Cardiac effects of granisetron in a prospective crossover randomized dose comparison trial

F. B. Cakir, O. Yapar, C. Canpolat, F. Akalin, S. G. Berrak

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose Cardiac side effects of granisetron have been studied mostly in adult patients that are using cardiotoxic chemotherapeutics. There is limited evidence in pediatric age group and no information in pediatric oncology patients with non-cardiotoxic chemotherapeutics. Methods In this prospective, crossover randomized study, the cardiac side effects of granisetron are compared in pediatric oncology patients who had carboplatin based chemotherapy. They were randomized to receive either 10 or 40 μg kg1 dose1 of granisetron before each cycle of chemotherapy. We drew blood for creatine phosphokinase (CPK), CPK-muscle band (MB) and Troponin-T before and 24 h after administering granisetron. Electrocardiography (ECG) tracings were taken at 0, 1, 2, 3, 6 and 24 h of granisetron. Twenty-four hours Holter ECG monitorisation was performed after each granisetron infusion. Results A total of 16 patients (median 8.7 years of age) were treated with weekly consecutive courses of carboplatin. There was bradycardia (p00.000) in patients that had granisetron at 40 μg/kg and PR interval was shortened in patients that had granisetron at 10 μg/kg dose (p00.021). At both doses of granisetron, QTc interval and dispersion were found to be similar. CPK, CK-MB and Troponin-T values were found to be normal before and 24 h after granisetron infusion. Conclusions As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 μg kg1 dose1 causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 μg kg1 dose1. However, our results should be supported by prospective randomized studies with larger samples of patient groups.

Original languageEnglish (US)
Pages (from-to)2451-2457
Number of pages7
JournalSupportive Care in Cancer
Volume20
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

Fingerprint

Granisetron
Creatine Kinase
Troponin T
Carboplatin
Bradycardia
Pediatrics
Drug Therapy
Muscles
Ambulatory Electrocardiography
Cross-Over Studies

Keywords

  • Cardiac side effects
  • Creatine Phosphokinase
  • Granisetron

ASJC Scopus subject areas

  • Oncology

Cite this

Cardiac effects of granisetron in a prospective crossover randomized dose comparison trial. / Cakir, F. B.; Yapar, O.; Canpolat, C.; Akalin, F.; Berrak, S. G.

In: Supportive Care in Cancer, Vol. 20, No. 10, 10.2012, p. 2451-2457.

Research output: Contribution to journalArticle

Cakir, F. B. ; Yapar, O. ; Canpolat, C. ; Akalin, F. ; Berrak, S. G. / Cardiac effects of granisetron in a prospective crossover randomized dose comparison trial. In: Supportive Care in Cancer. 2012 ; Vol. 20, No. 10. pp. 2451-2457.
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abstract = "Purpose Cardiac side effects of granisetron have been studied mostly in adult patients that are using cardiotoxic chemotherapeutics. There is limited evidence in pediatric age group and no information in pediatric oncology patients with non-cardiotoxic chemotherapeutics. Methods In this prospective, crossover randomized study, the cardiac side effects of granisetron are compared in pediatric oncology patients who had carboplatin based chemotherapy. They were randomized to receive either 10 or 40 μg kg1 dose1 of granisetron before each cycle of chemotherapy. We drew blood for creatine phosphokinase (CPK), CPK-muscle band (MB) and Troponin-T before and 24 h after administering granisetron. Electrocardiography (ECG) tracings were taken at 0, 1, 2, 3, 6 and 24 h of granisetron. Twenty-four hours Holter ECG monitorisation was performed after each granisetron infusion. Results A total of 16 patients (median 8.7 years of age) were treated with weekly consecutive courses of carboplatin. There was bradycardia (p00.000) in patients that had granisetron at 40 μg/kg and PR interval was shortened in patients that had granisetron at 10 μg/kg dose (p00.021). At both doses of granisetron, QTc interval and dispersion were found to be similar. CPK, CK-MB and Troponin-T values were found to be normal before and 24 h after granisetron infusion. Conclusions As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 μg kg1 dose1 causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 μg kg1 dose1. However, our results should be supported by prospective randomized studies with larger samples of patient groups.",
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AB - Purpose Cardiac side effects of granisetron have been studied mostly in adult patients that are using cardiotoxic chemotherapeutics. There is limited evidence in pediatric age group and no information in pediatric oncology patients with non-cardiotoxic chemotherapeutics. Methods In this prospective, crossover randomized study, the cardiac side effects of granisetron are compared in pediatric oncology patients who had carboplatin based chemotherapy. They were randomized to receive either 10 or 40 μg kg1 dose1 of granisetron before each cycle of chemotherapy. We drew blood for creatine phosphokinase (CPK), CPK-muscle band (MB) and Troponin-T before and 24 h after administering granisetron. Electrocardiography (ECG) tracings were taken at 0, 1, 2, 3, 6 and 24 h of granisetron. Twenty-four hours Holter ECG monitorisation was performed after each granisetron infusion. Results A total of 16 patients (median 8.7 years of age) were treated with weekly consecutive courses of carboplatin. There was bradycardia (p00.000) in patients that had granisetron at 40 μg/kg and PR interval was shortened in patients that had granisetron at 10 μg/kg dose (p00.021). At both doses of granisetron, QTc interval and dispersion were found to be similar. CPK, CK-MB and Troponin-T values were found to be normal before and 24 h after granisetron infusion. Conclusions As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 μg kg1 dose1 causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 μg kg1 dose1. However, our results should be supported by prospective randomized studies with larger samples of patient groups.

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