Subacute intestinal obstruction or ileus. Moderate to severe hepatic impairment. Congenital long QT syndrome or other risk factors for QT prolongation (e.g. electrolyte abnormalities and cumulative high-dose anthracycline therapy). Pregnancy, lactation.
Lactation: excretion in milk unknown; use with caution
Indication
Nausea and vomiting, Chemotherapy-induced nausea and vomiting, Post-operative nausea and vomiting
Contra Indication
Hypersensitivity.
Dose
N/A
Side Effect
>10%
Headache (10-21%)
1-10%
Diarrhea (1-9%),Constipation (3-18%),Asthenia (5%),Somnolence (10%),Sedation (10%),Drowsiness (10%)
Frequency Not Defined
Anxiety,Fatigue,Malaise,Increased LFTs
Pregnancy Category
Name :
B
Description
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Mode of Action
Granisetron is a selective 5-HT3-receptor antagonist with little or no affinity for other serotonin receptors. It blocks serotonin in the chemoreceptor zone.
Interaction
Phenobarbital may induce metabolism of granisetron.
Pregnancy Category Note
Pregnancy Category: B
Lactation: excretion in milk unknown; use with caution
Adult Dose
Chemotherapy Induced Nausea & Vomiting
Oral
1 mg PO 1 hr before chemotherapy, then 1 mg 12 hr after 1st dose; OR 2 mg 1 hr before chemotherapy
IV
0.01 mg/kg/dose infused over 5 min or direct injected over 30 sec, 30 min before chemotherapy
Radiation-Induced Nausea & Vomiting
2 mg PO, 1 hr before radiation treatment
Postoperative Nausea & Vomiting
Prevention: 1 mg (undiluted) IV push over 30 seconds; administer before anesthetic induction or immediately before reversal of anesthesia
Treatment: 1 mg (undiluted) IV push over 30 seconds
Elderly:
Chemotherapy Induced Nausea & Vomiting
Oral: 2 mg 1 hr before chemotherapy, then 1 mg 12 hr after 1st dose; OR 2 mg 1 hr before chemo
IV: 0.01 mg/kg/dose infused over 5 min or direct injected over 30 sec, 30 min before chemotherapy
Radiation-Induced Nausea & Vomiting
2 mg PO, 1 hr before radiation treatment
Postoperative Nausea & Vomiting
Prevention: 1 mg (undiluted) IV push over 30 seconds; administer before anesthetic induction or immediately before reversal of anesthesia
Treatment: 1 mg (undiluted) IV push over 30 seconds
Hepatic impairment
No dosage adjustment required
Child Dose
Chemotherapy Induced Nausea & Vomiting
<2 years: Safey and efficacy not established
2-16 years: As adults; 0.01 mg/kg infused over 5 min or direct inj over 30 sec, 30 min before chemotherapy
Oral administration: Currently FDA-approved for IV administration in children; safety and efficacy of oral administration is not established
Postoperative Nausea & Vomiting
Safety and efficacy not established
Not approved for postoperative N/V in pediatric patients because of lack of efficacy and QT prolongation observed in clinical trials
Renal Dose
Renal impairment
IV
Severe (CrCl <30 mL/min): Total clearance was not affected in patients with severe renal failure who received a single 40 mcg/kg IV dose
PO
No dosage adjustment required
Administration
May be taken with or without food. Take up to 1 hr before chemotherapy.
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