Kytril

Kytril

 [ki´tril]
trademark for preparations of granisetron, an antiemetic used with antineoplastic agents. or cancer radiotherapy.

granisetron hydrochloride

Granisol, Kytril, Sancuso

Pharmacologic class: 5-hydroxytryptamine3 antagonist

Therapeutic class: Antiemetic

Pregnancy risk category B

Action

Binds to serotonin receptors in chemoreceptor trigger zone and vagal nerve terminals, blocking serotonin release and controlling nausea and vomiting

Availability

Injection: 1 mg/ml

Oral solution: 2 mg/10 ml in 30-ml bottles

Tablets: 1 mg

Transdermal system (patch): 52-cm2 patch (containing 34.3 mg granisetron delivering 3.1 mg/24 hours)

Indications and dosages

To prevent nausea and vomiting caused by chemotherapy

Adults and children ages 2 to 16: For I.V. use, 10 mcg/kg I.V. within 30 minutes before chemotherapy. For P.O. use (adults only), 1 mg P.O. b.i.d., with first dose given at least 1 hour before chemotherapy and second dose given 12 hours later on days when chemotherapy is administered; or 2 mg P.O. daily at least 1 hour before chemotherapy. For transdermal use (adults only), apply patch for up to 7 days.

To prevent nausea and vomiting caused by radiation therapy

Adults: 2 mg P.O. daily within 1 hour of radiation therapy

Acute postoperative nausea and vomiting

Adults: 1 mg I.V. undiluted, administered over 30 seconds

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• pregnant or breastfeeding patients
• children younger than age 18 (safety of P.O. and transdermal use not established)
• children younger than age 2 (safety of I.V. use not established).

Administration

• For I.V. infusion, dilute with 20 to 50 ml of normal saline solution or dextrose 5% in water.
• Infuse I.V. over 5 minutes, starting 30 minutes before chemotherapy.
• For direct I.V. injection, give undiluted over 30 seconds.
• Don't mix I.V. form with other drugs.
• For P.O. use, give first dose 1 hour before chemotherapy and second dose 12 hours after first.
• Apply a single transdermal patch to upper outer arm for 24 to 48 hours before chemotherapy.
• Remove patch a minimum of 24 hours after chemotherapy completion. Patch may be worn up to 7 days depending on duration of chemotherapy.

Adverse reactions

CNS: headache, anxiety, stimulation, weakness, drowsiness, dizziness

CV: hypertension

GI: nausea, vomiting, diarrhea, constipation, abdominal pain

Hematologic: anemia, leukopenia, thrombocytopenia

Skin: alopecia, application site reactions (patch)

Other: altered taste, decreased appetite, fever, chills, shivering

Interactions

Drug-diagnostic tests.Alanine aminotransferase, aspartate aminotransferase: increased levels

Electrolytes: altered levels

Hemoglobin, platelets, white blood cells: decreased levels

Drug-herbs.Horehound: enhanced serotonergic effects

Patient monitoring

• Monitor hepatic enzyme levels and CBC with white cell differential.
• Monitor temperature and blood pressure. Have patient use caution when ambulating, to avoid orthostatic hypotension.
• Know that patch may be degraded by direct exposure to natural or artificial sunlight.

Patient teaching

• Instruct patient to apply a single transdermal patch to upper outer arm 24 to 48 hours before chemotherapy.
• Instruct patient to remove patch by gently peeling it off in a minimum of 24 hours after chemotherapy completion.
• Instruct patient to remove patch if a severe or generalized skin reaction (such as rash or itching) occurs.
• Advise patient to avoid direct exposure of application site to natural or artificial sunlight by covering site with clothing while wearing patch and for 10 days after patch removal.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Advise patient to minimize GI upset by eating frequent, small servings of healthy food.
• Tell patient he'll undergo regular blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests and herbs mentioned above.

Kytril

Granisetron, see there.

Kytril

A brand name for GRANISETRON.
References in periodicals archive ?
Aloxi (palonosetron), Zofran generic (ondansetron), Kytril generic (granisetron), Emend (aprepitant) and Akynzeo (netupitant-palonosetron FDC) are the examples of currently available drugs to manage both CINV subtypes.
The defective drugs, manufactured between 2001 and 2005, were Kytril, Bactroban, Paxil CR, and Avandamet.
The drugs, manufactured in Puerto Rico between 2001 and 2005, included the antinausea drug Kytril, the antidepressant Paxil CR, the diabetes medication Avandamet, and the anti-infection ointment Bactroban.
Ortiz said the company allowed several drugs to be adulterated between 2001 and 2005, including Paxil CR, a skin-infection ointment called Bactroban, an anti-nausea drug called Kytril, and a diabetes drug called Avandamet.
Drugs covered under Part B included Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel), Kytril (granisetron), Neulasta (pegfilgrastim), and Aloxi (palonosetron) in 2006.
Food and Drug Administration (FDA) of its Abbreviated New Drug Applications (ANDAs) for Granisetron Hydrochloride Injection, 1 mg/mL, 1 mL single dose, and 1mg/mL, 4mL multiple dose vials, the generic equivalent of Hoffmann-LaRoche's Kytril Injection.
Table I: Key settlements following non-compliant management of external players in the commercial area Company Date Products Rationale Astrazeneca 2003 Zoladex Illegal sales and marketing Baye yer 2003 Cipro, Adalat Inflated prices Pfizer (Warner 2004 Neurontin Off-label Lambert) promotion GSK 2005 Zofran, Kytril inflated prices Serono 2005 Serostim Illegal marketing Schering-Plough 2006 Temodar Illegal sales marketing Company Settlement ($ millions) Astrazeneca 354.
According to Ayotte, Glaxo engaged in a scheme to inflate the price of the anti-nausea drugs Zofran and Kytril for the Medicare and Medicaid programs, which reimburse health-care providers based on the manufacturers' prices.
GlaxoSmithKline is paying $150m to settle US Justice Department charges that it fraudulently priced two of its drugs: Zofran and Kytril.
Competition authorities required the group to wash their hands of a number of drugs before the merger could be completed including herpes treatment Famvir and Vectavir and anti-nausea drug Kytril.
Singh held multiple leadership positions in the oncology franchise at Hoffman-La Roche, where he led the launches of several oncology and supportive care products including Xeloda and Kytril.