Effects of granisetron with doxorubicin or epirubicin on ECG intervals

Abstract

Commercially available serotonin-type 3 (5-HT3) receptor antagonists (ondansetron, granisetron, and tropisetron) have shown no clinically significant adverse effects on the cardiovascular system. In the dose-ranging evaluation of dolasetron, computer-generated ECGs revealed clinically asymptomatic prolongations of ECG intervals. We performed a clinical trial in which the possible changes in ECG intervals following a single 3-mg i.v. injection of granisetron and an injection of either doxorubicin or epirubicin were registered using computerized ECG analysis in cancer patients. A total of 30 patients who were designated to receive 3 mg granisetron i.v. for the prophylaxis of emesis induced by doxorubicin or epirubicin were entered into the study. Computer-generated ECG tracings were obtained before treatment, following the injection of 3mg granisetron, and immediately after doxorubicin or epirubicin injection. The mean PR interval duration increased from 160 to 166 ms after granisetron infusion (P=0.02). Doxorubicin and epirubicin did not potentiate this change. There was no statistically significant change in cardiac rhythm, QRS duration, or QTc intervals. The observed minor changes in the PR time following i.v. injection of granisetron do not seem to be of clinical relevance.

The acute effect of tropisetron on ECG parameters in cancer patients

“…Jantunen et al designed a study focused specially on the cardiac effects of a 5-HT 3 receptor antagonist, granisetron (single 3 mg IV infusion) when used with cardiotoxic chemotherapy (doxorubicine or epirubicine) in 30 cancer patients. They observed only asymptomatic increases in the PR intervals, but no significant changes in QRS duration, cardiac rhythm, or QTc intervals [15]. Buyukavci et al [8] published their study which demonstrated the effects of ondansetron and granisetron on ECG in children receiving chemotherapy for acute leukemia.…”

Electrocardiographic findings of palonosetron in cancer patients

“…The cardiotoxicity of 5-HT 3 antagonists used as antiemetic on cancer-diagnosed patients receiving chemotherapy has been studied. Jantunen et al [20] studied the cardiac effect of 3 mg IV granisetron on 30 patients receiving cardiotoxic medication (doxorubicin, epirubicin). They did not detect any changes in ECG except for the prolongations in PR intervals before granisetron infusion and at the fifth and tenth minutes following the infusion.…”

Efficacy of prophylactic intravenous granisetron in postoperative emesis in adults

“…The event was judged as unlikely to be related to the administration of granisetron, because cases of ventricular fibrillation have been reported in 944 patients who have received the agent in previous clinical studies of PONV, nor have any such cases been reported in the postmarketing surveillance of more than 20 000 granisetron-treated patients. Furthermore, the cardiac safety of granisetron has been demonstrated in studies involving both healthy volunteers and cancer patients [24,[26][27][28][29][30][31].…”