Drug reference

Granisetron

Antiemetic

AntiemeticATC A04AA02

CDSCO approvedATC A04AA02

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Manufacturer advises avoid unless potential beneﬁt outweighs risk—limited information available.

FDA category + note

Top interactionssee all 12 →

AlfentanilSevereDatabaseDDInter
AlmotriptanSevereDatabaseDDInter
AmiodaroneSevereDatabaseDDInter
AmisulprideSevereDatabaseDDInter

Mechanism

Granisetron is a speciﬁc 5HT3-receptor antagonist which blocks 5HT3 receptors in the gastrointestinal tract and in the CNS.

Indications

Management of nausea and vomiting in patients receiving cytotoxicsPrevention of postoperative nausea and vomitingTreatment of postoperative nausea and vomitingNausea and vomiting induced by cytotoxic chemotherapy for planned duration of 3–5 days where oral antiemetics cannot be used (transdermal)Management of nausea and vomiting induced by cytotoxic chemotherapy or radiotherapyNauseaChemotherapy-induced nausea and vomitingPostoperative nausea and vomiting (PONV)Nausea secondary to upper abdominal irradiationHyperemesis of pregnancychemotherapy induced nausea and vomiting (CINV)Prevention of chemotherapy-induced nausea and vomiting

Dosing

Adult: By transdermal application using patches: Apply 3.1 mg/24 hours, to clean, dry, non-irritated, non-hairy skin on upper arm (or abdomen if upper arm cannot be used) 24–48 hours before treatment; patch may be worn for up to 7 days; remove at least 24 hours after completing chemotherapy.…
Renal adjustment: Manufacturer advises use with caution in severe impairment—limited information available.
Hepatic adjustment: Manufacturer advises caution in severe impairment (no information available).
Max dose: 9 mg per day (combined total dose for oral and intravenous routes, or for IV injection/infusion in chemotherapy/radiotherapy management).

Pharmacokinetics

Half-life

6 to 9 h (depending on route)

Metabolism

Metabolized predominantly by the liver by the CYP3A family

Contraindications

Subacute intestinal obstruction
Susceptibility to QT-interval prolongation (including electrolyte disturbances)

Side effects

Common

ConstipationHeadacheConstipation or diarrheaLight-headednessdizzinessmild constipationabdominal discomfort

Serious

ECG interval changes (QT prolongation)
Serotonin syndrome

Pregnancy & lactation

Pregnancy

Manufacturer advises avoid unless potential beneﬁt outweighs risk—limited information available.

Lactation

Manufacturer advises avoid—present in milk in animal studies.

Drug interactions

Alfentanil

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Almotriptan

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amiodarone

Severe

Database

Increased risk of QT prolongation and Torsades de Pointes. Amiodarone is a potent QT prolonging agent.

Avoid concomitant use if possible. If co-administration is necessary, monitor ECG for QT prolongation very closely. Consider alternative antiemetics or antiarrhythmics if feasible. Correct electrolyte imbalances.

Source: DDInter

Amisulpride

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amitriptyline

Severe

Database

Drug interaction classified as: synergy.

Source: DDInter

Amoxapine