From: Granisetron as a Novel Treatment for Acute Food Protein-induced Enterocolitis Syndrome
| Medications | Ondansetron | Granisetron |
|---|---|---|
| International FPIES guidelines | Recommended | None |
| Japanese FPIES guidelines | None | None |
| Year available | 1990 | 1991 |
| Mechanism of action | Blocking 5-HT3 receptors suppresses the action of serotonin, which is involved in the vomiting reflex. | |
| Indications | Prevention and treatment of chemotherapy-induced nausea and vomiting, vomiting after radiation therapy, and postoperative nausea and vomiting | |
| Side effects | The main side effects are constipation, headache, dizziness, etc. Caution is required given QT prolongation and cardiac arrhythmia may occur in rare cases. | |
| Half-life | Approximately 4 hours in adult patients with cancer (as per FDA data) | Approximately 9 hours after a single intravenous dose (as per FDA data) |
| Effect duration | It has a short half-life and may need to be given multiple times a day. It is best used to treat acute vomiting and for short-term symptom management. | There are reports of a long half-life in children. In many cases, once a day administration is sufficient. It is suitable for cases when continuous prevention of nausea and vomiting is required. |
| Different dosage forms | Oral tablets, dissolving tablets, intravenous injections, infusions | Oral tablets, intravenous injections, transdermal patches (long-acting) |
| It is available as an oral or dissolving tablet, making it suitable for use when short-term care is required. | Depending on the patient’s condition, there are many different dosage forms: Transdermal patches are suitable when chemotherapy lasts for several days. | |
| Metabolic pathways | Metabolized by hepatic CYP450 enzymes (mainly CYP3A4, CYP2D6). | It is metabolized primarily in the liver (CYP3A4), with little effect from CYP2D6. |
