Dual-Targeted Antiemetic Strategy: A Review of Granisetron-Scopolamine Transdermal Patch for PONV and CINV Management

Post-Operative Nausea and Vomiting (PONV) and Chemotherapy-Induced Nausea and Vomiting (CINV) are common clinical concerns that adversely affect patient recovery and quality of life. Existing pharmacological interventions, including single-agent and combination therapies, often exhibit limitations in fully controlling symptoms and may lead to undesirable side effects. This review examines the pharmacological rationale, clinical implications, and potential benefits of combining granisetron, a selective serotonin (5-HT3) receptor antagonist, with scopolamine, a muscarinic (M1) receptor antagonist, in a transdermal patch formulation. Current literature highlights the role of serotonin- and acetylcholine-mediated pathways in nausea and vomiting, suggesting that targeting both pathways may enhance antiemetic efficacy. The transdermal delivery system facilitates sustained and controlled drug release, potentially improving patient adherence and minimizing adverse effects such as sedation, dizziness, and gastrointestinal discomfort. The formulation may be particularly beneficial for patients requiring prolonged antiemetic coverage during chemotherapy or postoperative recovery. This review provides an overview of the pharmacological mechanisms, clinical outcomes, and design considerations associated with the granisetron-scopolamine combination patch. Furthermore, it discusses advancements in transdermal technology and potential directions for future research, including clinical trials and cost-effectiveness evaluations. The findings contribute to the ongoing development of improved antiemetic strategies for the effective management of PONV and CINV.