Granisetron

CLINICAL USE

Prevention or treatment of nausea and vomiting induced by cytotoxic chemotherapy, radiotherapy, or postoperative nausea and vomiting (PONV)

DOSE IN NORMAL RENAL FUNCTION

Cytotoxic chemotherapy or radiotherapy: PO: 1–2 mg within 1 hour before start —of treatment, then 2 mg daily in 1–2 divided doses during treatmentIV: 3 mg before start of cytotoxic —therapy; up to 2 additional 3 mg doses can be given within 24 hours no less than 10 minutes apartIV Infusion: 40 mcg/kg (max 3 mg) —before treatment; repeated once more if requiredPONV: 1 mg IV before induction of anaesthesia; then 1 mg as required (maximum 2 mg in one day)

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :312.4 (348.9 as hydrochloride)

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :≈65

%Excreted unchanged in urine &nbsp &nbsp : <20

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :3

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :4–5/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in normal renal function. Company recommends timing

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : for greater than 2 hours after granisetron dose

HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function. Company recommends timing

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : for greater than 2 hours after granisetron dose

CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

Oral, IV bolus,

IV infusion

Rate of Administration

IV bolus: diluted in 5 mL sodium chloride 0.9% over not less than 30 seconds

IV infusion

:

20 to 50 &nbsp &nbsp : mL over 5 minutes

Comments

Compatible with sodium chloride 0.9%, sodium chloride 0.18% and glucose 4% solution, glucose 5%, Hartmann’s solution, sodium lactate injection, 10% mannitolMaximum administered dose over 24 hours should not exceed 9 mg

OTHER INFORMATION

No special dosing adjustments necessary in patients with renal or hepatic failure.

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