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referring to the Grani Training December 2014

Supplement. referring to the Grani Training December 2014. Key Benefits of Grani - Denk. approved, safe and effective - even for children most economic treatment best patient compliance wide indication profile. Key Benefits of Grani - Denk.

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referring to the Grani Training December 2014

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  1. Supplement referring to theGrani Training December 2014

  2. Key Benefits of Grani-Denk approved, safe and effective - even for children most economic treatment best patient compliance wide indication profile

  3. Key Benefits of Grani-Denk • Grani Denk and On.setron Denk are approved, safe and effective even for children (Grani Denk is brilliant as its formulation is without benzyl alcohol => iv. very well tolerated and without risk of anaphylactic shock) • Compared to Ondansetron: • -only one single administration of 1-3 mg iv. as prophylaxis is as effective as 8mg iv Ondan-setronfollowed by 8 mg orally every 12 hours (morning and evening) up to a duration of 5 days in total, depending on the duration of treatment (CT/RT). • -Granisetron seems to be more potent (less amount of drug) and with this more cost effective. (Studies define both as equally effective at recommended doses- see above.) • -On.setrontablets are an excellent emergency treatment at home in cases of CINV or PONV when discharged from hospital. • Saving time with shorter infusions – most economic treatment*: • -Granisetron: ca. 30 sec. slow iv. injection or slower infusion administered over 5 min, 5 min prior to CT • -Ondansetron iv.“…8 mg administered as a slow injection or as an infusion over 15 minutesimmediately • before treatment, followedby treatment with dosage forms other than intravenous. • -Palonosetron has to be administered 30 min before CT => longest waiting time until treatment with CT! • Still patent protected, no low cost generics available = expensive treatment! •  Grani Denk has the shortest administration and waiting time – the most economic treatment! Generics available! *Nice to know: A Comparative trial of two iv doses of granisetron (1 versus 3 mg) in the prevention of chemotherapy-induced acute emesis: showed that 1 mg grani is not inferior to 3 mg when both doses are combined with dexamethasone. Therefore, the 1-mg dose of intravenous grani should be the recommended as a prophylactic regimen for the prevention of acute emesis. (question of efficacy and economics…)*reference

  4. Benefits • Best Patient Compliance: • GraniDenk has much shorter waiting time => less mental stress before CT/ RT; • GraniDenk: only one single administration is effective! • GraniDenk without benzyl alcohol is well tolerated (compared to other Granisetron iv. products) • Oral dispersible On.setron tablets are easily to swallow even for children – excellent emergency medication at home! • Regarding the approved indications of Palonosetron: • Not approved for treatment of acute N&V and not for delayed N&V! • Only for the prevention of acute N&V associated with highly emetogenic cancer chemotherapy, and associated with moderately emetogenic cancer chemotherapy. • NOT approved for RT or PONV!! • NOT approved for children!! • still patent protected – high economic costs

  5. Differences in Indications

  6. Reported Off Label Use Granisetron • Severe pruritus in a haemodialysed patient: dramatic improvement with granisetron. • Br J Dermatol. 2003 Feb;148(2):376-7. • Albares MP, Betlloch I, Guijarro J, Vergara G, Pascual JC, Botella R. • Pruritus in a patient with advanced cancer successfully treated with continuous infusion of granisetron. • Support Care Cancer. 2004 Mar;12(3):208-9. Epub 2004 Jan 21. • Porzio G, Aielli F, Narducci F, Cannita K, Piccolo D, Marchetti P. • Abstract : We present a case of a patient with advanced cancer affected by severe pruritus not related with cholestasis and/or opioid treatment successfully treated with subcutaneous continuous infusion of granisetron (3 mg/24 h diluted in normal saline via a disposable elastomeric infusion device). Confirmatory studies with a control group are warranted to confirm these preliminary results. • Intramuscularinjectionofgranisetronintothemassetermuscleincreasesthepressurepainthreshold in healthyparticipantsandpatientswithlocalizedmyalgia. • Clin J Pain. 2007 Jul-Aug;23(6):467-72.; Christidis N, Nilsson A, Kopp S, Ernberg M. • CONCLUSIONS: This study indicates that intramuscular injection of granisetron into the masseter muscle increases the PPT in healthy participants and in patients with craniofacial myalgia

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