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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Dolasetron 10-mg/mL Oral Liquid
From International Journal of Pharmaceutical Compounding, 11/1/05

METHOD OF PREPARATION

1. Calculate the required quantity of each ingredient for the total amount to be prepared.

2. Accurately weigh and/or measure each ingredient.

3. If tablets are used, pulverize the tablets to a fine powder, or use bulk dolasetron mesylate powder.

4. Slowly add the Ora-Plus and mix, forming a smooth paste and then a uniform suspension or solution.

5. Slowly add the Ora-Sweet SF or strawberry syrup (strawberry fountain syrup, Gordon Food Service, Grand Rapids, Michigan) to volume and mix well.

6. Package and label.

PACKAGING

Package in tight, light-resistant containers.

LABELING

Keep out of reach of children. Use only as directed. Shake well before taking (if tablets are used).

STABILITY

A beyond-use date of 90 days can be used for this preparation.1,2

USE

Dolasetron mesylate oral liquid is used as an antiemetic and antimigraine agent.

QUALITY CONTROL

Quality-control assessment can include weight/volume, pH (pH 4 to 4.5 if the "Ora" family of vehicles is used and 3.6 to 4.6 if strawberry syrup is used), specific gravity, active drug assay, color, clarity, rheological properties/pourability, physical observation, and physical stability (discoloration, foreign materials, gas formation, mold growth).3

DISCUSSION

Dolasetron mesylate is a selective inhibitor of type 3 serotonergic (5-HT3) receptors and has antiemetic activity. It is used in the treatment of cancer chemotherapy-induced nausea and vomiting and in postoperative nausea and vomiting. It is administered orally or by intravenous infusion.4 Dolasetron is structurally and pharmacologically related to other 5-HT3 receptor antagonists, such as granisetron and ondansetron.

Dolasetron Mesylate USP (C^sub 19^H^sub 20^N^sub 2^O^sub 3^-CH^sub 4^O^sub 3^S, MW 420.48, Anzemet) occurs as a white to off-white powder that is freely soluble in water and propylene glycol, and slightly soluble in alcohol and saline solution.2 Dolasetron (Anzemet) tablets also contain carnauba wax, croscarmellose sodium, hypromellose, lactose, magnesium stearate, polyethylene glycol, Polysorbate 80, pregelatinized starch, synthetic red iron oxide, titanium dioxide, and white wax. The tablets are printed with a black ink that contains lecithin, pharmaceutical glaze, propylene glycol, and synthetic black iron oxide.5

Ora-Plus is an oral suspending vehicle that accepts dilution of up to 50% or more with water, flavoring agents, or syrups and still retains its suspending properties. It has a pH of approximately 4.2 and an osmolality of about 230 mOsm/kg. It is a thixotropic vehicle with Α viscosity of approximately 1,000 cps at 250C. It contains purified water, microcrystalline cellulose, sodium carboxymethylcellulose, xanthan gum, carrageenan, sodium phosphate and citric acid as buffering agents, simethicone as an antifoaming agent, and potassium sorbate and methylparaben as preservatives.6

Ora-Sweet SF sugar-free, alcohol-free syrup is a flavoring vehicle for oral extemporaneous preparations. It has a citrus-berry flavor blend. It is buffered to a pH of approximately 4.2 and may be used alone or in combination with other vehicles. It will tolerate a dilution to 50% with dissolved actives in water or suspending agents and still retain an acceptable taste. It has an osmolality of 2,150 mOsm/kg. It contains water, sodium saccharin, xanthan gum, glycerin, and sorbitol; citric acid and sodium citrate as buffers; methylparaben, propylparaben, and potassium sorbate as preservatives; and flavoring agents.7

Strawberry syrup is prepared using the same method as for cherry syrup. It consists of strawberry juice (475 mL), sucrose (800 g), alcohol (20 mL), and purified water (to make 1000 mL). It should be preserved in tight, light-resistant containers. Exposure to excessive heat should be prevented. It should be labeled to state the Latin binomial name and, following the official name, the part of the plant source from which it was derived. It contains from 1.0% to 2.0% alcohol. It is used as an oral vehicle.2,8

References

1. Johnson CE, Wagner DS, Bussard WE. Stability of dolasetron in two oral liquid vehicles. Am J Health Syst Pharm 2003; 60(21): 2242-2244.

2. US Pharmacopeial Convention, Inc. USP-Pharmacists' Pharmacopeia. Rockville, MD: US Pharmacopeial Convention, Inc.; 2005: 362, 408-431, 683.

3. Allen LV Jr. Standard operating procedure for physical quality assessment of oral and topical liquids. IJPC 1999; 3(2): 146-147.

4. McEvoy GK, ed. AHFS Drug Information-2005. Bethesda, MD: American Society of Health-Systems Pharmacists; 2005: 2802-2804.

5. [No author listed.] Physicians' Desk Reference. 58th ed. Montvale, NJ: Thomson PDR; 2004: 723-726.

6. Ora-Plus [product information]. Minneapolis, MN: Paddock Laboratories, Inc.

7. Ora-Sweet SF [product information]. Minneapolis, MN: Paddock Laboratories, Inc.

8. Ehrenstein E. Aqueous preparations. In: Martin EW, Cook EF, eds. Remington's Practice of Pharmacy. 12th ed. Easton, PA: Mack Publishing Company; 1961:355.

Copyright International Journal of Pharmaceutical Compounding Nov/Dec 2005
Provided by ProQuest Information and Learning Company. All rights Reserved

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