Kevatril (Granisetron Hydrochloride)

Granisetron Hydrochloride is a selective 5‑HT3 receptor antagonist used to control nausea and vomiting associated with several treatment pathways.

• Chemotherapy‑induced nausea and vomiting: reduces the frequency and severity of acute and delayed episodes.
• Postoperative nausea and vomiting: helps maintain patient comfort and reduces the need for rescue antiemetics after surgery.
• Radiation‑induced nausea and vomiting: provides prophylaxis and treatment for nausea related to radiotherapy.

• Granisetron Hydrochloride acts by selectively antagonizing peripheral and central 5‑HT3 receptors. By blocking serotonin binding at these ligand‑gated ion channels, it prevents serotonin‑mediated activation of the vomiting centre in the medulla, thereby inhibiting the emetic reflex triggered by chemotherapy, radiation, or surgical stimuli.

Granisetron Hydrochloride is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Constipation: reduced bowel movements.
• Dizziness: transient light‑headedness.
• Fatigue: feeling of tiredness.
• Diarrhoea: occasional loose stools.
• Dry mouth: reduced salivation.

Serious or Rare Side Effects

• QT interval prolongation: may predispose to cardiac arrhythmia.
• Severe allergic reaction: rash, itching, swelling, or anaphylaxis.
• Cardiac arrhythmias: irregular heartbeats.
• Hepatic dysfunction: elevated liver enzymes.
• Seizures: rare neurologic events.

Granisetron Hydrochloride should be used with caution in specific clinical situations.

• Cardiac assessment: evaluate patients with known QT prolongation or arrhythmias before initiating therapy.
• Electrolyte monitoring: correct hypokalaemia, hypomagnesaemia, or hypocalcaemia which can exacerbate QT prolongation.
• Concomitant QT‑prolonging drugs: avoid or monitor closely when used together.
• Hepatic impairment: dose adjustment may be required in moderate to severe liver disease.
• Renal impairment: consider dose modification in severe renal dysfunction.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Granisetron Hydrochloride can interact with other medicines, affecting safety or efficacy.

Major Interactions (Avoid)

• Other QT‑prolonging agents (e.g., certain antiarrhythmics, macrolide antibiotics): may increase risk of cardiac arrhythmias.
• Apomorphine: can cause severe hypotension and syncope.

Moderate Interactions (Monitor Closely)

• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may raise granisetron plasma levels.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce drug exposure.
• Other antiemetics (e.g., ondansetron): additive effects on QT interval.
• Anesthetic agents (e.g., propofol): monitor for enhanced sedation or cardiovascular effects.