Kytril: Advanced Nausea and Vomiting Control for Chemotherapy Patients
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Synonyms | |||
Kytril (granisetron hydrochloride) is a potent 5-HT3 receptor antagonist specifically formulated for the prevention and treatment of nausea and vomiting induced by chemotherapy, radiotherapy, and postoperative recovery. Developed with a strong evidence base, it offers targeted action to block serotonin pathways responsible for emetic responses, ensuring patient comfort and treatment adherence. Its efficacy is well-documented in both adult and pediatric populations, making it a cornerstone of supportive care in oncology. Available in multiple formulations including tablets, oral solution, and injectable forms, Kytril provides flexibility tailored to clinical needs and patient preferences.
Features
- Contains granisetron hydrochloride as the active ingredient
- Available in 1 mg tablets, 2 mg/10 mL oral solution, and 1 mg/mL injectable formulation
- Selective 5-HT3 receptor antagonist with high binding affinity
- Rapid onset of action; injectable form acts within minutes
- Long duration of efficacy, often covering entire emetogenic risk periods
- Compatible with most intravenous solutions and administration sets
- Manufactured under strict pharmaceutical quality controls
Benefits
- Significantly reduces incidence and severity of chemotherapy-induced nausea and vomiting (CINV)
- Enhances quality of life during cancer treatment by minimizing disruptive gastrointestinal side effects
- Supports chemotherapy regimen adherence by managing treatment-related emesis effectively
- Reduces need for rescue antiemetic medications and associated healthcare visits
- Flexible dosing options accommodate inpatient, outpatient, and home care settings
- Well-tolerated profile with predominantly mild and transient side effects
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 prevention and treatment of postoperative nausea and vomiting (PONV) and radiation-induced nausea and vomiting. Its use is standard in hematology-oncology, radiation oncology, and surgical departments, particularly where moderate to highly emetogenic protocols are administered. Clinical guidelines frequently recommend Kytril as first-line prophylaxis for patients receiving emetogenic chemotherapy.
Dosage and direction
For chemotherapy-induced nausea and vomiting:
- Adults: 2 mg orally once daily or 1 mg orally twice daily. First dose should be administered up to 1 hour before chemotherapy.
- Alternatively: 10 mcg/kg intravenously administered within 30 minutes before chemotherapy, infused over 5 minutes.
- Pediatrics: 20 mcg/kg intravenously (max 1 mg) or 40 mcg/kg orally (max 2 mg) before chemotherapy.
For postoperative nausea and vomiting:
- Adults: 1 mg intravenously administered before induction of anesthesia or postoperatively.
Dosage adjustments are rarely needed for renal or hepatic impairment. Tablets should be swallowed whole with water; oral solution should be measured with the provided dosing syringe.
Precautions
- Use with caution in patients with known hypersensitivity to other 5-HT3 receptor antagonists
- Monitor patients with cardiac conduction abnormalities (e.g., QT prolongation) as granisetron may increase risk
- Exercise caution in patients with gastrointestinal obstruction; antiemetics may mask underlying ileus
- Elderly patients may be more sensitive to side effects; consider dose monitoring
- Not recommended during pregnancy unless potential benefit justifies potential risk to fetus
- Breastfeeding should be discontinued during treatment due to secretion in human milk
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 cardiac arrhythmias or congenital long QT syndrome
- Pediatric patients for postoperative nausea and vomiting (safety not established)
Possible side effect
Most side effects are mild to moderate and transient:
- Headache (most common, 14-21%)
- Constipation (3-11%)
- Diarrhea (4-9%)
- Asthenia (5-8%)
- Dizziness (4-7%)
- Abdominal pain (3-6%)
- Insomnia (3-5%)
- Transient elevations in liver enzymes (2-4%)
- Injection site reactions (pain, redness with IV administration)
Serious but rare side effects include hypersensitivity reactions, serotonin syndrome (especially with other serotonergic drugs), and QT interval prolongation.
Drug interaction
- Serotonergic drugs (SSRIs, SNRIs, tramadol): increased risk of serotonin syndrome
- Drugs that prolong QT interval (antiarrhythmics, antipsychotics, antibiotics): additive effect on cardiac conduction
- Apomorphine: contraindicated due to risk of hypotension and syncope
- CYP3A4 inducers (rifampin, carbamazepine): may decrease granisetron levels
- CYP3A4 inhibitors (ketoconazole, clarithromycin): may increase granisetron levels
- No clinically significant interactions with dexamethasone or neurokinin-1 antagonists
Missed dose
If a scheduled dose is missed prior to chemotherapy, administer as soon as possible. If vomiting occurs after oral administration, do not repeat dose; consider alternative administration route for subsequent doses. For maintenance therapy, skip missed dose and resume regular schedule; do not double dose.
Overdose
No specific antidote exists. Symptoms may include severe headache, dizziness, and constipation. Cases of QT prolongation at doses exceeding 10 times recommended have been reported. Management includes supportive care and symptomatic treatment. Hemodialysis is unlikely to be effective due to high protein binding. Contact poison control center for latest guidance.
Storage
- Store at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F)
- Protect from light
- Keep oral solution in original bottle; use within 1 month after opening
- Do not freeze injectable solution
- Keep all medications out of reach of children and pets
- Discard unused portion of IV solution after single use
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Kytril is a prescription medication that should be used only under supervision of a qualified healthcare professional. Dosage and administration should be determined based on individual patient characteristics and treatment protocol. Always consult prescribing information and current clinical guidelines before administration. Report any adverse events to the appropriate regulatory authority.
Reviews
“Kytril has been transformative in our oncology practice. Patients receiving highly emetogenic regimens now complete treatment with significantly improved comfort levels. The once-daily oral option particularly enhances outpatient management.” - Dr. Elena Rodriguez, Medical Oncologist
“In our pediatric oncology unit, Kytril injection has demonstrated excellent control of acute CINV with minimal side effects. The availability of oral solution has been invaluable for younger patients.” - Pediatric Hematology Team, University Hospital
“Compared to earlier antiemetics, Kytril provides more consistent protection throughout the critical 24-hour post-chemotherapy period. The reduction in rescue medication needs has been statistically significant in our patient population.” - Clinical Pharmacy Director, Cancer Center