be taken within one hour before chemotherapy (and 12 hours later, when taken twice a day).
 
Each granisetron patch contains 34.3 mg and is applied to the upper outer arm a minimum of 24 hours before chemotherapy. The patch may be applied up to a maximum of 48 hours before chemotherapy as needed. Remove the patch a minimum of 24 hours after finishing chemotherapy. The patch can be worn for up to 7 days depending on the length of the chemotherapy treatment.
 
There is also an injectable form of granisetron that can be given by IV within 30 minutes before chemotherapy.
 
Radiation
 
The recommended granisetron dose for the prevention of nausea and vomiting due to radiation is 2 mg once daily, taken within one hour before radiation.
 
Surgery
 
The recommended dosage for prevention of postoperative nausea and vomiting in adult patients is 1 mg of granisetron, undiluted, administered intravenously over 30 seconds, before induction of anesthesia or immediately before reversal of anesthesia. 
 
The recommended dosage for the treatment of nausea and/or vomiting after surgery is 1 mg of granisetron, undiluted, administered intravenously over 30 seconds. 

Granisetron Overdose

If you take too much granisetron, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

 

 

Other Requirements

  • Store granisetron tablets between 15º and 30ºC (59º and 86ºF). Keep container closed tightly. Protect from light.
  • Keep this and all medications out of the reach of children.