Granisetron, Transdermal

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KEY POINTS

• This medicine is a patch put on the skin to prevent nausea and vomiting. Use it exactly as directed.
• While you are wearing the patch, cover the patch with protective clothing when you need to be outdoors, and for 10 days after you take it off.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Taking this medicine within 1 to 14 days of taking certain other medicines may cause life-threatening side effects. Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: 5-HT3 receptor antagonist; antiemetic (antinausea)

Generic and brand names: granisetron, transdermal; Sancuso

What is this medicine used for?

This medicine is put on the skin to prevent nausea and vomiting caused by chemotherapy.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine, medical tape or adhesive dressings, or other skin patches
• Liver disease
• Pain or swelling in your stomach

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Carefully follow the instructions for using this medicine. Be sure you know when to take the medicine and how much medicine you should take. If you are not sure how to use this medicine, ask your healthcare provider or pharmacist for help.

Check with your healthcare provider before using this medicine in children under age 18.

Put a single patch on your upper arm 24 to 48 hours before chemotherapy. Remove the patch 24 hours after you finish chemotherapy. You may wear the patch for up to 7 days.

Wash your hands before using this medicine. Apply the patch as soon as it is removed from the protective pouch. Put the sticky side of the patch on clean, dry skin on the outside of your upper arm. Choose a spot with no redness or irritation. Do not cut the patch. Make sure all the edges of the patch are firmly attached. Wash your hands after handling a patch.

You may shower and wash normally while wearing the patch. Do not swim, or use a sauna or whirlpool. Do not use a heating pad on or around the patch. Heat changes the way the medicine works.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Sunlight or sunlamps may make the medicine in the patch less effective and may irritate your skin. While you are wearing the patch, cover the patch with protective clothing when you need to be outdoors, and for 10 days after you take it off. Do not use a sunlamp or tanning bed while you are using this medicine.

If you have a severe rash or itching, gently peel off the patch and contact your healthcare provider.

This medicine may cause a life-threatening problem called serotonin syndrome if you take it with certain other medicines, such as antidepressants, migraine medicines, pain medicines, some cough medicines, and St. John’s wort. Make sure that your providers know ALL of the medicines that you take. Contact your healthcare provider right away if you have:

• Restlessness
• Hallucinations
• Loss of coordination or trouble walking
• Fast heart beat
• Rapid changes in blood pressure
• Increased body temperature, flushing, sweating
• Nausea and vomiting
• Stiff muscles
• Diarrhea

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are using this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Pounding or irregular heartbeat; chest pain; fast or slow heartbeat; severe dizziness or fainting; trouble breathing; pain or swelling in the abdomen; fever; severe headache; confusion; hallucinations; unusual thoughts or behavior; severe agitation; muscle twitching or stiffness; flushing; sweating; seizures; trouble walking; severe nausea, vomiting, or diarrhea; severe redness, rash, blisters, or itching.

Other: Headache, mild dizziness, drowsiness, constipation, mild diarrhea, mild nausea or vomiting, anxiety, mild rash or itching.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alfuzosin (Uroxatral)
• Anagrelide (Agrylin)
• Antibiotics such as azithromycin (Zithromax, Zmax), bedaquiline (Sirturo), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), levofloxacin (Levaquin), linezolid (Zyvox), metronidazole, moxifloxacin (Avelox), ofloxacin, pentamidine (NebuPent, Pentam), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), mirtazapine (Remeron), nortriptyline (Pamelor), sertraline (Zoloft), and trazodone
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend)
• Antipsychotic medicines such as asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• Apomorphine (Apokyn)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Buspirone
• Cancer medicines such as arsenic trioxide (Trisenox), bortezomib (Velcade), bosutinib (Bosulif), ceritinib (Zykadia), crizotinib (Xalkori), dasatinib (Sprycel), degarelix (Firmagon), eribulin (Halaven), goserelin (Zoladex), histrelin (Vantas), lapatinib (Tykerb), nilotinib (Tasigna), pazopanib (Votrient), sorafenib (Nexavar), sunitinib (Sutent), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Dextromethorphan, an ingredient in many cough, cold, or allergy medicines such as Robitussin-DM
• Dextromethorphan/quinidine (Nuedexta)
• Doxepin (Silenor)
• Eliglustat (Cerdelga)
• Ezogabine (Potiga)
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, procainamide, propafenone (Rythmol), quinidine, ranolazine (Ranexa), and sotalol (Betapace, Sorine)
• HIV medicines such as lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and saquinavir (Invirase)
• Lithium (Lithobid)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat breathing or lung problems such as arformoterol (Brovana) and formoterol (Perforomist)
• Mifepristone (Korlym, Mifeprex)
• Migraine medicines such as almotriptan (Axert), dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, Sumavel), and zolmitriptan (Zomig)
• Natural remedies such as SAMe, St. John’s wort, and tryptophan
• Other nausea medicines such as dolasetron (Anzemet), droperidol (Inapsine), ondansetron (Zofran), and promethazine
• Pain medicines such as fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), meperidine (Demerol), methadone (Dolophine, Methadose), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Pasireotide (Signifor)
• Procarbazine (Matulane)
• Products that contain methylene blue (Hyophen, Prosed DS, Urophen, Uta)
• Tetrabenazine (Xenazine)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store the patch in the original package at room temperature. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.