Kytril: Effective Prevention of Chemotherapy-Induced Nausea and Vomiting
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Synonyms | |||
Kytril (granisetron hydrochloride) is a potent 5-HT3 receptor antagonist specifically formulated for the prevention and management of nausea and vomiting associated with emetogenic cancer chemotherapy, radiotherapy, and postoperative recovery. Developed to target the underlying physiological mechanisms of emesis, it offers a critical therapeutic option for patients undergoing challenging treatment regimens. Its efficacy and favorable safety profile have established it as a cornerstone in supportive oncology care, helping to improve treatment adherence and quality of life.
Features
- Active ingredient: Granisetron hydrochloride
- Available formulations: Oral tablets, oral solution, and injectable solution
- Selective and high-affinity binding to 5-HT3 receptors
- Rapid onset of action with prolonged duration of effect
- Multiple administration routes for flexible clinical use
- Demonstrated stability across a range of storage conditions
Benefits
- Significantly reduces the incidence and severity of acute and delayed chemotherapy-induced nausea and vomiting (CINV)
- Enhances patient comfort and quality of life during cancer treatment
- Supports chemotherapy regimen adherence by mitigating treatment-related side effects
- Provides reliable antiemetic coverage with a single dose in many cases
- Minimizes the need for rescue medication and associated side effects
- Suitable for use in both adult and pediatric patient populations
Common use
Kytril is primarily indicated for the prevention of nausea and vomiting associated with initial and repeat courses of emetogenic cancer therapy, including high-dose cisplatin. It is also used for the prevention and treatment of postoperative nausea and vomiting (PONV) and nausea/vomiting associated with radiotherapy. Its use is common in oncology, surgical, and radiation oncology settings, often administered as part of a comprehensive antiemetic protocol.
Dosage and direction
For chemotherapy-induced nausea and vomiting:
- Adults: 2 mg orally once daily or 1 mg orally twice daily. Alternatively, 10 mcg/kg intravenously administered over 5 minutes, beginning within 30 minutes before chemotherapy.
- Pediatrics: 20 mcg/kg intravenously (up to 1 mg) over 5 minutes, administered within 30 minutes before chemotherapy.
For radiotherapy-induced nausea and vomiting:
- Adults: 2 mg orally once daily given within 1 hour of radiotherapy.
For postoperative nausea and vomiting:
- Adults: 1 mg intravenously administered before induction of anesthesia, immediately before reversal of anesthesia, or postoperatively.
Tablets should be swallowed whole with water; the oral solution should be measured with the provided dosing cup. Dosage may be adjusted based on clinical need, emetogenic potential of the therapy, and patient response.
Precautions
- Use with caution in patients with hepatic impairment; dosage adjustment may be necessary.
- Electrolyte imbalances should be corrected prior to administration, as hypokalemia or hypomagnesemia may increase the risk of arrhythmias.
- Monitor for signs of hypersensitivity reactions during and following administration.
- Not recommended for patients with congenital long QT syndrome or those taking other QT-prolonging drugs unless benefits outweigh risks.
- Use in elderly patients should be approached with care due to potential decreased hepatic, renal, or cardiac function.
Contraindications
- Hypersensitivity to granisetron or any component of the formulation.
- Concomitant use with apomorphine due to risk of profound hypotension and loss of consciousness.
- History of severe cardiovascular disease, particularly uncorrected hypokalemia, hypomagnesemia, or clinically significant bradycardia, unless potential benefit justifies potential risk.
Possible side effect
Common side effects may include:
- Headache (often mild to moderate)
- Constipation
- Diarrhea
- Asthenia
- Dizziness
Less common but serious side effects:
- QT interval prolongation
- Serotonin syndrome (especially when used with other serotonergic drugs)
- Hypersensitivity reactions including anaphylaxis
- Extrapyramidal symptoms (rare)
Most side effects are transient and manageable; patients should report persistent or severe symptoms to their healthcare provider.
Drug interaction
- Concomitant use with drugs that prolong QT interval (e.g., certain antipsychotics, antiarrhythmics, antibiotics) may increase risk of torsades de pointes.
- May enhance serotonergic effects of SSRIs, SNRIs, MAOIs, and other serotonergic drugs, increasing risk of serotonin syndrome.
- CYP3A4 inducers (e.g., rifampin, carbamazepine) may decrease granisetron plasma concentrations.
- CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) may increase granisetron exposure.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. For chemotherapy or radiotherapy schedules, coordinate with the healthcare team if a dose is omitted.
Overdose
Symptoms of overdose may include severe headache, dizziness, and blurred vision. There is no specific antidote for granisetron overdose. Treatment should be symptomatic and supportive, including ECG monitoring for QT prolongation. Hemodialysis is not likely to be effective due to high protein binding.
Storage
- Store at controlled room temperature (20–25°C or 68–77°F); excursions permitted between 15–30°C (59–86°F).
- Protect from light.
- Keep oral solution and tablets in the original container; ensure the cap is tightly closed.
- Do not freeze the injectable solution.
- Keep out of reach of children and pets.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Dosage, administration, and suitability depend on individual patient factors and clinical context.
Reviews
Clinical studies and meta-analyses consistently demonstrate Kytril’s efficacy in reducing CINV, with particular strength in acute phase control. Healthcare professionals note its reliability and patient tolerability. Some reviews highlight the convenience of oral dosing for outpatient management. A minority of reports mention headache as a drawback, though it is generally manageable. Overall, it is regarded as an effective option within antiemetic guidelines.