Granisetron

Granisetron Transdermal Patch



(gra nis' e tron)

Sancuso®

Granisetron immediate-release injection is used to prevent nausea and vomiting caused by cancer chemotherapy and to prevent and treat nausea and vomiting that may occur after surgery. Granisetron extended-release (long-acting) injection is used with other medications to prevent nausea and vomiting caused by cancer chemotherapy that may occur immediately or several days after receiving chemotherapy medications. Granisetron is in a class of medications called 5-HT3 receptor antagonists. It works by blocking serotonin, a natural substance in the body that causes nausea and vomiting.

Granisetron immediate-release injection comes as a solution (liquid) to be injected intravenously (into a vein) and granisetron extended-release injection comes as a liquid to be injected subcutaneously (under the skin). To prevent nausea and vomiting caused by cancer chemotherapy, granisetron immediate-release and extended-release injection(s) are usually given by a healthcare provider in a hospital or clinic within 30 minutes before the start of chemotherapy. To prevent nausea and vomiting caused by surgery, granisetron immediate-release is usually given  during surgery. To treat nausea and vomiting caused by surgery, granisetron is given as soon as nausea and vomiting occurs.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before using granisetron injection,

tell your doctor and pharmacist if you are allergic to granisetron, alosetron (Lotronex), dolasetron (Anzemet), ondansetron (Zofran, Zuplenz), palonosetron (Aloxi, in Akynzeo), any other medications, or any of the ingredients in granisetron injection. Ask your pharmacist for a list of the ingredients.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Nexterone, Pacerone); azithromycin (Zithromax), chlorpromazine, citalopram (Celexa); clarithromycin (Biaxin, in Prevpac); erythromycin (E.E.S., ERYC, Erythrocin, others); fentanyl (Abstral, Actiq, Duragesic, Fentora, Lazanda, Subsys); ketoconazole (Nizoral); lithium (Lithobid); medications for heart problems; medications to treat migraines such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig); mirtazapine (Remeron); monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan), methylene blue; linezolid (Zyvox), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); moxifloxacin (Avelox); pimozide (Orap); phenobarbital; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax, others), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); serotonin–norepinephrine reuptake inhibitors (SNRI) medications desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine; sotalol (Betapace, Sorine); thioridazine; and tramadol (Conzip, Ultram, in Ultracet). If you are receiving the extended-release injection, also tell your doctor if you are taking anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); antiplatelet medications such as cilostazol, clopidogrel (Plavix), dipyridamole (Persantine, in Aggrenox), prasugrel (Effient), or ticlopidine. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects. Many other medications may also interact with granisetron, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

tell your doctor if you have recently had stomach surgery or have constipation. Also, tell your doctor if you or anyone in your family has or has ever had long QT syndrome (condition that increases the risk of developing an irregular heartbeat that may cause fainting or sudden death), another type of irregular heartbeat or heart rhythm problem, electrolyte imbalance, or kidney or heart disease.

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using granisetron injection, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Call your doctor if you forget to apply your patch at least 24 hours before you are scheduled to begin your chemotherapy.

Transdermal granisetron may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:



constipation

headache

skin redness lasting longer than 3 days after you remove the patch

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or seek emergency medical treatment:



rash, redness, bumps, blisters, or itching of the skin under or around the patch

hives

tightness of the throat

difficulty breathing or swallowing

hoarseness

dizziness, light-headedness, or fainting

fast, slow or irregular heartbeat

agitation

hallucinations (seeing things or hearing voices that do not exist)

fever

excessive sweating

confusion

nausea, vomiting, or diarrhea

loss of coordination

stiff or twitching muscles

seizures

coma (loss of consciousness)
Transdermal granisetron may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.  However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.  See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.