Pharmacodynamics of transdermal granisetron in women with nausea and vomiting of pregnancy

Abstract

Granisetron significantly improved symptoms of nausea and vomiting as gauged by the PUQE score. After IV infusion the reduction in PUQE score was observed within 1 day. When granisetron was administered as a patch, benefit likewise was seen within 1 day suggesting rapid absorption of the medication transdermally. The beneficial effect of transdermal granisetron on the PUQE score persisted for the entire 7 days during which the patch was in place. In this small cohort, the granisetron patch appeared to be efficacious in reducing the symptoms of nausea and vomiting. The patch provides another option for treating this disorder and may be particularly useful in women who cannot tolerate oral medications.

Nausea and vomiting of pregnancy - What's new?

“…For these patients the transdermal route as a simple method to deliver drug has a significant added value and can improve patient’s compliance (Zur, 2013). In this context our group has recently evaluated the pharmacodynamics of granisetron (category B), administered with a transdermal patch to women with NVP (Caritis et al, 2016). The study demonstrated that granisetron significantly improved symptoms of NVP.…”

Polymorphisms inCYP1A1andCYP3A5Genes Contribute to the Variability in Granisetron Clearance and Exposure in Pregnant Women with Nausea and Vomiting

“…To our knowledge, this is the first study to demonstrate that polymorphisms in CYP3A5 and CYP1A1 can affect the AUC and clearance of granisetron. Our findings may account for the observed variability in granisetron exposure and thereby antiemetic efficacy in women treated for NVP …”

“…The methods and primary results of this study have been reported previously . In brief, we conducted a pharmacokinetic study of granisetron in 16 pregnant women from gestational ages 12–19 weeks with NVP.…”

“…Results from studies in nonpregnant and pregnant women have shown variability in the drug exposure and the antiemetic response to granisetron. We hypothesized that the variability in the exposure and the antiemetic response to granisetron in women treated for NVP could be explained in part by genetic polymorphisms in CYP enzymes and the ABCB1 transporter.…”

Management of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Multiple-Day Highly or Moderately Emetogenic Chemotherapy: Role of Transdermal Granisetron

“…Similarly, GTDS has been successfully used in women with nausea and vomiting associated with pregnancy who could not tolerate administration via the oral route. The reduction of nausea and vomiting was observed within one day, suggesting that the onset of action with the transdermal delivery was comparable with the intravenous infusion [41]. In chronic pain management, opioid titration is a critical step in patient compliance; unfortunately, even though tolerance reduces the incidence of opioid-induced nausea and vomiting over time, its incidence can be high and impair patients' impression of the received treatment, leading to withdrawal for adverse events.…”