Compare Sustol vs. Emend

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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Helps prevent nausea and vomiting due to cancer chemotherapies.

Sustol (granisetron) is a long-acting injection that helps to prevent nausea and vomiting due to cancer chemotherapies, but causes bleeding and bruising at the injection site.

Stops nausea and vomitting caused by chemotherapy and surgery.

Emend (aprepitant) is used with other medicines to stop nausea and vomiting that can happen after chemotherapy and surgery.

Upsides
  • Each dose of Sustol (granisetron) provides relief from nausea and vomiting for at least 7 days.
  • Dosing is less frequent than alternatives.
  • Injection may be preferrable if you have difficulty swallowing a pill.
  • Emend (aprepitant) can help stop nausea that lasts several days after receiving chemo, which is harder to control than the nausea that starts immediately.
  • Emend (aprepitant) can also be used to stop nausea in adults that happens after surgery.
  • Emend (aprepitant) also comes as a liquid for children over 6 months and adults who can't take pills.
  • The side effects of Emend (aprepitant) are usually mild and include hiccups and fatigue.
Downsides
  • Sustol (granisetron) must be given at the doctor's office or infusion center 30 minutes before chemotherapy.
  • The dose of Sustol (granisetron) needs to be adjusted if you have poor kidney function.
  • Available as an expensive, branded product only.
  • Emend (aprepitant) only stops nausea and vomiting from happening. It won't work if you already have nausea and vomiting.
  • Emend (aprepitant) has to be used in combination with other medicines to treat chemotherapy related nausea.
  • Emend (aprepitant) needs to be taken for the first three days of chemo.
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Used for
  • Prevention of nausea and vomiting due to cancer chemotherapy
  • Prevention of acute and delayed nausea and vomiting associated with highly-emetogenic chemotherapy
  • Prevention of acute and delayed nausea and vomiting associated with moderately-emetogenic chemotherapy
  • Prevention of postoperative nausea and vomiting
Dosage forms
  • Extended-release injection
  • Pill
  • Liquid
Price
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Reviews
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Side effects
The Sustol (granisetron) FDA package insert doesn’t have numbers about how common side effects are.
6possible side effects
  • Fatigue
    13%
  • Diarrhea
    9%
  • Weakness
    7%
  • Indigestion
    7%
  • Hiccups
    5%
  • Lower white blood cells
    4%
See more detailed side effects
Risks and risk factors
  • Serotonin syndrome
    • Taking other medicines that affect serotonin levels such as anti-depressants
  • Troublesome stomach side-effects (ileus)
    • Taking other medications that cause constipation such as Norco and Percocet.
  • Injection site reactions
    • Bruising/bleeding more likely if also taking medications that affect blood coagulation
  • Allergic reactions
See more detailed risks and warnings
  • Drug Interactions
  • Decreased INR when used with warfarin (Coumadin)
    • Taking warfarin with Emend (aprepitant)
  • Risk of reduced efficacy of hormone based birth control
    • Taking hormone-based birth control
See more detailed risks and warnings