Granisetron, ondansetron and tropisetron are potent and highly selective 5-HT3 antagonists. They have no dopamine antagonist properties and so are not associated with extrapyramidal side-effects. Their selective activity made them obvious candidates for migraine.
An open pilot study of granistron administered as a single dose intravenous infusion (40 É g/kg) over 15 minutes to treat seven migraine attacks in six patients. All but one patient experienced marked and rapid relief of headache, nausea and vomiting withnorecurrence.
A randomized double-blind placebo-controlled study of 28 acute migraine patients given intravenous granisetron (40 É g/kg or 80 É g/kg) was less successful although the 80 É g/kg dose was associated with significant improvement in headache.
Given the limited data and some minor concerns about toxicology with long-term repeated doses, 5-HT3 antagonists should not be used for the routine management of migraine but are reserved for the treatment of post-operative or cytostatically-induced nausea and vomiting.
Curr Med Res Opin. 2001;17(1s) © 2001 Librapharm Limited
Cite this: Anti-emetics - Medscape - Dec 01, 2001.