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Granisetron (Transdermal route)

Pronunciation:

gra-NIS-e-tron

Brand Names:

  • Sancuso

Dosage Forms:

  • Patch, Extended Release

Classifications:

Therapeutic

Antiemetic

Pharmacologic

Serotonin Receptor Antagonist, 5-HT3

Uses of This Medicine:

Granisetron skin patch is used to prevent nausea and vomiting that may occur after cancer treatment (chemotherapy). Granisetron works in the nervous system to block the action of a chemical that causes nausea and vomiting.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Appropriate studies have not been performed on the relationship of age to the effects of granisetron transdermal patch in the pediatric population. Safety and efficacy have not been established.

Older adults

Although appropriate studies on the relationship of age to the effects of granisetron transdermal patch have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related heart, liver, or kidney problems, which may require caution in patients receiving granisetron transdermal patch.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amisulpride
  • Apomorphine
  • Bepridil
  • Cisapride
  • Dronedarone
  • Fluconazole
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Almotriptan
  • Amineptine
  • Amiodarone
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Anagrelide
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azithromycin
  • Brompheniramine
  • Buprenorphine
  • Buserelin
  • Buspirone
  • Carbamazepine
  • Chloroquine
  • Chlorpheniramine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Cocaine
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Desvenlafaxine
  • Dextromethorphan
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Duloxetine
  • Eletriptan
  • Erythromycin
  • Escitalopram
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Fluvoxamine
  • Frovatriptan
  • Furazolidone
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydroxychloroquine
  • Hydroxytryptophan
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Iproniazid
  • Isocarboxazid
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Levomilnacipran
  • Linezolid
  • Lithium
  • Lofepramine
  • Lopinavir
  • Lorcaserin
  • Lumefantrine
  • Mefloquine
  • Melitracen
  • Meperidine
  • Methadone
  • Methylene Blue
  • Metronidazole
  • Mifepristone
  • Milnacipran
  • Mirtazapine
  • Moclobemide
  • Moxifloxacin
  • Nafarelin
  • Naratriptan
  • Nefazodone
  • Nialamide
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Opipramol
  • Paliperidone
  • Panobinostat
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentazocine
  • Perflutren Lipid Microsphere
  • Phenelzine
  • Pimavanserin
  • Pitolisant
  • Posaconazole
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Rasagiline
  • Rizatriptan
  • Salmeterol
  • Selegiline
  • Sertraline
  • Sevoflurane
  • Sibutramine
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • St John's Wort
  • Sulpiride
  • Sumatriptan
  • Sunitinib
  • Tacrolimus
  • Tapentadol
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tianeptine
  • Toremifene
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Tryptophan
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Vilazodone
  • Vinflunine
  • Voriconazole
  • Vortioxetine
  • Zolmitriptan
  • Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Phenobarbital

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bowel blockage or
  • Gastric distention (enlarged abdomen) May cover up symptoms of these stomach or bowel problems.

Proper Use of This Medicine:

Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.

This medicine should come with patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

To use the skin patch:

  • Wash your hands with soap and water before and after applying a patch. Do not touch your eyes until after you have washed your hands.
  • Wash the area of skin where you will apply the patch gently with soap and warm water. Rinse completely and dry with a clean dry towel.
  • Apply the patch right away after removing it from the protective pouch. Do not cut it into smaller pieces and do not touch the sticky surface of the patch.
  • Apply the patch to a clean, dry, intact skin area on your upper outer arm. Do not put the patch over rashes, cuts, or irritated skin. Avoid putting the patch on areas where it could be rubbed off by tight clothing.
  • Press the patch firmly in place with your fingertips to make sure that the edges of the patch stick well.
  • Leave the patch in place for at least 24 hours after completion of chemotherapy. The patch can be worn for up to 7 days depending on how long you are receiving chemotherapy.
  • Avoid swimming, strenuous exercise, or using a sauna or whirlpool while using this medicine.
  • Do not expose the patch to direct sunlight or sunlamps. This could destroy the medicine in the patch. If you will be exposed to direct sunlight or sunlamps, cover your skin with clothing where you have the patch. Keep the clothing on this area while you are wearing it and for 10 days after you remove it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For transdermal dosage form (skin patch):
    • For prevention of nausea and vomiting caused by chemotherapy:
      • Adults One patch applied at least 24 to 48 hours before chemotherapy.
      • Children Use and dose must be determined by your doctor.

Missed dose

If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

Storage

Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

After removing a used patch, fold the patch in half with the sticky sides together. Make sure to dispose of it out of the reach of children and pets.

Precautions While Using This Medicine:

Check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

Do not take other medicines containing granisetron while using Sancuso®. Using these medicines together may cause serious unwanted side effects.

Check with your doctor right away if you start to have pain or swelling in your stomach area. These may be signs of a serious stomach or bowel problem.

Granisetron may cause a serious condition called serotonin syndrome if taken together with some medicines such as fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tramadol (Ultram®), a MAO inhibitor (eg, methylene blue injection, Eldepryl®, Marplan®, Nardil®, Parnate®), or medicine to treat depression (eg, fluoxetine, mirtazapine, paroxetine, Celexa®, Effexor®, Lexapro®, Paxil®, Zoloft®). Check with your doctor first before taking any other medicines with granisetron.

Serious skin reactions may occur while using the patch. Remove the patch and check with your doctor right away if you have a skin rash, itching, redness, or any skin irritation while you are wearing the patch.

Do not use a heating pad or heat lamp near the Sancuso® patch. Also, avoid sunlamps and tanning beds while using this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Difficulty having a bowel movement (stool)
Rare
Arm, back, or jaw pain
blurred vision
chest pain or discomfort
chest tightness or heaviness
confusion
cough
difficulty with swallowing
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast or irregular heartbeat
headache
hives or welts, itching, or skin rash
nausea
nervousness
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of the skin
slow heartbeat
sweating
trouble breathing
unusual tiredness or weakness
Incidence not known
Black, tarry stools
bleeding gums
blood in the urine or stools
chills
diarrhea
fear
fever
painful or difficult urination
pale skin
pinpoint red spots on the skin
sleepiness or unusual drowsiness
sore throat
sores, ulcers, or white spots on the lips or in the mouth
stomach pain
swollen glands
troubled breathing with exertion
unusual bleeding or bruising
vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
Decreased appetite
hair loss or thinning of the hair
lack or loss of strength
pain, itching, redness, discoloration, or irritation where you applied the patch
trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 9/15/2016
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