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5-HT3 antagonist antiemetic

Granisetron

Brand names: Kytril, Sancuso (patch)

Adult dose

Dose: PO 1–2mg OD-BD. IV 1–3mg slow before chemo. Patch (Sancuso): 1 patch 24–48h before chemo, leave for up to 7 days
Route: PO/IV/Transdermal
Frequency: OD-BD

Clinical pearls

  • CINV (chemotherapy-induced) and PONV
  • Lower QT effect than ondansetron

Contraindications

  • Concurrent strong QT-prolonging drugs
  • Hypersensitivity

Side effects

  • Headache
  • Constipation
  • QT prolongation
  • Serotonin syndrome with serotonergic agents

Interactions

  • QT-prolonging drugs
  • Serotonergic drugs
  • Apomorphine (avoid — severe hypotension)

Monitoring

  • ECG if QT risk

Reference: BNF; NICE TA313; ESMO antiemetic guidelines; https://bnf.nice.org.uk/drugs/granisetron/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.