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DRUG INFORMATION ROUNDS

Low-Dose Granisetron for Postoperative Nausea and Vomiting Prophylaxis

Drug Information Specialty Resident, University of Pittsburgh Medical Center

Susan J Skledar, RPh MPH

Director, Drug Use and Disease State Management Program, University of Pittsburgh Medical Center; Assistant Professor, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh

Nicole T Ansani, PharmD

Associate Director, Drug Information and Pharmacoepidemiology Center, University of Pittsburgh Medical Center; Assistant Professor, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh

Reprints: Shelby L Corman PharmD, Drug Information Center, University of Pittsburgh Medical Center, 137 Victoria Hall, 200 Lothrop St., Pittsburgh, PA 15213-2582, fax 412/624-6350, cormansl{at}msx.upmc.edu

OBJECTIVE: To evaluate the use of low-dose granisetron in postoperative nausea and vomiting prophylaxis.

DATA SOURCES: Clinical trials available through PubMed and OVID (1966–July 2003), as well as information supplied by the drug manufacturer, were accessed.

DATA SYNTHESIS: Safety concerns associated with droperidol and limited availability of other agents have created a need to restructure prophylaxis guidelines for postoperative nausea and vomiting. It has recently been proposed that granisetron may be effective at a dose that is one-tenth of the Food and Drug Administration–approved dose. Conflicting evidence for this regimen is evaluated.

CONCLUSIONS: Based on the scarcity of supporting data, this regimen is not recommended for prophylaxis in patients at risk for postoperative nausea and vomiting.

Key Words: granisetron, postoperative nausea, vomiting

Published Online, February 24, 2004. www.theannals.com, DOI 10.1345/aph.1D328

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