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                           :312.4 (348.9 as hydrochloride)

%Protein binding                           :≈65

%Excreted unchanged in urine     : <20

Volume of distribution (L/kg)       :3

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50     : Dose as in normal renal function

10 to 20     : Dose as in normal renal function

<10           : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD                :Unknown dialysability. Dose as in normal renal function

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

HD                     : for greater than 2 hours after granisetron dose

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

HD                     : for greater than 2 hours after granisetron dose

CAV/VVHD      :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     : 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.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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