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granisetron (injection)

Generic Name: granisetron (injection) (gra NIS e tron)
Brand Name: Sustol

What is granisetron?

Granisetron blocks the actions of chemicals in the body that can trigger nausea and vomiting.

Granisetron injection is used to prevent nausea and vomiting that may be caused by medicine to treat cancer (chemotherapy), or after having surgery.

Granisetron is sometimes used together with other anti-nausea medications.

Granisetron may also be used for purposes not listed in this medication guide.

Important Information

Before you are treated with granisetron injection, tell your doctor about all your medical conditions, especially heart problems. Also, make sure your doctor knows about all the medicines you are using.

Before taking this medicine

You should not receive granisetron if you are allergic to it.

To make sure granisetron is safe for you, tell your doctor if you have:

  • kidney disease;

  • heart disease;

  • a heart rhythm disorder;

  • a personal or family history of long QT syndrome;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

  • if you have recently had stomach or intestinal surgery; or

  • if you are allergic to a medicine like granisetron (dolasetron, ondansetron, Aloxi, Anzemet, Lotronex, Zofran, or others).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether granisetron passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is granisetron given?

Granisetron is injected under the skin, or into a vein through an IV.

A healthcare provider will give you this injection.

Granisetron injection is usually given at least 30 minutes before the start of chemotherapy.

When used to prevent nausea and vomiting caused by surgery, you will receive granisetron injection either before or after the procedure.

Your doctor will determine how often to treat you with granisetron, and for how long.

What happens if I miss a dose?

Because you will receive granisetron injection in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving granisetron?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Granisetron side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some side effects may occur up to 2 weeks or more after you have received a granisetron injection.

Call your doctor at once if you have:

  • pain, swelling, bleeding, skin changes, or a hard lump where the injection was given;

  • severe constipation;

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

  • high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common side effects may include:

  • headache;

  • stomach pain, constipation;

  • fever; or

  • abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Granisetron dosing information

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

IV: 10 mcg/kg over 5 minutes, beginning 30 minutes before initiation of chemotherapy.

Orally: 2 mg, given up to 1 hour before chemotherapy, or 1 mg twice a day (the first dose is given up to 1 hour before chemotherapy, and the second dose is given 12 hours later).

Granisetron transdermal system: Apply a single patch 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 appropriate. Remove the patch a minimum of 24 hours after completion of chemotherapy. The patch can be worn for up to 7 days depending on the duration of the chemotherapy regimen. Granisetron transdermal system is a 52 cm2 patch containing 34.3 mg of granisetron. The patch releases 3.1 mg of granisetron per 24 hours for up to 7 days.

The transdermal system (patch) should be applied to clean, dry, intact healthy skin on the upper outer arm. Granisetron transdermal system should not be placed on skin that is red, irritated or damaged. Each patch is packed in a pouch and should be applied directly after the pouch has been opened. The patch should not be cut into pieces.

Usual Adult Dose for Nausea/Vomiting--Radiation Induced:

2 mg orally given within 1 hour of radiotherapy.

Usual Adult Dose for Nausea/Vomiting -- Postoperative:

Prevention and Treatment
IV: 1 mg undiluted over 30 seconds, given before induction of anesthesia, or immediately before reversal of anesthesia; or give after surgery.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

Greater than or equal to 2 to 16 years: 10 mcg/kg IV 30 minutes before start of chemotherapy.

Study (n=80)
Randomized double-blind clinical studies have used granisetron injection in the range of 10 to 40 mcg/kg.

What other drugs will affect granisetron?

Granisetron can cause a serious heart problem, especially if you use certain medicines at the same time, including antibiotics, antidepressants, heart rhythm medicine, antipsychotic medicines, and medicines to treat cancer, malaria, HIV or AIDS.

Receiving granisetron while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:

  • lithium;

  • ritonavir;

  • St. John's wort;

  • an antidepressant;

  • migraine headache medicine;

  • a narcotic (opioid) medication or muscle relaxer; or

  • other anti-nausea medications.

This list is not complete. Other drugs may interact with granisetron, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with granisetron.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about granisetron.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.01.

Date modified: January 03, 2018
Last reviewed: October 19, 2016