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A single 5 mg intravenous injection may be used to prophylaxis acute nausea and vomiting caused by cytotoxic chemotherapy. This infusion can be administered on the same day as the treatment. It should be administered in a continuous infusion for not less than one minute. It is mixed with 100111L of suitable infusion fluid (such as sodium chloride 0.9%, glucose 5%) and given for 15 minutes. For an additional five days, the subsequent doses of 5mg daily should be taken orally at least one hour before meals.

Children older than two years may receive 200 micrograms/kg (maximum dosage of 5 mg) before chemotherapy. This can be done Tropisetron intravenously over at least 1 min or by infusion (at 50 micrograms/mL with a suitable infusion liquid). Children weighing less than 25kg may receive the same dose intravenously for as many days as necessary. If oral administration is impossible, the same amount can be administered intravenously.

Adults may receive 2 mg intravenous injections (not less than 30 seconds) or an infusion (over fifteen minutes) within two hours after the end of anesthesia. The same dose can be used for prevention.

It blocks the presynaptic 5-HT3 receptors in the peripheral neurons and the CNS; thus, the vomiting reflex is prevented. It blocks the vomiting reflex (and the nausea feeling accompanying the same) provoked by chemotherapeutic anti-tumor preparations stimulating the serotonin (5-HT3) throw from the enterochromaffin-like cells in the gastrointestinal tract mucous membrane as well as postoperative nausea and vomiting syndrome (PONV). It has a 24-hour effect that can be taken once daily. It works well when it is used again after repeated chemotherapy courses. Tropisetron is unlike other medications used to prevent nausea and vomiting. It does not cause extrapyramidal (movement coordination changes) or tremors.

Liver microsomal enzyme inducers (rifamycin and phenobarbital) reduce the blood tropisetron level. Patients who metabolize tropisetron rapidly should be given larger doses of preparation. It is not necessary for patients who metabolize tropisetron slowly. Cytochrome P450 inhibitors like cimetidine have a minimal effect on tropisetron plasma levels. There is no need to alter the preparation dose. There were no studies of tropisetron interaction and preparations for anesthesia.

Many patients who received tropisetron with other preparations that caused this interval lengthening experienced a QT interval increase. The same study also determined that tropisetron was ineffective in reducing QT interval lengthening when used in therapeutic doses. However, caution is essential when prescribing tropisetron or preparations that cause QT interval lengthening.

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