SANCUSO Before Chemo

Sancuso Before Chemo

  • SANCUSO can be worn for up to 7 days in a row for chemotherapy regimens of up to 5 consecutive days
  • How does Sancuso prevent CINV

a. How CINV starts

i. Some chemotherpy may irritate cells in the small intenstine and/or the brain

ii. Once irretated, cells in the small intesntine send messages to the brain

iii. When irritated, cells in one area of the brain send messages to a different area of the brain

iv. Upon recieveing these messages, the brain instructs the body to react through feelings of nausa and/or vomiting

b. How sancuso helps to prevent CINV

i. From the time you apply the patch, Sancuso slowelu continuously deleivers grainsetron through your skin and into your blood stream until the patch is rmeoved within 7 days

ii. Gransitron block cells in the small intesntine from sending messages to the brain that triggers CINV

iii. Gransitron blocks cells in one area of the brain from sendinf messafes to a different area od the brain that triggetrs CINV

iv. Because the brain does not receive these messages, the feeling of nausa and movimign are less likely to occur

  • How to use Sancuso (granisetron transdermal system)

a. Before starting Sancuso

i. Tell your health care provider about all the medicines you take, including prescription and non prescription medicines, vitamins, and herbal supplements. Some of them may affect Sancuso works for how your other mediciations work.

    • Follow these steps for proper application

a. The Sancuso Transdermal system comes inside a pouch which is inside a carton

b. Remove the patch from the carton; tear the pouch open and remove the patch. Each pouch contains 1 SANCUSO patch stuck onto a rigid plastic film, and a separate clear protective liner.

i. Do not remove the SANCUSO patch from the pouch until you are ready to use it

ii. Do not cut the SANCUSO patch into pieces

a. Remove the thin, clear protective liner to expose the printed side of the patch

b. Bend the patch in the middle and remove one half of the rigid plastic film. Be careful not to stick the patch to itself and avoid touching the sticky side of the patch.

c. While holding the remaining half of the rigid plastic film, apply the patch to the skin. Remove the second half of the rigid plastic film and press the whole patch firmly in place with your fingers and smooth down. Press firmly making sure it sticks well, especially around the edges.

d. Wash your hands right away after applying the patch to remove any medicine that might have stuck to your fingers.

e. Keep the patch in place for the duration of the chemotherapy. Remove the patch at least 1 day (24 hours) after chemotherapy is finished. The patch can be worn up to 7 days, depending on the number of days your chemotherapy treatment lasts.

i. Do not re-use the SANCUSO patch after you remove it. See instructions included with your SANCUSO patch on how to remove and throw away after use.

    • Wearing Sancuso

1. Avoid sunlight. The medicine in SANCUSO may not work as well and/or may affect your skin if exposed to direct sunlight or the light from sunlamps or tanning beds. While you are wearing SANCUSO, you must keep it covered (ie, under clothing) if there is a risk of exposure to sunlight or sunlamps. Continue to keep the application area covered for 10 days after removing SANCUSO

2. Showering or bathing will not change the way that SANCUSO works— however, you should try to avoid immersing SANCUSO in water for long periods of time to prevent the patch from coming off

3. Because there is no information on the effect of swimming, strenuous exercise, or use of a sauna or whirlpool on the patch, you should also avoid these activities while wearing SANCUSO

    • When not to use Sancuso

a. Avoid use if you are allergic to granisetron or any of the other ingredients in SANCUSO, or if you have allergies to medical adhesive tape, adhesive dressings, or other skin patches

b. Avoid use if you are pregnant or breastfeeding unless your healthcare professional has told you that you can use it. Be sure to tell your healthcare professional if you are pregnant, if you become pregnant, or plan to become pregnant while using SANCUSO, or if you are planning to breastfeed or are breastfeeding.

    • Possible side effects of Sancuso

a. SANCUSO can cause side effects in some patients. The most common side effects with SANCUSO are constipation and headache.

b. Be sure to notify your healthcare professional if you have pain in your abdomen or your abdomen becomes swollen.

c. While you are wearing SANCUSO, you may see some mild redness at or around the patch application site. If uncomfortable irritation or excessive itchiness occurs, remove the patch, and call your healthcare professional.


    SANCUSO® (granisetron transdermal system) is indicated for the prevention of nausea and vomiting in adults receiving moderately and/or highly emetogenic chemotherapy regimens of up to 5 consecutive days.


    Sancuso is contraindicated in patients with known hypersensitivity to granisetron or to any of the components of the transdermal system.

    • Progressive Ileus and Gastric Distention: Sancuso may mask a progressive ileus and/or gastric distention. This should be particularly considered before use of Sancuso in patients who have had recent abdominal surgery. Monitor for decreased bowel activity, particularly in patients with risk factors for gastrointestinal obstruction.
    • Serotonin Syndrome: The development of serotonin syndrome has been reported with 5-HT3 receptor antagonists. Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of Sancuso and other serotonergic drugs.
    • If symptoms of serotonin syndrome occur, discontinue Sancuso and initiate supportive treatment. Patients should be informed of the increased risk of serotonin syndrome, especially if Sancuso is used concomitantly with other serotonergic drugs. Skin Reactions: In clinical trials with Sancuso, application site reactions were reported that were generally mild in intensity and did not lead to discontinuation of use. The incidence of reactions was comparable with placebo. If severe reactions, or a generalized skin reaction occur (e.g., allergic rash, including erythematous, macular, papular rash or pruritus), remove the Sancuso transdermal system.
    • Increased Drug Exposure with Use of External Heat Sources: Prolonged exposure to heat results in increasing plasma concentrations of granisetron during the period of heat exposure. Do not apply a heat pad or heat lamp over or in the vicinity of the Sancuso transdermal system and avoid extended exposure to heat.
    • Phototoxicity with Ultraviolet Light Exposure: Granisetron may be affected by direct natural or artificial sunlight, including sunlamps. An in vitro study using Chinese hamster ovary cells suggests that granisetron has the potential for photogenotoxicity. To avoid a potential skin reaction, advise patients to cover the application site of the transdermal system with clothing if there is a risk of exposure to direct natural or artificial sunlight throughout the period of wear and for 10 days following its removal.

    Adverse Reactions

    The most common adverse reaction (≥ 3%) is constipation.

    You are encouraged to report suspected adverse reactions to Cumberland Pharmaceuticals Inc. at 1-800-Sancuso or FDA at 1-800-FDA-1088 or medwatch.

    See full Prescribing Information for SANCUSO.