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Sustol
Sustol (generic name: granisetron extended-release) is an injectable medication used to prevent nausea and vomiting caused by chemotherapy. It is a 5-HT3 receptor antagonist that works by blocking serotonin, a chemical in the body that can trigger nausea and vomiting during cancer treatments. Sustol is specifically designed to provide long-lasting protection from chemotherapy-induced nausea and vomiting (CINV) for up to 5 days.
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Frequently Asked Questions
How long does Sustol last?
Sustol provides protection against chemotherapy-induced nausea and vomiting for up to 5 days after administration.
Can Sustol be used with other anti-nausea medications?
Yes, Sustol can be combined with other anti-nausea medications like dexamethasone or NK1 receptor antagonists (e.g., aprepitant) for additional nausea control. Your healthcare provider will determine the best combination for your chemotherapy regimen.
What should I do if I experience constipation while taking Sustol?
If you experience severe constipation, contact your healthcare provider immediately. They may recommend the use of laxatives or other treatments to relieve constipation.
Can I take Sustol if I have a heart condition?
Sustol can cause QT prolongation, so it should be used with caution in patients with a history of heart rhythm problems. Your healthcare provider will monitor your heart function if necessary.
How is Sustol different from other anti-nausea medications?
Sustol is an extended-release injection, meaning it provides long-lasting protection (up to 5 days) from chemotherapy-induced nausea and vomiting. This makes it particularly useful for chemotherapy regimens that cause delayed nausea and vomiting.
Comprehensive Drug Guide
How Does Sustol Work?
Sustol works by blocking 5-HT3 receptors in the gut and brain. These receptors are involved in the transmission of signals that cause nausea and vomiting, particularly after chemotherapy. By inhibiting the action of serotonin at these receptor sites, Sustol helps to reduce or prevent chemotherapy-induced nausea and vomiting for up to 5 days after administration.
Common Dosages
- 10 mg/0.4 mL solution for subcutaneous injection.
Typical Dosing
- The typical dose is 10 mg administered as a subcutaneous injection. It is given once per chemotherapy cycle, at least 30 minutes before starting chemotherapy.
Typical Dosing
FDA Approved Indications
- Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC) and highly emetogenic chemotherapy (HEC).
Who Shouldn't Take Sustol?
- Hypersensitivity to granisetron or any other components of the medication.
- Known history of bowel obstructions, as the medication can slow gut motility.
Advice From The Pharmacist
- Administered by a healthcare professional: Sustol is injected by your healthcare provider at least 30 minutes before chemotherapy. It is given subcutaneously (under the skin), typically in the upper arm or abdomen.
- Stay hydrated: Nausea and vomiting can lead to dehydration, so it's important to maintain adequate fluid intake before and after chemotherapy.
- Monitor for side effects: Notify your healthcare provider if you experience any unusual symptoms such as severe constipation or signs of an allergic reaction.
Side Effects of Sustol
Common Side Effects
- Injection site reactions (pain, redness, swelling)
- Constipation
- Fatigue
- Headache
- Stomach pain
Uncommon/Severe Side Effects
- Severe constipation: Sustol can slow down bowel movements, which can lead to serious constipation or bowel obstruction.
- Allergic reactions: Rare but serious hypersensitivity reactions, including anaphylaxis.
Risks and Warnings of Sustol
- Constipation Risk: Sustol can cause delayed gastric emptying and severe constipation, particularly in patients with a history of bowel disorders. Monitoring bowel function is critical, and laxatives may be prescribed if necessary.
- Injection Site Reactions: Sustol is given as a subcutaneous injection, and it may cause injection site pain, swelling, or redness. These reactions are generally mild but should be monitored for severity.
- QT Prolongation: Sustol has the potential to cause QT interval prolongation (a type of irregular heart rhythm). Patients with a history of heart rhythm disorders or those taking medications that prolong the QT interval should be monitored closely.
Interactions with Sustol
Common Drug Interactions
- Medications that prolong QT interval: Combining Sustol with medications known to prolong the QT interval (e.g., amiodarone, quinidine, or haloperidol) may increase the risk of heart rhythm problems.
- Other antiemetics: If you are using other medications for nausea and vomiting (e.g., ondansetron or dexamethasone), discuss with your healthcare provider how to coordinate their use with Sustol.
- Medications affecting bowel motility: Combining Sustol with other drugs that can slow down gut motility (e.g., opioids) may increase the risk of constipation.
Alternatives to Sustol
- Zofran (Ondansetron): A 5-HT3 receptor antagonist used to prevent nausea and vomiting caused by chemotherapy, surgery, and radiation therapy.
- Aloxi (Palonosetron): Another long-acting 5-HT3 receptor antagonist used for the prevention of chemotherapy-induced nausea and vomiting.
- Emend (Aprepitant): A neurokinin-1 (NK1) receptor antagonist used in combination with other antiemetics for preventing nausea and vomiting caused by chemotherapy.
- Compazine (Prochlorperazine): An antiemetic from the phenothiazine class used to control severe nausea and vomiting.
