Parenteral Manual

Granisetron hydrochloride

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
KYTRIL
Classification: 
Antiemetic
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Prevention and treatment of chemotherapy and radiation-related nausea and vomiting.
  • Prevention and treatment of postoperative nausea and vomiting.
Reconstitution and Stability: 
  • Available as a 1 mg/mL vial
  • Vials should be stored at room temperature
Compatibility: 

- Solution Compatible: D5W, 0.9%NS, dextrose-saline solutions

- Additive/Above Cassette Compatible: dexamethasone, methylprednisolone

- Y-site Compatible: acyclovir, amikacin, ampicillin, fluconazole, heparin, KCl (up to 40 mmol/L) metronidazole, morphine, TPN (amino acids/dextrose)

- Incompatible: amphotericin B

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

YES
Usual dilution: undiluted (1 mg/mL) over 30 seconds or

                        dilute in a small volume of D5W or NS over 5 minutes
IV Intermittent Infusion YES
Usual dilution: 0.2 mg/mL
Infusion time: 30-60 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Chemotherapy and radiation-induced nausea and vomiting:
- Adults and Children (>2 years old):

  • 10-40 mcg/kg/day divided once or twice daily (Maximum: 3 mg/dose or 9 mg/day)
  • Administer initial dose 15-60 minutes before chemotherapy

Postoperative nausea and vomiting:

- Children (>4 years old):

  • 20-40 mcg/kg given as a single dose (Maximum: 1 mg/dose)
  • Administer before induction of surgery, immediately before reversal of anaesthesia, or  postoperatively.

- Adults:

  • 1 mg given as a single dose

- No dosage adjustment required in renal dysfunction.

Potential hazards of parenteral administration: 
  • Headache, asthenia, somnolence
  • Diarrhea, constipation, abdominal pain, decreased appetite
  • Hypotension, hypertension, arrhythmias, A-V block
Notes: 
  • Although doses of 100 mcg/kg have been used, 40 mcg/kg is the usual maximum dose
  • Safety and efficacy have not been established for children <2 years of age.

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