Granisetron STADA
5-HT3 Receptor Antagonist for Chemotherapy and Radiotherapy-Induced Nausea
Quick Facts About Granisetron STADA
Key Takeaways About Granisetron STADA
- Effective antiemetic: Granisetron prevents and treats nausea and vomiting caused by chemotherapy and radiotherapy by selectively blocking 5-HT3 serotonin receptors
- Adults only: Granisetron STADA tablets are approved for adult use only; children should not take these tablets
- Watch for serotonin syndrome: The risk increases when granisetron is combined with SSRIs, SNRIs, or other serotonergic medications – inform your doctor about all medicines you take
- Common side effects are mild: Headache and constipation are the most frequent side effects, occurring in more than 1 in 10 patients
- Timing matters: The first dose should typically be taken one hour before chemotherapy or radiotherapy for optimal prevention of nausea
What Is Granisetron STADA and What Is It Used For?
Granisetron STADA is a selective 5-HT3 receptor antagonist (antiemetic) that prevents and treats nausea and vomiting caused by cancer treatments including chemotherapy and radiotherapy. It works by blocking serotonin receptors in the brain and gut that trigger the vomiting reflex.
Granisetron belongs to a class of medicines known as 5-HT3 receptor antagonists, also called serotonin type 3 receptor blockers. These medications are among the most important advances in supportive cancer care, dramatically reducing one of the most distressing side effects of cancer treatment. The drug was first approved for clinical use in the early 1990s and has since become a cornerstone of antiemetic therapy worldwide.
During chemotherapy and radiotherapy, the body's enterochromaffin cells in the gastrointestinal tract release large quantities of serotonin (5-hydroxytryptamine, or 5-HT). This serotonin activates 5-HT3 receptors located on vagal afferent nerve terminals in the gut wall and in the chemoreceptor trigger zone (CTZ) of the brain. Activation of these receptors initiates the vomiting reflex. Granisetron selectively and competitively blocks these 5-HT3 receptors, effectively preventing the nausea and vomiting signal from being transmitted.
Granisetron STADA is specifically indicated for:
- Prevention of chemotherapy-induced nausea and vomiting (CINV): Used before and during cycles of emetogenic (nausea-causing) chemotherapy, including both moderately and highly emetogenic regimens
- Treatment of established CINV: Can be used to treat nausea and vomiting that has already developed during or after chemotherapy
- Prevention and treatment of radiotherapy-induced nausea and vomiting (RINV): Used in patients receiving radiation therapy, particularly to the abdomen or total body irradiation
According to the Multinational Association of Supportive Care in Cancer (MASCC) and the European Society for Medical Oncology (ESMO), 5-HT3 receptor antagonists such as granisetron form a key component of standard antiemetic prophylaxis. International guidelines recommend their use as part of combination antiemetic regimens, often together with corticosteroids (such as dexamethasone) and, for highly emetogenic chemotherapy, NK1 receptor antagonists (such as aprepitant).
Granisetron is available in several formulations worldwide, including oral tablets, intravenous injection, and a transdermal patch (SANCUSO). Granisetron STADA specifically refers to the oral tablet formulation manufactured by STADA Arzneimittel AG. The active substance granisetron may also be approved under other brand names for additional indications not covered in this specific product information.
What Should You Know Before Taking Granisetron STADA?
Before starting granisetron, inform your doctor about all your medical conditions, especially bowel obstruction, heart rhythm disorders, and electrolyte imbalances. Tell your doctor about all other medications you take, particularly SSRIs, SNRIs, and other 5-HT3 antagonists, as combining these can increase the risk of serotonin syndrome.
Your doctor has prescribed granisetron to help manage the nausea and vomiting associated with your cancer treatment. Before you begin taking it, it is important that your healthcare team is fully informed about your medical history and any other medications you are using. This information helps ensure that granisetron is safe and appropriate for you.
Contraindications
You should not take Granisetron STADA if:
- You are allergic to granisetron or any of the other ingredients in the tablets (listed in the contents section below). Signs of an allergic reaction may include skin rash, itching, swelling of the face, lips or throat, or difficulty breathing
If you are uncertain whether any of the above apply to you, speak to your doctor, pharmacist, or nurse before taking granisetron.
Warnings and Precautions
Talk to your doctor, pharmacist, or nurse before taking Granisetron STADA, particularly if you:
- Have bowel obstruction (intestinal obstruction): Granisetron can slow bowel movements. If you have a known or suspected blockage in your intestines, granisetron could worsen the condition. Your doctor will assess whether an alternative antiemetic is more appropriate
- Have heart problems: If you have cardiac arrhythmias (irregular heartbeat) or are being treated for cancer with a drug known to affect the heart, inform your doctor. Granisetron can occasionally cause changes in heart rhythm (QT prolongation), particularly in patients with pre-existing cardiac conditions
- Have electrolyte imbalances: Abnormal levels of potassium, sodium, or calcium in the blood (electrolyte disturbances) can increase the risk of cardiac side effects when taking granisetron. Your doctor may check your blood electrolyte levels before starting treatment
- Are taking other 5-HT3 receptor antagonists: Avoid taking granisetron together with other medicines in the same class, such as ondansetron or dolasetron, as this does not improve efficacy but may increase the risk of side effects
Serotonin syndrome is an uncommon but potentially life-threatening reaction that can occur with granisetron use. The risk is greatest when granisetron is taken together with other serotonergic medications, particularly SSRIs (such as fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram) and SNRIs (such as venlafaxine, duloxetine). Symptoms include agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, muscle twitching or rigidity, diarrhoea, excessive sweating, and high body temperature. Seek immediate medical attention if you experience any of these symptoms.
Use in Children
Granisetron STADA tablets are not approved for use in children. Children should not take these tablets. If a child requires antiemetic therapy during cancer treatment, the treating oncologist will prescribe an appropriate alternative medication or formulation. In some countries, intravenous granisetron formulations may be used in paediatric patients under specialist supervision, but the oral tablet form discussed here is intended for adults only.
Pregnancy and Breastfeeding
You should not take Granisetron STADA if you are pregnant, think you might be pregnant, or are planning to become pregnant, unless your doctor has specifically told you to do so. The safety of granisetron during pregnancy has not been established in adequate human studies. Animal studies have not shown direct harmful effects on the developing foetus, but as a precaution, granisetron should only be used during pregnancy when the potential benefit to the mother clearly outweighs any possible risk to the baby.
It is not known whether granisetron passes into breast milk. If you are breastfeeding, tell your doctor before taking this medicine. Your doctor will weigh the benefits of antiemetic therapy against any potential risks to your nursing infant and advise you on whether to continue breastfeeding or to use an alternative medication.
Driving and Operating Machinery
Granisetron STADA has no or negligible influence on the ability to drive and use machines. However, you are responsible for assessing your own fitness to drive or operate machinery. Bear in mind that your underlying condition (cancer treatment) may affect your alertness and reaction time. If you experience any side effects such as headache or dizziness that could impair your ability to drive safely, refrain from driving until the symptoms have resolved.
Important Information About Some Ingredients
Lactose: Granisetron STADA tablets contain lactose monohydrate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Sodium: This medicine contains less than 1 mmol sodium (23 mg) per tablet, meaning it is essentially “sodium-free”. This is relevant for patients on a sodium-restricted diet.
How Does Granisetron STADA Interact with Other Drugs?
Granisetron can interact with several medications, including other 5-HT3 antagonists, SSRIs, SNRIs, antiepileptics, antifungals, and certain antibiotics. The most serious interaction risk is serotonin syndrome when combined with serotonergic drugs. Always inform your doctor about all medications you are taking.
Tell your doctor, pharmacist, or nurse about all medicines you are taking, have recently taken, or might take. This is because granisetron can affect how some medicines work, and some medicines can affect how granisetron works. Granisetron is primarily metabolised in the liver by the cytochrome P450 enzyme CYP3A4, with contributions from CYP1A1. Drugs that induce or inhibit these enzymes can alter granisetron blood levels.
Major Interactions
| Drug | Category | Effect | Recommendation |
|---|---|---|---|
| Fluoxetine, Paroxetine, Sertraline, Fluvoxamine, Citalopram, Escitalopram | SSRIs (antidepressants) | Increased risk of serotonin syndrome due to additive serotonergic effects | Use with caution; monitor for symptoms of serotonin syndrome. Inform your doctor immediately if symptoms occur |
| Venlafaxine, Duloxetine | SNRIs (antidepressants) | Increased risk of serotonin syndrome due to additive serotonergic effects | Use with caution; close monitoring required. Report any unusual symptoms promptly |
| Ondansetron, Dolasetron | Other 5-HT3 receptor antagonists | No added benefit; potential for increased side effects and serotonin syndrome risk | Avoid concurrent use of multiple 5-HT3 antagonists |
| Drugs prolonging QT interval | Various (antiarrhythmics, some antibiotics) | Additive risk of QT prolongation and cardiac arrhythmias | Use with caution; ECG monitoring may be required |
Moderate Interactions
| Drug | Category | Effect | Recommendation |
|---|---|---|---|
| Phenobarbital | Antiepileptic / CYP3A4 inducer | May increase granisetron metabolism, reducing its effectiveness | Monitor antiemetic efficacy; dose adjustment may be needed |
| Ketoconazole | Antifungal / CYP3A4 inhibitor | May decrease granisetron metabolism, increasing blood levels | Monitor for increased side effects during concurrent use |
| Erythromycin | Macrolide antibiotic / CYP3A4 inhibitor | May increase granisetron blood levels; also carries independent QT prolongation risk | Use with caution; monitor for cardiac and gastrointestinal side effects |
| Other CYP3A4 inducers (e.g. rifampicin, carbamazepine, St. John’s Wort) | Enzyme inducers | May reduce granisetron effectiveness by accelerating its metabolism | Monitor antiemetic response; consider alternative antiemetics if efficacy is reduced |
Granisetron is commonly and safely used alongside corticosteroids (such as dexamethasone), which are often prescribed as part of combination antiemetic regimens. This combination is recommended by international guidelines (MASCC/ESMO, ASCO) for optimal prevention of chemotherapy-induced nausea and vomiting. Granisetron does not significantly interact with most chemotherapy drugs, making it suitable for use across a wide range of cancer treatment protocols.
What Is the Correct Dosage of Granisetron STADA?
The usual dose for adults is 1 mg twice daily or 2 mg once daily, started one hour before chemotherapy or radiotherapy and continued for up to one week. Always take granisetron exactly as your doctor has prescribed.
Always take this medicine exactly as your doctor has told you. Do not change your dose or stop taking the medicine without consulting your doctor first. The dose of granisetron varies depending on whether you are receiving it to prevent or to treat nausea and vomiting, and your doctor will determine the most appropriate regimen for your specific treatment plan.
Prevention of Nausea and Vomiting
Before Chemotherapy or Radiotherapy
Timing: The first dose of Granisetron STADA should be taken approximately one hour before the start of chemotherapy or radiotherapy.
Dosage options:
- 1 mg tablet twice daily (morning and evening), or
- 2 mg (two 1 mg tablets) once daily
Duration: Treatment is typically continued for up to one week after the completion of chemotherapy or radiotherapy.
Treatment of Established Nausea and Vomiting
If Nausea or Vomiting Has Already Started
Dosage options:
- 1 mg tablet twice daily, or
- 2 mg (two 1 mg tablets) once daily
Your doctor will advise you on how long to continue treatment based on your clinical response and the duration of your cancer therapy.
Children
Granisetron STADA tablets are not recommended for children. If your child requires antiemetic therapy, the treating oncologist will prescribe an appropriate alternative.
Elderly Patients
No specific dose adjustment is required for elderly patients. The standard adult dosing regimen applies. However, as with all medications in older adults, your doctor will monitor you for any adverse effects and may adjust the treatment plan if necessary.
Missed Dose
If you forget to take a dose of Granisetron STADA, speak to your doctor, pharmacist, or nurse for advice. Do not take a double dose to make up for the one you missed. Simply continue with your next scheduled dose as normal.
Overdose
If you take more Granisetron STADA than prescribed, or if a child accidentally swallows the medicine, contact your doctor, hospital, or poison control centre immediately for an assessment of risk and advice. Symptoms of overdose may include mild headache. Treatment will be symptomatic, based on the specific symptoms experienced. There is no specific antidote for granisetron overdose.
Stopping Granisetron STADA
Do not stop taking your medicine before your treatment course is complete. If you stop taking granisetron prematurely, your symptoms of nausea and vomiting may return. Complete the full course as prescribed by your doctor to ensure optimal protection against chemotherapy or radiotherapy-induced nausea. If you have any concerns about continuing treatment, discuss them with your healthcare team.
What Are the Side Effects of Granisetron STADA?
The most common side effects of granisetron are headache and constipation, each affecting more than 1 in 10 people. Other common side effects include insomnia, diarrhoea, and changes in liver function tests. Seek immediate medical attention if you experience signs of anaphylaxis or serotonin syndrome.
Like all medicines, Granisetron STADA can cause side effects, although not everybody gets them. Most side effects are mild and temporary. It is important to be aware of the following potential reactions so you can seek appropriate medical attention if needed.
- Anaphylaxis (severe allergic reaction): Swelling of the throat, face, lips, or mouth; difficulty breathing or swallowing; severe skin rash or hives
- Serotonin syndrome: Agitation, confusion, rapid heart rate, high blood pressure, excessive sweating, fever, muscle twitching or rigidity, diarrhoea, nausea, vomiting, chills, tremor, loss of coordination, and restlessness
Very Common
May affect more than 1 in 10 people
- Headache
- Constipation – your doctor will monitor this
Common
May affect up to 1 in 10 people
- Insomnia (difficulty sleeping)
- Diarrhoea
- Changes in liver function (shown by blood tests) – typically transient elevations in liver enzymes
Uncommon
May affect up to 1 in 100 people
- Skin rash, allergic skin reaction, or urticaria (hives) – red, raised, itchy patches on the skin
- Changes in heart rhythm (cardiac arrhythmias) and ECG abnormalities
- Abnormal involuntary movements, such as tremor, muscle stiffness, and muscle contractions (extrapyramidal reactions)
- Serotonin syndrome (see warning box above for full list of symptoms)
It is important to note that some side effects, such as nausea, diarrhoea, and changes in liver function, may also be related to your underlying cancer treatment rather than to granisetron itself. Your medical team will help differentiate between drug side effects and treatment-related symptoms.
Reporting Side Effects
Reporting suspected adverse reactions after authorisation is important. It allows continued monitoring of the medicine’s benefit-risk balance. Healthcare professionals and patients are encouraged to report any suspected side effects to their national pharmacovigilance authority. In the UK, report via the Yellow Card Scheme; in the US, via the FDA MedWatch programme; in the EU, via your national medicines agency.
How Should You Store Granisetron STADA?
Store Granisetron STADA tablets at room temperature (below 30°C), in the original packaging, out of the reach and sight of children. Do not use after the expiry date printed on the carton and blister pack.
Keep this medicine out of the sight and reach of children at all times. Do not use Granisetron STADA after the expiry date stated on the blister pack and carton after “EXP”. The expiry date refers to the last day of the stated month.
Storage conditions: Store at or below 30°C. Keep the tablets in the original packaging to protect from moisture and light.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures help to protect the environment from pharmaceutical contamination.
What Does Granisetron STADA Contain?
Each Granisetron STADA tablet contains granisetron (as hydrochloride) as the active ingredient, along with standard pharmaceutical excipients including lactose monohydrate. The 1 mg tablets are round, white to off-white, film-coated, and marked with “GS” on one side.
Active Ingredient
The active substance is granisetron. Each 1 mg film-coated tablet contains 1 mg granisetron (as granisetron hydrochloride). Each 2 mg film-coated tablet contains 2 mg granisetron (as granisetron hydrochloride).
Inactive Ingredients (Excipients)
The other ingredients are: lactose monohydrate, microcrystalline cellulose (E460), hypromellose (E464), sodium starch glycolate, magnesium stearate (E470b), titanium dioxide (E171), macrogol 400, and polysorbate 80 (E433). These are standard pharmaceutical excipients used to ensure proper tablet formation, film coating, disintegration, and absorption.
Tablet Appearance and Packaging
1 mg tablets: Round, white to off-white, film-coated tablets marked with “GS” on one side and plain on the other.
2 mg tablets: Round, white to off-white, film-coated tablets marked with “GS2” on one side and plain on the other.
Available in blister packs of 1, 2, 4, 5, 6, 7, 10, 14, 20, 28, 30, 50, 90, 100, 150, 200, 250, and 500 tablets. Not all pack sizes may be marketed in your country.
Manufacturer
Marketing authorisation holder: STADA Arzneimittel AG, Stadastrasse 2–18, 61118 Bad Vilbel, Germany. The tablets are also manufactured by Haupt Pharma Münster GmbH in Münster, Germany.
How Does Granisetron Work in the Body?
Granisetron works by selectively blocking 5-HT3 (serotonin type 3) receptors in the chemoreceptor trigger zone of the brain and on vagal nerve terminals in the gut. This prevents the serotonin released during chemotherapy and radiotherapy from triggering the vomiting reflex.
To understand how granisetron works, it helps to understand the mechanism of chemotherapy-induced nausea and vomiting (CINV). When cytotoxic drugs (chemotherapy agents) damage the mucosa of the small intestine, they cause enterochromaffin cells – specialised hormone-producing cells in the gut lining – to release large amounts of serotonin (5-hydroxytryptamine, 5-HT). This flood of serotonin activates 5-HT3 receptors on two key sites:
- Vagal afferent nerve endings in the gastrointestinal tract: These nerves carry signals from the gut to the brainstem, specifically to the nucleus tractus solitarius and the vomiting centre
- Chemoreceptor trigger zone (CTZ) in the area postrema: This region of the brain lies outside the blood-brain barrier and can detect emetogenic substances in the blood and cerebrospinal fluid
Granisetron is a potent, highly selective antagonist at the 5-HT3 receptor. It binds competitively to the receptor, blocking serotonin from activating it. By preventing the serotonin signal from reaching the vomiting centre, granisetron effectively suppresses both the acute phase of CINV (occurring within 24 hours of chemotherapy) and, to a lesser extent, the delayed phase (occurring 24–120 hours after chemotherapy).
Unlike older antiemetics such as metoclopramide or prochlorperazine, granisetron does not significantly interact with dopamine, histamine, or muscarinic receptors. This selectivity means it causes fewer neurological side effects (such as sedation, extrapyramidal reactions, or dystonias) compared to dopamine antagonist antiemetics.
Pharmacokinetic Profile
After oral administration, granisetron is rapidly absorbed from the gastrointestinal tract. The oral bioavailability is approximately 60%, as the drug undergoes moderate first-pass metabolism in the liver. Peak plasma concentrations are reached within 1–2 hours after dosing.
Granisetron is distributed widely throughout the body and is approximately 65% bound to plasma proteins. It is extensively metabolised in the liver, primarily by the CYP3A4 enzyme system (with a minor contribution from CYP1A1), producing N-demethylated and ring-oxidised metabolites that have negligible pharmacological activity. The elimination half-life is approximately 9–12 hours in healthy adults, which supports twice-daily or once-daily dosing. Approximately 12% of the administered dose is excreted unchanged in the urine, with the remainder excreted as metabolites in urine and faeces.
Frequently Asked Questions About Granisetron STADA
Granisetron STADA is used to prevent and treat nausea and vomiting caused by chemotherapy (cancer treatment with cytotoxic drugs) and radiotherapy (radiation treatment). It belongs to the 5-HT3 receptor antagonist class of antiemetic medications and is approved for use in adults only. It works by blocking serotonin receptors in the brain and gastrointestinal tract that trigger the vomiting reflex during cancer treatment.
The most common side effects of granisetron are headache and constipation, each affecting more than 1 in 10 people. Other common side effects include insomnia (difficulty sleeping), diarrhoea, and changes in liver function tests (typically transient elevations). Most side effects are mild and temporary. Seek immediate medical attention if you experience signs of a severe allergic reaction (anaphylaxis) or serotonin syndrome.
Granisetron can interact with certain antidepressants, particularly SSRIs (such as fluoxetine, paroxetine, sertraline, citalopram, escitalopram) and SNRIs (such as venlafaxine, duloxetine). The combination may increase the risk of serotonin syndrome, a potentially life-threatening condition characterised by agitation, confusion, rapid heartbeat, sweating, and muscle rigidity. Always inform your doctor about all medications you are taking before starting granisetron.
For prevention of nausea and vomiting, the first dose is usually taken approximately one hour before chemotherapy or radiotherapy begins. The standard dose is either 1 mg twice daily or 2 mg (two 1 mg tablets) once daily. Treatment is typically continued for up to one week after the completion of your cancer treatment. Swallow the tablets whole with a glass of water. Always follow your doctor’s specific instructions regarding dose and timing.
Granisetron STADA tablets are approved for use in adults only. Children should not take these tablets. For paediatric patients who require antiemetic therapy during cancer treatment, the treating oncologist will prescribe an appropriate alternative medication or formulation. In some countries, intravenous granisetron formulations may be used in children under specialist supervision, but the oral tablet form is intended exclusively for adults.
Serotonin syndrome is a rare but potentially life-threatening drug reaction caused by excessive serotonergic activity in the nervous system. It can occur when granisetron is used alone, but is significantly more likely when granisetron is taken alongside other serotonergic medications such as SSRIs or SNRIs. Symptoms include agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, excessive sweating, fever, diarrhoea, muscle twitching or rigidity, tremor, and loss of coordination. If you experience any of these symptoms, seek immediate medical attention.
References
This article is based on the following international medical guidelines and peer-reviewed sources. All medical claims have evidence level 1A, the highest quality of evidence based on systematic reviews of randomised controlled trials.
- Roila F, Molassiotis A, Herrstedt J, et al. 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Annals of Oncology. 2016;27(suppl 5):v119–v133. doi:10.1093/annonc/mdw270
- Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline Update. Journal of Clinical Oncology. 2020;38(24):2782–2797. doi:10.1200/JCO.20.01296
- European Medicines Agency (EMA). Granisetron – Summary of Product Characteristics. EMA product information database. Accessed January 2026.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd list. Geneva: WHO; 2023.
- Navari RM, Aapro M. Antiemetic Prophylaxis for Chemotherapy-Induced Nausea and Vomiting. New England Journal of Medicine. 2016;374(14):1356–1367. doi:10.1056/NEJMra1515442
- Jordan K, Jahn F, Aapro M. Recent developments in the prevention of chemotherapy-induced nausea and vomiting (CINV): a comprehensive review. Annals of Oncology. 2015;26(6):1081–1090.
- British National Formulary (BNF). Granisetron. NICE BNF monograph. Accessed January 2026.
- U.S. Food and Drug Administration (FDA). Granisetron – Prescribing Information. FDA labelling database. Accessed January 2026.
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, a group of licensed specialist physicians with expertise in oncology, clinical pharmacology, and supportive cancer care.
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Board-certified physicians specialising in medical oncology, clinical pharmacology, and supportive care with documented academic and clinical experience.
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