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granisetron vs palonosetron

Side-by-side comparison of granisetron and palonosetron Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
granisetron 5-HT3 Receptor Antagonist (Antiemetic)
palonosetron 5-HT3 Receptor Antagonist (Antiemetic)
Type
granisetron Prescription
palonosetron Prescription
Summary
granisetron

Granisetron oral solution helps prevent nausea and vomiting caused by cancer treatments like chemotherapy and radiation. It belongs to a class of drugs called 5-HT3 receptor antagonists.

palonosetron

Palonosetron is a medicine that helps prevent nausea and vomiting. It is often used before, during, and after chemotherapy or surgery.

What It Treats
granisetron

Granisetron is used to prevent nausea and vomiting. It is for people receiving cancer therapy that causes vomiting. This includes high doses of cisplatin, radiation, total body irradiation, and fractionated abdominal radiation.

palonosetron

Palonosetron is used to prevent nausea and vomiting caused by cancer chemotherapy. It can prevent these side effects from both the first treatment and any repeat treatments. Palonosetron is also used to prevent nausea and vomiting after surgery.

How It Works
granisetron

Granisetron blocks a natural substance called serotonin in the body. Serotonin can trigger nausea and vomiting. By blocking serotonin, granisetron helps prevent these side effects.

palonosetron

Palonosetron blocks a natural substance in your body called serotonin. Serotonin can trigger nausea and vomiting. By blocking serotonin, palonosetron helps prevent these symptoms.

Common Side Effects
granisetron
  • Headache
  • Constipation
  • Weakness or fatigue
  • Diarrhea
  • Abdominal pain
palonosetron
  • Headache
  • Constipation
FAERS Reports
granisetron
  • Feeling sick to your stomach 1,306
  • Throwing up 755
  • Fever with low white blood cell count 718
  • Loose, watery stools 709
  • Fever 641
palonosetron
  • Feeling sick to your stomach 399
  • Feeling very tired 249
  • Fever with low white blood cell count 249
  • Loose, watery stools 246
  • Throwing up 246
Serious Warnings
granisetron

Granisetron can cause a heart problem called QT prolongation. Tell your doctor if you take other medicines that can also cause this issue, as it could lead to serious heart problems.

palonosetron

Palonosetron can cause serious allergic reactions, including anaphylaxis. Tell your doctor right away if you have any signs of an allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat. Palonosetron can also cause serotonin syndrome, especially if you are taking other medicines that affect serotonin. Symptoms may include agitation, hallucinations, fast heart rate, fever, and muscle stiffness.

Pregnancy
granisetron

Tell your doctor if you are pregnant or breastfeeding. It is not known if granisetron will harm an unborn baby. It is also not known if granisetron passes into breast milk.

palonosetron

It is not known if palonosetron can harm an unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if palonosetron passes into breast milk. Talk to your doctor about the best way to feed your baby if you are taking palonosetron.

Also Compare — Nearby Drugs

Compare granisetron with

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How to Read This granisetron vs palonosetron Comparison

granisetron is classified in the 5-HT3 Receptor Antagonist (Antiemetic) drug class, while palonosetron sits within the 5-HT3 Receptor Antagonist (Antiemetic) class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, granisetron has 4,129 submissions while palonosetron has 1,389. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between granisetron and palonosetron — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.