Special Warning : אזהרת שימוש

4.4 Special warnings and precautions for use
As granisetron may reduce lower bowel motility, patients with signs of sub-acute intestinal obstruction should be monitored following administration of Setron.

As for other 5-HT3 antagonists, ECG changes including QT interval prolongation have been reported with granisetron. In patients with pre-existing arrhythmias or cardiac conduction disorders this might lead to clinical consequences. Therefore, caution should be exercised in patients with cardiac co-morbidities, on cardiotoxic chemotherapy and/or with concomitant electrolyte abnormalities (see section 4.5.) 
Cross-sensitivity between 5-HT3 antagonists (e.g. dolasetron, ondansetron) has been reported.

Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Serotonin Syndrome
Concomitant administration of granisetron and buprenorphine/opioids may result in serotonin syndrome, a potentially life-threatening condition (see section 4.5).

If concomitant treatment with other serotonergic agents is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.

Symptoms of serotonin syndrome may include mental-status changes, autonomic instability, neuromuscular abnormalities, and/or gastrointestinal symptoms.

If serotonin syndrome is suspected, a dose reduction or discontinuation of therapy should be considered depending on the severity of the symptoms.
Setron is essentially 'sodium free' as it contains less than 23 mg per tablet. To be used with caution in patients on a low sodium diet.

Paediatric population
There is insufficient clinical evidence to recommend administration of these tablets to children.

Effects on Driving

4.7 Effects on ability to drive and use machines
Granisetron has no or negligible influence on the ability to drive and use machines.