Granisetron Transdermal System (Sancuso®)

Author: OncoLink Team
Last Reviewed: June 12, 2020

Pronounced:gra-NIS-e-tron

Classification:Antiemetic; Serotonin -3 (5-HT3) receptor antagonist

About: Granisetron Transdermal System (Sancuso®)

Granisetron Transdermal System is a serotonin -3 (5-HT3) receptor antagonist. 5-HT3 receptors are found on areas of nerves in the brain and stomach that can trigger a vomiting reflex. Granisetron stops this reflex and helps prevent and manage acute and delayed nausea and vomiting. Granisetron is used for patients receiving cancer medications that are known to cause severe nausea and vomiting.

How to Use Granisetron Transdermal System

Granisetron Transdermal System is an adhesive patch that is worn on the upper arm before, during, and after your cancer treatment. “Transdermal” means that the medication slowly enters through your skin into your body over time. Apply the patch to a clean, hairless, and dry area of your upper outer arm. The area should not have any lotions, creams, moisturizers, powders, or other skin products on it. Do no place the patch on skin that has been recently shaved. Do not place the patch over skin that is red or open. Press the patch firmly onto the skin. 

Often, you can apply one patch 24-48 hours before your cancer treatment. You should leave the patch on for at least 24 hours after your last dose of cancer treatment for that week. The patch is adhesive, or sticky enough, to stay on for up to 7 days. Ask your care team how long you should wear the patch.

Only remove granisetron from the pouch when you are ready to use that patch, ideally immediately before application. Do not cut the patch into smaller pieces. The unprinted, sticky side of the patch has two pieces of plastic film. Bend the patch in the middle and remove one half of the plastic film. Be careful not to fold the medication patch onto itself and try not to touch the sticky side. While holding the other half of the plastic film still on the patch, place the patch onto the skin. Remove the plastic and press firmly, especially around the edges. Wash your hands after applying the patch.

If the patch starts to peel or come off, you can use medical tape on the edges of the patch to keep it down. Do not wrap or tape the entire patch. If the patch is damaged or comes more than halfway off, call your provider. 

When you take off the patch, peel it off gently and fold the patch in half, with the medicated side on the inside. Throw into the garbage, away from children and pets. Wash your hands. If there is some adhesive left on the skin, clean with soap and water (avoid alcohol to remove it). The area may be a little red. If this redness does not go away in 3 days, call your provider.

Do not use heating pads or heat lamps near the area of the patch because prolonged exposure to heat may increase concentrations of the drug in your body. Showering and bathing are fine. Do not use tanning beds or sunlamps, and avoid direct exposure to sunlight while wearing the patch and for 10 days after you take it off (keep the area covered with clothing).

Be sure to tell your healthcare provider about all medications and supplements you take, and if you have an allergy to medical adhesive tape or adhesive dressings.

Storage and Handling

Granisetron should be stored in the original, labeled package it came in at room temperature. Only remove granisetron from the pouch when you are ready to use that patch. Keep package out of reach of children and pets.

Where do I get this medication?

Granisetron Transdermal System is available through retail/mail order pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution. You can work with your provider’s office if this medication needs a prior authorization.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources, if they are available.

Possible Side Effects of Granisetron Transdermal System

This medication is given to manage and/or prevent side effects of your cancer treatment. If you are having side effects from this medication you should talk to your team about if this medication is necessary to your treatment or if there are other options to help manage the side effect this medication is treating. These are some of the most common side effects: 

Constipation

There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve the constipation.

Less common, but important side effects can include:

  • Masking of an Ileus or Bowel ObstructionAn ileus is a lack of movement of the bowels. A bowel obstruction is a blockage of the small or large intestine. If it is a complete obstruction you will have trouble passing gas and stool. A partial blockage can cause diarrhea. Other symptoms include severe belly pain, nausea, and vomiting. If you are having any of these symptoms you should contact your provider. Because granisetron manages nausea and vomiting and these are possible symptoms of a bowel obstruction, an ileus or bowel obstruction could be the cause and be overlooked.
  • Serotonin Syndrome: Taking this medication with serotonergic medications (often used to treat migraines and depression) can lead to serotonin syndrome. Symptoms of serotonin syndrome that you should notify your provider of are changes in your mental status (agitation, hallucinations, coma), your nervous system (change in heart rate or blood pressure, sweating, dizziness) or in how your muscles are working (tremors, trouble walking). You should call your provider if you are having any symptoms of serotonin syndrome.
  • Skin Reactions: While redness at the site is normal and common for up to 3 days after removing the patch, a more severe or generalized skin reaction can happen. If you have itchiness, a rash, or swelling, take the patch off and call your provider.

Reproductive Concerns

You should consult your healthcare team prior to becoming pregnant, fathering a child or breastfeeding while receiving this medication.  

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