Generic Name and Formulations:
Granisetron extended-release 10mg/0.4mL; per pre-filled syringe; viscous liq for SC inj.
Indications for SUSTOL:
In combination with other antiemetics, to prevent acute and delayed nausea/vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide (AC) combination regimens.
Give as a slow, SC inj over 20–30secs with IV dexamethasone ≥30mins before chemotherapy. ≥18yrs: 10mg on Day 1 of chemotherapy; give no sooner than once every 7 days. For MEC: use IV dexamethasone 8mg on Day 1. For AC: use IV dexamethasone 20mg on Day 1, then 8mg orally twice daily on Days 2–4. If concomitant NK1 receptor antagonist: see full labeling. Renal impairment (CrCl 30–59mL/min): give Sustol on Day 1 of chemotherapy and no sooner than once every 14 days; (CrCl <30mL/min): avoid.
<18yrs: not established.
Hypersensitivity to other 5-HT3 receptor antagonists.
Monitor for inj site reactions (including infections, bruising/hematoma, bleeding, others); if ongoing or unresolved reactions, administer in unaffected areas. Abdominal surgery. May mask progressive ileus and/or gastric distention. GI obstruction. Monitor for constipation, decreased bowel activity. Monitor for serotonin syndrome; discontinue if symptoms occur. Renal impairment. Pregnancy. Nursing mothers.
Selective 5-HT3 receptor antagonist.
Increased risk of severe bruising and/or hematoma with concomitant antiplatelets or anticoagulants. Increased risk of serotonin syndrome with concomitant other SSRIs, SNRIs, MAOIs, mirtazapine, fentanyl, lithium, tramadol, or IV methylene blue.
Inj site reactions, constipation, fatigue, headache, diarrhea, abdominal pain, insomnia, dyspepsia, dizziness, asthenia, gastroesophageal reflux; hypersensitivity, serotonin syndrome.
Clinical Pain Advisor Articles
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Reducing Mortality After Overdose: Is Treatment for Opioid Use Disorder Effective?
- A Physician's Guide to Incorporating Patient Spirituality in Practice
- Low Literacy Self-Management Program for Chronic Pain May Be Effective
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- The Challenge of Compassion in Modern Healthcare Settings
- Republican Opposition to Obamacare: What's Done, What's to Come
- Lowering Default Pill Counts in EMRs May Effectively Reduce Postoperative Opioid Prescription Numbers
- Steps Taken to Increase Use of Electronic Tools in Medicine
- Daily and Retrospective Pain Measurements Comparable in Hip Osteoarthritis