• Granisetron

    (gra ni' se tron)

    WHY is this medicine prescribed?

    Granisetron is used to prevent nausea and vomiting caused by cancer chemotherapy and radiation therapy. Granisetron is in a class of medications called 5-HT3 antagonists. It works by blocking serotonin, a natural substance in the body that causes nausea and vomiting.

    HOW should this medicine be used?

    Granisetron comes as a tablet and a solution (liquid) to take by mouth. When taken to prevent nausea and vomiting caused by chemotherapy, granisetron is usually taken 1 hour before chemotherapy is begun. A second dose may be taken 12 hours after the first dose. When taken to prevent nausea and vomiting caused by radiation, granisetron is usually taken within 1 hour before treatment. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take granisetron exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

    Are there OTHER USES for this medicine?

    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking granisetron,
    • tell your doctor and pharmacist if you are allergic to granisetron, dolasetron (Anzemet), ondansetron, (Zofran), or any other medications.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention ketoconazole (Nizoral). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking granisetron, call your doctor.

    What SPECIAL DIETARY instructions should I follow?

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

    What should I do IF I FORGET to take a dose?

    Granisetron should only be taken before chemotherapy or radiation therapy, as instructed by your doctor. It should not be taken on a regularly scheduled basis.

    What SIDE EFFECTS can this medicine cause?

    Granisetron may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • headache
    • weakness
    • stomach pain
    • heartburn
    • constipation
    • diarrhea
    • pain
    • dizziness
    • drowsiness
    • difficulty falling asleep or staying asleep
    • nervousness
    • cough
    • fever
    Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
    • hives
    • skin rash
    • itching
    • difficulty breathing or swallowing
    • fainting
    • blurred vision
    Granisetron may cause other side effects. Call your doctor if you have any unusual problems while taking 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 [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
    Symptoms of overdose may include:
    • headache

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor.
    Do not let anyone else take 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.

    Brand Names

    • Kytril®

    Granisetron Transdermal

    (gra nis' e tron)

    WHY is this medicine prescribed?

    Granisetron transdermal patches are used to prevent nausea and vomiting caused by chemotherapy. Granisetron is in a class of medications called 5HT3 inhibitors. It works by stopping the release of a certain natural substance (serotonin) from the stomach and intestine and by preventing it from acting on the part of the brain that controls nausea and vomiting.

    HOW should this medicine be used?

    Transdermal granisetron comes as a patch to apply to the skin. It is usually applied 24 to 48 hours before chemotherapy begins. The patch should be left in place for at least 24 hours after chemotherapy is finished, but should not be worn continuously for longer than a total of 7 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply transdermal granisetron exactly as directed. Do not apply more patches or apply the patches more often than prescribed by your doctor.
    You should apply the granisetron patch to the outer area of your upper arm. Be sure that the skin in the area where you plan to apply the patch is clean, dry, and healthy. Do not apply the patch to skin that is red, dry or peeling, irritated, or oily. Also do not apply the patch to skin that you have recently shaved or treated with creams, powders, lotions, oils, or other skin products.
    After you apply your granisetron patch, you should wear it all the time until you are scheduled to remove it. You may bathe or shower normally while you are wearing the patch, but you should not soak the patch in water for long periods of time. Avoid swimming, strenuous exercise, and using saunas or whirlpools while you are wearing the patch.
    If your patch loosens before it is time to remove it, you may apply medical adhesive tape or surgical bandages around the edges of the patch to keep it in place. Do not cover the entire patch with bandages or tape, and do not wrap bandages or tape all the way around your arm. Call your doctor if your patch comes more than half-way off or if it becomes damaged.
    To apply the patch, follow these steps:
    1. Take the foil pouch out of the carton. Tear open the foil pouch at the slit and and remove the patch. Each patch is stuck onto a thin plastic liner and a separate rigid plastic film. Do not open the pouch in advance, because you must apply the patch as soon as you remove it from the pouch. Do not try to cut the patch into pieces.
    2. Peel the thin plastic liner off of the printed side of the patch. Throw the liner away.
    3. Bend the patch in the middle so that you can remove one piece of the plastic film from the sticky side of the patch. Be careful not to stick the patch to itself or to touch the sticky part of the patch with your fingers.
    4. Hold the part of the patch that is still covered with the plastic film, and apply the sticky side to your skin.
    5. Bend the patch back and remove the second piece of plastic film. Press the entire patch firmly in place and smooth it down with your fingers. Be sure to press firmly, especially around the edges.
    6. Wash your hands right away.
    7. When it is time to remove the patch, peel it off gently. Fold it in half so that it sticks to itself and throw it away in a garbage can that is out of the reach of children and pets. The patch cannot be reused.
    8. If there is any sticky residue on your skin, wash it away gently with soap and water. Do not use alcohol or dissolving liquids such as nail polish remover.
    9. Wash your hands after you handle the patch.
    Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

    Are there OTHER USES for this medicine?

    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before using transdermal granisetron,
    • tell your doctor and pharmacist if you are allergic to granisetron, any other medications, any other skin patches, or medical adhesive tape or dressings.
    • you should know that granisetron is also available as tablets and a solution (liquid) to be taken orally and as an injection. These products are sold under the brand name Kytril. Do not take granisetron tablets or solution or receive granisetron injection while you are wearing a granisetron patch because you may receive too much granisetron.
    • 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 ketoconazole (Nizoral) and phenobarbital. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
    • tell your doctor if you have stomach pain or swelling, or if you develop these symptoms during your treatment with transdermal granisetron.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using transdermal granisetron, call your doctor.
    • plan to protect the granisetron patch and the skin around it from real and artificial sunlight (tanning beds, sunlamps). Keep the patch covered with clothing if you need to be exposed to sunlight during your treatment. You should also protect the area on your skin where the patch was applied from sunlight for 10 days after you remove the patch.

    What SPECIAL DIETARY instructions should I follow?

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

    What should I do IF I FORGET to take a dose?

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

    What SIDE EFFECTS can this medicine cause?

    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 after you remove the patch (Call the doctor if it lasts longer than 3 days.)
    Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
    • rash, redness, bumps, blisters, or itching of the skin under or around the patch
    • hives
    • tightness of the throat
    • difficulty breathing or swallowing
    • hoarseness
    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 [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    If someone applies too many granisetron patches, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
    Symptoms of overdose may include:
    • headache

    What OTHER INFORMATION should I know?

    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.

    Brand Names

    • Sancuso®

    Granisetron Hydrochloride Injection

    (gra ni' se tron)

    WHY is this medicine prescribed?

    Your doctor has ordered granisetron to prevent nausea and vomiting caused by cancer chemotherapy. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for at least 5 minutes, about a half-hour before chemotherapy administration. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
    Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how you respond to the medication.

    What SPECIAL PRECAUTIONS should I follow?

    Before administering granisetron,
    • tell your doctor and pharmacist if you are allergic to granisetron or any other drugs.
    • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking granisetron, call your doctor.

    HOW should this medicine be used?

    Before you administer granisetron, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.
    It is important that you use your medication exactly as directed. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

    What SIDE EFFECTS can this medicine cause?

    Granisetron may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:
    • headache
    • dizziness
    • weakness
    • drowsiness
    • stomach pain
    • constipation
    • diarrhea
    If you experience any of the following symptoms, call your health care provider immediately:
    • chest pain
    • irregular heartbeat
    • trouble breathing
    • fainting spells
    • rash
    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 [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    • Your health care provider probably will give you a several-day supply of granisetron at a time. You will be told to store it at room temperature.
    Store your medication only as directed. Make sure you understand what you need to store your medication properly.
    Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    What are the SIGNS OF AN INFECTION?

    If you are receiving granisetron in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:
    • tenderness
    • warmth
    • irritation
    • drainage
    • redness
    • swelling

    Brand Names

    • Kytril®
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