Uses of Naurif: - Nausea - Vomiting Nausea and vomiting, Chemotherapy-induced nausea and vomiting, Post-operative nausea and vomiting Hypersensitivity.

Anti-emetic drugs, Supportive Care Therapy

Granisetron is a highly selective 5-HT3 receptor antagonist with little or no affinity for other serotonin receptors. It blocks serotonin peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone.Serotonin receptors of the 5-HT3 type are located peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema. During chemotherapy that induces vomiting, mucosal enterochromaffin cells release serotonin, which stimulates 5-HT3 receptors. This evokes vagal afferent discharge, inducing vomiting. Animal studies demonstrate that, in binding to 5-HT3 receptors, granisetron blocks serotonin stimulation and subsequent vomiting after emetogenic stimuli such as cisplatin. In the ferret animal model, a single granisetron injection prevented vomiting due to high-dose cisplatin or arrested vomiting within 5 to 30 seconds.In most human studies, granisetron has had little effect on blood pressure, heart rate or ECG. No evidence of an effect on plasma prolactin or aldosterone concentrations has been found in other studies.

How to use Granisetron: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Granisetron may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Take up to 1 hr before chemotherapy. Adult Dose: Chemotherapy Induced Nausea & Vomiting Oral 1 mg PO 1 hr before chemotherapy, then 1 mg 12 hr after 1st dose; OR 2 mg 1 hr before chemotherapy IV 0.01 mg/kg/dose infused over 5 min or direct injected over 30 sec, 30 min before chemotherapy Radiation-Induced Nausea & Vomiting 2 mg PO, 1 hr before radiation treatment Postoperative Nausea & Vomiting Prevention: 1 mg (undiluted) IV push over 30 seconds; administer before anesthetic induction or immediately before reversal of anesthesia Treatment: 1 mg (undiluted) IV push over 30 seconds Elderly: Chemotherapy Induced Nausea & Vomiting Oral: 2 mg 1 hr before chemotherapy, then 1 mg 12 hr after 1st dose; OR 2 mg 1 hr before chemo IV: 0.01 mg/kg/dose infused over 5 min or direct injected over 30 sec, 30 min before chemotherapy Radiation-Induced Nausea & Vomiting 2 mg PO, 1 hr before radiation treatment Postoperative Nausea & Vomiting Prevention: 1 mg (undiluted) IV push over 30 seconds; administer before anesthetic induction or immediately before reversal of anesthesia Treatment: 1 mg (undiluted) IV push over 30 seconds Hepatic impairment No dosage adjustment required Child Dose: Chemotherapy Induced Nausea & Vomiting <2 years: Safey and efficacy not established 2-16 years: As adults; 0.01 mg/kg infused over 5 min or direct inj over 30 sec, 30 min before chemotherapy Oral administration: Currently FDA-approved for IV administration in children; safety and efficacy of oral administration is not established Postoperative Nausea & Vomiting Safety and efficacy not established Not approved for postoperative N/V in pediatric patients because of lack of efficacy and QT prolongation observed in clinical trials Renal Dose: Renal impairment IV Severe (CrCl <30 mL/min): Total clearance was not affected in patients with severe renal failure who received a single 40 mcg/kg IV dose PO No dosage adjustment required

Phenobarbital may induce metabolism of granisetron.

Hypersensitivity.

Common - Sleepiness - Weakness - Headache - Constipation - Diarrhea >10% Headache (10-21%) 1-10% Diarrhea (1-9%),Constipation (3-18%),Asthenia (5%),Somnolence (10%),Sedation (10%),Drowsiness (10%) Frequency Not Defined Anxiety,Fatigue,Malaise,Increased LFTs

Pregnancy Category B. No evidence of impaired fertility or harm to the animal fetus have been found. However, this drug may be used in pregnancy only if clearly needed. It is not known whether granisetron is excreted in human milk. So cautions hould be exercised when granisetron is administered to a nursing mother.

Precaution: Subacute intestinal obstruction or ileus. Moderate to severe hepatic impairment. Congenital long QT syndrome or other risk factors for QT prolongation (e.g. electrolyte abnormalities and cumulative high-dose anthracycline therapy). Pregnancy, lactation. Lactation: excretion in milk unknown; use with caution

lnjection: Store below 25°C.Protect from light. Tablet: Store below °C.Protect from light.

Anti-emetic drugs, Supportive Care Therapy

Granisetron is a selective 5-HT3-receptor antagonist with little or no affinity for other serotonin receptors. It blocks serotonin in the chemoreceptor zone.

Pregnancy category B. No evidence of impaired fertility or harm to the animal fetus has been found. However, this drug may be used in pregnancy only if clearly needed. It is not known whether Granisetron is excreted in human milk. So caution should be exercised when granisetron is administered to a nursing mother.