Comparison of granisetron, ondansetron and tropisetron for control of vomiting and nausea induced by cisplatin

Severe nausea and vomiting are common and one of the most feared side effec ts of cisplatin-based chemotherapy, A total of 106 patients were randomized to receive a single dose of 8 mg ondansetron or 3 mg granisetron or 5 mg t ropisetron intravenously as prevention of cisplatin-induced acute nausea an d vomiting. Antiemetic therapy was done within 30 minutes before initiating chemotherapy. A questionnaire evaluating nausea, vomiting and retches was administered to patients and the responses were categorized as complete, pa rtial or failure. The response determination was repeated in the first 24 h ours, and within 24-72 hours following cisplatin administration. The complete response rates for ondansetron, granisetron and tropisetron in the first 24 hours were 51.4%, 65.7% and 61.1% respectively, All three age nts were highly effective against cisplatin-induced acute and late vomiting and the results were statistically significant. This study demonstrated no significant difference in effectiveness of these three antiemetics. 5-HT3 (5-hydroxytryptamine 3) receptor antagonists have similar efficacy in the p revention of nausea and vomiting due to cisplatin. Thus, we recommend that drug choice be based on cost-benefit and patient tolerance.