chemical structure of granisetron
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Granisetron

Granisetron is a serotonin 5-HT3 receptor antagonist used to treat nausea and vomiting following chemotherapy. Its main affect is to reduce the activity of the vagus nerve, which is a nerve that activates the vomiting center in the medulla oblongata. It does not have much effect on vomiting due to motion sickness. This drug does not have any effect on dopamine receptors or muscarinic receptors. more...

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Granisetron was invented by chemists working at the British drug company Beecham around 1988 and is expected to go generic in 2007/2008. It is produced by Roche Laboratories under the trade name Kytril®. The drug was approved in the United Kingdom in 1991 and in United States in 1994 by the FDA.

Granisetron breaks down slowly, staying in the body for a long time. One dose usually lasts 4 to 9 hours and is usually administered once or twice daily. This drug is removed from the body by the liver and kidneys.

Clinical Uses

  • Chemotherapy-induced nausea and vomiting
    • 5-HT3 receptor antagonists are the primary drugs used to treat and prevent chemotherapy-induced nausea and vomiting. Many times they are given intravenously about 30 minutes before beginning therapy.
  • Post-operative and post-radiation nausea and vomiting
  • Is a possible therapy for nausea and vomiting due to acute or chronic medical illness or acute gastroenteritis
  • Treatment of Cyclic vomiting syndrome although there are no formal trials to confirm efficacy.

Adverse Effects

Granisetron is a well-tolerated drug with few side effects. Headache, dizziness, and constipations are the most commonly reported side effects associated with its use. There have been no significant drug interactions reported with this drug's use. It is broken down by the liver's cytochrome P450 system and it has little effect on the metabolism of other drugs broken down by this system.

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Drug for Radiation-Induced Nausea and Vomiting
From American Family Physician, 11/15/99 by Monica Preboth

Granisetron (Kytril), a 5-HT3 receptor antagonist, has been approved by the U.S. Food and Drug Administration for the prevention of nausea and vomiting associated with radiation, including total body irradiation and fractionated abdominal radiation. Granisetron is currently approved for the prevention of nausea and vomiting associated with emetogenic cancer therapies, including high-dose cisplatin.

In clinical trials of patients undergoing total body irradiation for bone marrow transplantation, 22 percent of those who received granisetron did not experience vomiting or receive rescue antiemetics, compared with zero percent in a historical negative control group. In addition, patients who received granisetron also had fewer emetic episodes during the first day of radiation and over the four-day treatment period, compared with patients in the control group. Adverse events included headache, diarrhea and asthenia.

In another trial of patients receiving fractionated upper abdominal radiation for cancer, granisetron provided significantly greater protection from nausea and vomiting than placebo. Adverse events in this trial included diarrhea, asthenia and constipation.

COPYRIGHT 1999 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group

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