Two medicines, side by side
Granisetron vs palonosetron
Granisetron and palonosetron are both labeled for nausea and vomiting. Drugs@FDA records approvals of granisetron since 1993 and of palonosetron since 2003. How each works, in its label's words: Granisetron, “Granisetron is a selective 5-hydroxytryptamine 3 (5-HT 3 ) receptor antagonist with little or no affinity for other serotonin receptors, including 5-HT 1 ; 5-HT 1A ; 5-HT 1B/C ; 5-HT 2 ; …”; Palonosetron, “Palonosetron is a 5-HT 3 receptor antagonist with a strong binding affinity for this receptor and little or no affinity for other receptors.”
Check it at the source: the granisetron FDA label on DailyMed (effective August 31, 2017); the palonosetron FDA label on DailyMed (effective April 29, 2025).
Highlights of the granisetron record
Granisetron (Kytril) · label of August 31, 2017
Used for
From the label: indicationsGranisetron hydrochloride injection is a serotonin-3 (5-HT 3 ) receptor antagonist indicated for: • The prevention of nausea and/or vomiting associated with initial and repeat courses of emetogenic cancer therapy, including high-dose cisplatin. • The prevention and treatment of postoperative nausea and vomiting in adults. […]
On the market
- Earliest approval on file
- December 29, 1993
- Generic labelers
- 8 labelers
- Pharmacy cost
- $1.31 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the palonosetron record
Palonosetron (Aloxi) · label of April 29, 2025
Used for
From the label: indicationsPOSFREA is indicated in adults for prevention of: acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy (MEC). acute nausea and vomiting associated with initial and repeat courses highly emetogenic cancer chemotherapy (HEC). postoperative nausea and vomiting (PONV) for up to 24 hours following surgery. […]
On the market
- Earliest approval on file
- July 25, 2003
- Generic labelers
- 13 labelers
- Pharmacy cost
- Not in the survey
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 0
Source: FDA drug labels via openFDA (Granisetron label of August 31, 2017, Palonosetron label of April 29, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do granisetron and palonosetron differ on the record?
How each works, in its label's words: Granisetron, “Granisetron is a selective 5-hydroxytryptamine 3 (5-HT 3 ) receptor antagonist with little or no affinity for other serotonin receptors, including 5-HT 1 ; 5-HT 1A ; 5-HT 1B/C ; 5-HT 2 ; …”; Palonosetron, “Palonosetron is a 5-HT 3 receptor antagonist with a strong binding affinity for this receptor and little or no affinity for other receptors.”
Both are in FDA's class serotonin-3 receptor antagonists.
Generics: granisetron since 2007; palonosetron since 2015 (Drugs@FDA).
| Granisetron | Palonosetron | |
|---|---|---|
| Labeled for | Nausea and vomiting | Nausea and vomiting |
| Pharmacologic class | Serotonin-3 Receptor Antagonist | Serotonin-3 Receptor Antagonist |
| How it works (label) | Granisetron is a selective 5-hydroxytryptamine 3 (5-HT 3 ) receptor antagonist with little or no affinity for other serotonin receptors, including 5-HT 1 ; 5-HT 1A ; 5-HT 1B/C ; 5-HT 2 ; for alpha 1 -, alpha 2 - or beta-adrenoreceptors; … | Palonosetron is a 5-HT 3 receptor antagonist with a strong binding affinity for this receptor and little or no affinity for other receptors. |
| Half-life (label) | n/a | Mean terminal elimination half-life is approximately 40 hours. |
| Earliest approval on file (Drugs@FDA) | December 29, 1993 | July 25, 2003 |
| First generic approved | December 31, 2007 | October 13, 2015 |
| Generic labelers (NDC) | 8 labelers | 13 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $1.31 per tablet (Granisetron HCl 1 mg tablet) | n/a |
| 12-month price change | -19% | n/a |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 1 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 12,067 | 5,254 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Granisetron label, drug interactionsSerotonin syndrome (including altered mental status, autonomic instability, and neuromuscular symptoms) has been described following the concomitant use of 5-HT 3 receptor antagonists and other serotonergic drugs, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake Inhibitors (SNRIs) [see Warnings and Precautions (5.4) ].
Palonosetron label, drug interactionsSerotonin syndrome (including altered mental status, autonomic instability, and neuromuscular symptoms) has been described following the concomitant use of 5-HT 3 receptor antagonists and other serotonergic drugs, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs).
Source: FDA drug labels via openFDA
What next?
- Alternatives to granisetron
- every medicine labeled for the same conditions