suspension), and adolescents from the age of 12 years to
17 years (hard capsules).lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Powder
▶Emend(Merck Sharp & Dohme Ltd)
Aprepitant 125 mgEmend 125 mg oral powder sachets|
1 sachetP£ 15. 81
Capsule
▶Emend(Merck Sharp & Dohme Ltd)
Aprepitant 80 mgEmend 80 mg capsules| 2 capsuleP£ 31. 61
Aprepitant 125 mgEmend 125 mg capsules| 5 capsuleP£ 79. 03ANTIEMETICS AND ANTINAUSEANTS›
SEROTONIN (5HT 3 ) RECEPTOR ANTAGONISTSGranisetron
lDRUG ACTIONGranisetron is a specific 5 HT 3 -receptor
antagonist which blocks 5 HT 3 receptors in the gastro-
intestinal tract and in the CNS.lINDICATIONS AND DOSE
Management of nausea and vomiting induced by cytotoxic
chemotherapy
▶BY MOUTH
▶Child 12–17 years: 1 – 2 mg, to be taken within 1 hour
before start of treatment, then 2 mg daily in
1 – 2 divided doses for up to 1 week following
chemotherapy
▶BY INTRAVENOUS INFUSION
▶Child 2–17 years: 10 – 40 micrograms/kg (max. per dose
3 mg), repeated if necessary, to be given before start of
chemotherapy, for treatment, dose may be repeated
within 24 hours if necessary, not less than 10 minutes
after initial dose; maximum 2 doses per daylUNLICENSED USETablets not licensed in children (age
range not specified by manufacturer).
lCAUTIONSSubacute intestinal obstruction.susceptibility
to QT-interval prolongation (including electrolyte
disturbances)
lINTERACTIONS→Appendix 1 : granisetron
lSIDE-EFFECTS
▶Common or very commonConstipation.diarrhoea.
headache.insomnia
▶UncommonExtrapyramidal symptoms.QT interval
prolongation.serotonin syndrome
lPREGNANCYManufacturer advises avoid.
lBREAST FEEDINGAvoid—no information available.
lHEPATIC IMPAIRMENTManufacturer advises use with
caution.
lDIRECTIONS FOR ADMINISTRATIONForintravenous
infusion, dilute up to 3 mL of granisetron injection in
Glucose 5 % or Sodium Chloride 0. 9 % to a total volume of
10 – 30 mL; give over 5 minutes.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for injection
▶Granisetron (Non-proprietary)
Granisetron (as Granisetron hydrochloride) 1 mg per
1mlGranisetron 3 mg/ 3 ml concentrate for solution for injection
ampoules| 5 ampouleP£ 24. 00
Granisetron 1 mg/ 1 ml concentrate for solution for injection ampoules
| 5 ampouleP£ 8. 00Tablet
▶Granisetron (Non-proprietary)
Granisetron (as Granisetron hydrochloride) 1 mgGranisetron 1 mg
tablets| 10 tabletP£ 51. 20 DT = £ 40. 79
Granisetron (as Granisetron hydrochloride) 2 mgGranisetron 2 mg
tablets| 5 tabletPsDT = £ 52. 39
▶Kytril(Atnahs Pharma UK Ltd)
Granisetron (as Granisetron hydrochloride) 1 mgKytril 1 mg
tablets| 10 tabletP£ 52. 39 DT = £ 40. 79
Granisetron (as Granisetron hydrochloride) 2 mgKytril 2 mg
tablets| 5 tabletP£ 52. 39 DT = £ 52. 39Ondansetron
lDRUG ACTIONOndansetron is a specific 5 HT 3 -receptor
antagonist which blocks 5 HT 3 receptors in the gastro-
intestinal tract and in the CNS.lINDICATIONS AND DOSE
Prevention of postoperative nausea and vomiting
▶BY SLOW INTRAVENOUS INJECTION
▶Child: 100 micrograms/kg (max. per dose 4 mg) for
1 dose, dose to be given over at least 30 seconds before,
during, or after induction of anaesthesia
Treatment of postoperative nausea and vomiting
▶BY SLOW INTRAVENOUS INJECTION
▶Child: 100 micrograms/kg (max. per dose 4 mg) for
1 dose, dose to be given over at least 30 seconds
Prevention and treatment of chemotherapy- and
radiotherapy-induced nausea and vomiting—initial dose
▶BY INTRAVENOUS INFUSION
▶Child 6 months–17 years (body surface area up to
1.3 m^2 ): 5 mg/m^2 for 1 dose then give orally,
alternatively 150 micrograms/kg (max. per dose 8 mg),
dose to be administered immediately before
chemotherapy, then 150 micrograms/kg every 4 hours
(max. per dose 8 mg) for 2 further doses then give
orally; maximum 32 mg per day
▶Child 6 months–17 years (body surface area 1.3 m^2 and
above): 8 mg for 1 dose then give orally, alternatively
150 micrograms/kg (max. per dose 8 mg), dose to be
administered immediately before chemotherapy, then
150 micrograms/kg every 4 hours (max. per dose 8 mg)
for 2 further doses then give orally, intravenous
infusion to be administered over at least 15 minutes;
maximum 32 mg per day
Prevention and treatment of chemotherapy- and
radiotherapy-induced nausea and vomiting—(follow-on
dose based on body surface area)
▶BY MOUTH
▶Child 6 months–17 years (body surface area up to
0.6 m^2 ): 2 mg every 12 hours for up to 5 days (dose can
be started 12 hours after intravenous administration);
maximum 32 mg per day
▶Child 6 months–17 years (body surface area
0.6–1.2 m^2 ): 4 mg every 12 hours for up to 5 days (dose
can be started 12 hours after intravenous
administration); maximum 32 mg per day
▶Child 6 months–17 years (body surface area 1.3 m^2 and
above): 8 mg every 12 hours for up to 5 days (dose can
be started 12 hours after intravenous administration);
maximum 32 mg per day
Prevention and treatment of chemotherapy- and
radiotherapy-induced nausea and vomiting—(follow-on
dose based on body-weight)
▶BY MOUTH
▶Child 6 months–17 years (body-weight up to 10.1 kg): 2 mg
every 12 hours for up to 5 days (dose can be started
12 hours after intravenous administration); maximum
32 mg per day264 Nausea and labyrinth disorders BNFC 2018 – 2019
Nervous system4