EFFICACY AND COST OF GRANISETRON VERSUS ONDANSETRON IN THE PREVENTION OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING AMONG CANCER PATIENTS AT KENYATTA NATIONAL HOSPITAL

Differences in cost and similarities in the efficacy between ondansetron and granisetron have been reported in many clinical studies and prompted this study to determine whether such differences are important as Kenyatta National Hospital. Thirty-four adult cancer patients scheduled to start their consecutive three weekly cycles of cisplatin-based chemotherapy regimens, were recruited into a double-blind randomized crossover study to receive ondansetron 12 mg or granisetron 3 mg each combined with dexamethasone 8 mg as intravenous on the first day and continued on their respective oral combinations from day 2 to 4. The frequency of nausea and vomiting were recorded daily during 5 days of antiemetic treatment. Data were collected using a close ended questionnaire and statistical analysis was performed using STATA version 13 software. Statistical significance was checked using Fisher’s exact test and was considered when p value was less than 0.05. Female predominance was 70.6%, while dominant age was 50-70 years at 47.1% with a mean age of 53.5 (± 11.9) years and cervical cancer was leading cancer. Complete prevention of acute and delayed vomiting/nausea was observed in about 80 % of patients receiving either of the treatments. Direct cost with granisetron based antiemetic treatment regimen was higher compared with the one with ondansetron at a ratio of approximately 10:1. Ondansetron and granisetron each combined with dexamethasone have similar efficacy; the choice of each can depend on the cost. Ondansetron should be preferred to granisetron and further research for delayed chemotherapy induced nausea and vomiting requires to be done.