Skip to main content
SpringerLink
Log in

Tropisetron

An Update of its Use in the Prevention of Chemotherapy-Induced Nausea and Vomiting

  • Adis Drug Evaluation
  • Published:
Drugs Aims and scope Submit manuscript

Summary

Abstract

Tropisetron is a serotonin (5-hydroxytryptamine; 5-HT) antagonist that is primarily used in the prevention of chemotherapy-induced nausea and vomiting. Antagonism of 5-HT3 binding sites in the peripheral and central nervous system is the probable mechanism of prevention of acute nausea and vomiting. Effects on delayed nausea and vomiting are less well understood as these are probably not mediated solely by 5-HT3 receptors.

Tropisetron monotherapy is effective for the control of acute, and to a lesser extent delayed, nausea and vomiting in patients receiving moderately to severely emetogenic chemotherapy. The combination of dexamethasone and tropisetron is more effective than monotherapy. Complete control of cisplatin-induced nausea and vomiting was obtained in 69 to 97% of patients receiving the combination compared with 46 to 80% receiving tropisetron monotherapy in randomised trials.

There were generally no significant differences between the control of acute or delayed nausea and vomiting provided by tropisetron, ondansetron or granisetron in randomised, comparative trials. The antiemetic efficacy of tropisetron was maintained over multiple cycles of chemotherapy.

Most comparative studies showed tropisetron monotherapy to be more effective than metoclopramide in controlling acute nausea and vomiting, with the exception of 1 study which showed similar efficacy. However, high dose metoclopramide plus dexamethasone provided similar control of delayed emesis to tropisetron plus dexamethasone.

Tropisetron is also effective in children, including those who responded poorly to previous antiemetic treatment. Tropisetron and ondansetron generally have similar efficacies in this population.

The drug enhanced patients’ quality of life and was well tolerated by adults and children alike.

The recommended oral and IV dosage of tropisetron is 5mg once daily; there is no increase in efficacy with doses >5mg.

Conclusions: Tropisetron is similar to other 5-HT3 receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting in both adults and children. It is suitable as first-line therapy (combined with a corticosteroid) for the prevention of acute nausea and vomiting in patients treated with moderately to severely emetogenic chemotherapeutic agents. This combination is also moderately effective in the prevention of delayed nausea and vomiting.

Overview of Pharmacology

Tropisetron is a serotonin (5-hydroxytryptamine; 5-HT) antagonist that is primarily used in the treatment of patients with chemotherapy-induced nausea and vomiting. It has high affinity and specificity for 5-HT3 receptors; blockade of 5-HT3 binding sites in the peripheral and central nervous system is the probable mechanism of prevention of acute nausea and vomiting. Effects on delayed nausea and vomiting are less well understood as these are probably not mediated solely by 5-HT3 receptors. Tropisetron antagonised the emetic response in animal models of cisplatin-induced vomiting.

Tropisetron is rapidly and almost completely absorbed (≫95% of a 100mg dose within 2.2 hours) after oral administration, with absolute bioavailabilities of 52% for a 20mg dose and 66% for a 100mg dose. It has a large volume of distribution (attributed to its lipophilicity) and protein binding of 59 to 71%.

Tropisetron is metabolised predominantly in the liver into inactive metabolites. The plasma terminal elimination half-life (t½) of tropisetron was about 8 hours in extensive metabolisers and about 30 to 40 hours in poor metabolisers of the drug.

Although liver cirrhosis reduces the metabolic clearance of tropisetron and moderate to severe renal impairment reduces its nonrenal clearance, dosage adjustments in these populations are not necessary. Plasma t½ of tropisetron was unaffected by age in children, but in children aged 3 to 6 years plasma clearance was lower and the area under the plasma drug concentration-time curve higher than in those aged 10 to 15 years.

Therapeutic Efficacy

Tropisetron mono therapy is effective for the control of acute, and to a lesser extent delayed, nausea and vomiting in patients receiving moderately to severely emetogenic chemotherapy. The drug was most effective in patients who had received no previous chemotherapy, in adults aged >50 years and in men.

There were generally no significant differences in the control of acute and delayed nausea and vomiting between tropisetron, ondansetron or granisetron monotherapies in randomised, comparative trials. Control of acute nausea and vomiting was maintained over multiple cycles of chemotherapy with all 3 agents.

The combination of dexamethasone and tropisetron is more effective than tropisetron monotherapy. Complete control of cisplatin-induced acute vomiting was obtained in 69 to 97% of patients receiving the combination compared with 46 to 80% receiving tropisetron monotherapy in randomised trials. The combination of tropisetron and dexamethasone also provided greater protection against delayed emesis (51 to 81%) than tropisetron monotherapy (27 to 59%). However, much of this benefit may be attributable to dexamethasone, as delayed nausea and vomiting were only slightly better controlled (≤13% and ≤6% improvement, respectively) with tropisetron plus dexamethasone compared with dexamethasone monotherapy.

The combination of tropisetron and dexamethasone was also more effective in patients whose nausea and vomiting had previously not been well controlled with tropisetron monotherapy. Complete control of acute and delayed vomiting occurred in as many as 80% of patients treated with the combination compared with ≤64% (acute) and ≤70% (delayed vomiting) of those receiving tropisetron monotherapy in randomised double-blind studies.

The antiemetic efficacy of tropisetron monotherapy was generally greater than that of metoclopramide, although high dose metoclopramide plus dexamethasone provided equivalent control of delayed nausea and vomiting to tropisetron plus dexamethasone.

Results of a number of noncomparative trials indicated that tropisetron is effective in children, including those who had responded poorly to previous antiemetic treatment. Furthermore, comparative data suggest that tropisetron and ondansetron generally have similar antiemetic efficacy in this population. Tropisetron was usually administered at a daily dosage of 0.2 mg/kg up to a maximum of 5mg. In a trial involving 131 children aged 10 weeks to 21 years, complete response (no nausea or vomiting) was observed on day 1 in 67% of patients; delayed vomiting was controlled in 60% of all cycles of intravenous chemotherapy.

Improvements in quality of life with regard to nausea and vomiting during chemotherapy have been reported with tropisetron 5 and 10mg in 2 randomised, double-blind, multicentre trials. Food intake was not significantly affected during chemotherapy. Nurses considered tropisetron to be highly beneficial in over 85% of patients who received 5 days’ treatment.

Tolerability

Tropisetron was generally well tolerated by adults, being associated with adverse events commonly caused by 5-HT3 antagonists. Adverse events were usually mild, the most frequent being headache (≤18% of patients), constipation (≤7.6%) and fatigue (≤3.5%). The drug was also well tolerated by children; adverse events showed a similar pattern to that seen in adults. Tropisetron has not been shown to potentiate the adverse effects of cisplatin or other chemotherapeutic agents. Laboratory and ECG data are generally unaffected by the recommended dosage of tropisetron. Review of >80 000 patients treated with tropisetron revealed no reports of marked extrapyramidal effects.

In a trial involving 201 patients, metoclopramide was associated with a significantly higher incidence of adverse events than tropisetron. In direct comparisons of tropisetron with other 5-HT3 antagonists, tolerability profiles of all agents were very similar.

Dosage and Administration

Tropisetron is available in capsule form (5mg) for oral administration and in ampoules containing 2 or 5mg for oral or intravenous use.

The recommended dosage for oral or intravenous administration is 5mg once daily for 6 days in adults and 0.2 mg/kg (up to a maximum of 5mg) in children aged >2 years. It is recommended that tropisetron be given intravenously shortly before chemotherapy on day 1, either as an infusion (diluted) or as a slow (≥1 minute) injection, and orally each morning before food thereafter. However, oral doses may be substituted in practice for the initial intravenous dose, and therapy is generally not continued for the full 6 days because of the demonstrated equivalence with 5-HT3 receptor antagonists of single and multiple doses and oral and intravenous regimens.

The combination of tropisetron and dexamethasone is more effective than monotherapy and this is expected practice with moderately to highly emetogenic chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III
Table IV
Fig. 1
Table V
Table VI
Fig. 2
Table VII

Similar content being viewed by others

References

  1. Lee CR, Plosker GL, McTavish D. Tropisetron: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential as an antiemetic. Drugs 1993 Nov; 46: 925–43

    Article  PubMed  CAS  Google Scholar 

  2. Roila F, Ballatori E, Tonato M, et al. 5-HT3 receptor antagonists: differences and similarities. Eur J Cancer A 1997 Aug; 33: 1364–70

    Article  PubMed  CAS  Google Scholar 

  3. Perez EA. A risk-benefit assessment of serotonin 5-HT3 receptor antagonists in antineoplastic therapy-induced emesis. Drug Saf 1998 Jan; 18: 43–56

    Article  PubMed  CAS  Google Scholar 

  4. Gebauer A, Merger M, Kilbinger H. Modulation by 5-HT3 and 5-HT4 receptors of the release of 5-hydroxytryptamine from the guinea-pig small intestine. Naunyn Schmiedebergs Arch Pharmacol 1993 Feb; 347: 137–40

    Article  PubMed  CAS  Google Scholar 

  5. de Bruijn KM. Tropisetron: a review of the clinical experience. Drugs 1992; 43 Suppl. 3: 11–22

    Article  PubMed  Google Scholar 

  6. Fischer V, Baldeck J-P, Tse FLS. Pharmacokinetics and metabolism of the 5-hydroxytryptamine antagonist tropisetron after single oral doses in humans. Drug Metab Dispos 1992; 20(4): 603–7

    PubMed  CAS  Google Scholar 

  7. Novartis Pharma AG. Navoban (tropisetron). Product monograph. Basel, Switzerland: Novartis Pharma AG, 1998

    Google Scholar 

  8. Gaedicke G, Erttmann R, Henze G, et al. Pharmacokinetics of the 5HT3 receptor antagonist tropisetron in children. Pediatr Hematol Oncol 1996 Sep–Oct; 13: 405–16

    Article  PubMed  CAS  Google Scholar 

  9. Wymenga ANM, van der Graaf WTA, Wils JA, et al. Arandomized, double-blind, multicentre study comparing daily 2 and 5 mg of tropisetron for the control of nausea and vomiting induced by low-dose cisplatin- or non-cisplatin-containing chemotherapy. Ann Oncol 1996 Jul; 7: 505–10

    Article  PubMed  CAS  Google Scholar 

  10. Yakushiji M, Tanaka H, Furue H, et al. Clinical phase II study of tropisetron capsule in the treatment of nausea and vomiting induced by anti-cancer drugs [in Japanese]. Gan to Kagaku Ryoho 1995 Jul; 22: 1073–86

    PubMed  CAS  Google Scholar 

  11. Van Belle SJP, Stamatakis L, Bleiberg H, et al. Dose-finding study of tropisetron in cisplatin-induced nausea and vomiting. Ann Oncol 1994; 5: 821–5

    PubMed  Google Scholar 

  12. Bruntsch U, Drechsler S, Eggert J, et al. Prevention of chemotherapy-induced nausea and vomiting by tropisetron (Navoban) alone or in combination with other antiemetic agents. Semin Oncol 1994 Oct; 21 Suppl. 9: 7–11

    PubMed  CAS  Google Scholar 

  13. Drechsler S, Bruntsch U, Eggert J, et al. Comparison of three tropisetron-containing antiemetic regimens in the prophylaxis of acute and delayed chemotherapy-induced emesis and nausea. Support Care Cancer 1997 Sep; 5: 387–95

    Article  PubMed  CAS  Google Scholar 

  14. Sorbe B, Andersson H, Schmidt M, et al. Tropisetron (Navoban) in the prevention of chemotherapy-induced nausea and vomiting — the Nordic experience. Support Care Cancer 1994 Nov; 2: 393–9

    Article  PubMed  CAS  Google Scholar 

  15. Falkson CI, Falkson HC. Antiemetic efficacy of tropisetron in patients failing previous antiemetic therapy. Oncology 1995; 52: 427–31

    Article  PubMed  CAS  Google Scholar 

  16. Bleiberg H, Hulstaert F, Buyse M, et al. Tropisetron in the prevention of acute and delayed nausea and vomiting over six courses of emetogenic chemotherapy. Anticancer Drugs 1998 Oct; 9: 773–7

    Article  PubMed  CAS  Google Scholar 

  17. The Nordic Antiemetic Trial Group, Sorbe BG, Högberg T, et al. Navoban (tropisetron) alone and in combination with dexamethasone in the prevention of chemotherapy-induced nausea and vomiting: the Nordic experience. Anticancer Drugs 1995 Feb; 6 Suppl. 1: 31–6

    Article  PubMed  CAS  Google Scholar 

  18. de Wit R, Schmitz PIM, Verweij J, et al. Analysis of cumulative probabilities shows that the efficacy of 5HT3 antagonist prophylaxis is not maintained. J Clin Oncol 1996 Feb; 14: 644–51

    PubMed  Google Scholar 

  19. Chang T-C, Hsieh F, Lai C-H, et al. Comparison of the efficacy of tropisetron versus a metoclopramide cocktail based on the intensity of cisplatin-induced emesis. Cancer Chemother Pharmacol 1996 Jan; 37: 279–85

    Article  PubMed  CAS  Google Scholar 

  20. Chua DTT, Sham JST, Au GKH, et al. The antiemetic efficacy of tropisetron plus dexamethasone as compared with conventional metoclopramide-dexamethasone combination in Orientals receiving cisplatin chemotherapy: a randomized crossover trial. Br J Clin Pharmacol 1996 May; 41: 403–8

    Article  PubMed  CAS  Google Scholar 

  21. Lauria R, Palmieri G, Pepe R, et al. Comparison of tropisetron (ICS 205-930) with alizapride plus dexamethasone in the prevention of emesis induced by repeated cisplatin administration. Eur J Clin Res 1994; 5: 171–83

    Google Scholar 

  22. Madej G, Krzakowski M, Pawinski A, et al. A comparative study of the use of navoban (ICS 205-930), a 5-HT3 antagonist, versus a standard antiemetic regimen of dexamethasone and metoclopramide in the treatment of cisplatin-containing chemotherapy. Drug Invest 1993 Sep; 6: 162–9

    Article  Google Scholar 

  23. Sorbe BG, Högberg T, Glimelius B, et al. A randomized, multicenter study comparing the efficacy and tolerability of tropisetron, a new 5-HT3 receptor antagonist, with a metoclopramide-containing antiemetic cocktail in the prevention of cisplatin-induced emesis. Cancer 1994 Jan 15; 73: 445–54

    Article  PubMed  CAS  Google Scholar 

  24. Anderson H, Thatcher N, Howell A, et al. Tropisetron compared with a metoclopramide-based regimen in the prevention of chemotherapy-induced nausea and vomiting. Eur J Cancer A 1994; 30A(5): 610–5

    Article  PubMed  CAS  Google Scholar 

  25. Bruntsch U, Rüfenacht E, Parker I, et al. Tropisetron in the prevention of chemotherapy-induced nausea and vomiting in patients responding poorly to previous conventional antiemetic therapy. Ann Oncol 1993; 4 Suppl. 3: S25–29

    Article  Google Scholar 

  26. Jantunen IT, Kataja VV, Johansson RT. Ondansetron and tropisetron with dexamethasone in the prophylaxis of acute vomiting induced by non-cisplatin-containing chemotherapy. Acta Oncol 1992; 31(5): 573–5

    Article  PubMed  CAS  Google Scholar 

  27. Mantovani G, Macciò A, Bianchi A, et al. Comparison of granisetron, ondansetron, and tropisetron in the prophylaxis of acute nausea and vomiting induced by cisplatin for the treatment of head and neck cancer: a randomized controlled trial. Cancer 1996 Mar 1;77: 941–8

    Article  PubMed  CAS  Google Scholar 

  28. Marty M, Kleisbauer J-P, Fournel P, et al. Is Navoban (tropisetron) as effective as Zofran (ondansetron) in cisplatin-induced emesis? Anticancer Drugs 1995 Feb; 6 Suppl. 1: 15–21

    Article  PubMed  CAS  Google Scholar 

  29. Monda M, diGrazia M, De Vita F, et al. Tropisetron vs granisetron nell’emesi acuta e ritardata indotta da cis-platino: dati preliminari [in Italian, abstract]. Tumori 1994; 80 Suppl.: 150

    Google Scholar 

  30. Zaluski J, Puistola U, Madej G, et al. Ondansetron plus dexamethasone, ondansetron and tropisetron in the prophylaxis of cisplatin-induced acute emesis: a multicentre, double-blind, randomised, parallel group study. Eur J Clin Res 1997; 9: 21–31

    Google Scholar 

  31. Pin Z, Yan S, Honggang Z, et al. A randomized trial of tropisetron in the prophylaxis of nausea and vomiting induced by chemotherapy [in Chinese]. Chin J Oncol 1996; 18(2): 154–6

    Google Scholar 

  32. Campora E, Simoni C, Rosso R. Tropisetron versus ondansetron in the prevention and control of emesis in patients undergoing chemotherapy with FAC/FEC for metastatic or surgically treated breast cancer [in Italian]. Minerva Med 1994 Jan–Feb; 85: 25–31

    PubMed  CAS  Google Scholar 

  33. Jantunen IT, Muhonen TT, Kataja VV, et al. 5-HT3 receptor antagonists in the prophylaxis of acute vomiting induced by moderately emetogenic chemotherapy — a randomised study. Eur J Cancer A 1993; 29A(12): 1669–72

    Article  PubMed  CAS  Google Scholar 

  34. Yalçin S, Tekuzman G, Baltali E, et al. Serotonin receptor antagonists in prophylaxis of acute and delayed emesis induced by moderately emetogenic, single-day chemotherapy. Am J Clin Oncol 1999; 22(1): 94–6

    Article  PubMed  Google Scholar 

  35. Massidda B, Ionta MT. Prevention of delayed emesis by a single intravenous bolus dose of 5-HT3-receptor-antagonist in moderately emetogenic chemotherapy. J Chemother 1996 Jun; 8: 237–42

    PubMed  CAS  Google Scholar 

  36. Massidda B, Laconi S, Foddi MR, et al. Prevention of non-cisplatin induced emesis: role of the antagonists of 5-HT3 receptors [abstract]. Ann Oncol 1994; 5 Suppl. 8: 204

    Google Scholar 

  37. Garcia-del-Muro X, Vadell C, Pérez Manga G, et al. Randomised double-blind study comparing tropisetron alone and in combination with dexamethasone in the prevention of acute and delayed cisplatin-induced emesis. Eur J Cancer A 1998 Jan; 34: 193–5

    Article  PubMed  CAS  Google Scholar 

  38. Adams M, Soukop M, Barley V, et al. Tropisetron alone or in combination with dexamethasone for the prevention and treatment of emesis induced by non-cisplatin chemotherapy: a randomized trial. Anticancer Drugs 1995 Aug; 6: 514–21

    Article  PubMed  CAS  Google Scholar 

  39. Malik I, Moid I, Khan Z, et al. Prospective randomized comparison of tropisetron with and without dexamethasone against high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting. Am J Clin Oncol 1999; 22(2): 126–30

    Article  PubMed  CAS  Google Scholar 

  40. Sorbe BG, Berglind A-M, Andersson H, et al. Astudy evaluating the efficacy and tolerability of tropisetron in combination with dexamethasone in the prevention of delayed platinum-induced nausea and emesis. Cancer 1998 Sep 1; 83: 1022–32

    Article  PubMed  CAS  Google Scholar 

  41. Van Belle SJP, Cocquyt VFJ, Bleiberg H, et al. Optimal combination therapy with Navoban (tropisetron) in patients with incomplete control of chemotherapy-induced nausea and vomiting. Anticancer Drugs 1995 Feb; 6 Suppl. 1: 22–30

    Article  PubMed  Google Scholar 

  42. Schmidt M, Sorbe B, Högberg T, et al. Efficacy and tolerability of tropisetron and dexamethasone in the control of nausea and vomiting induced by cisplatin. Ann Oncol 1993; 4 Suppl. 3: S31–34

    Article  Google Scholar 

  43. Benoit Y, Hulstaert F, Vermylen C, et al. Control of nausea and vomiting by Navoban (tropisetron) in 131 children receiving cytotoxic chemotherapy. Anticancer Drugs 1995 Feb; 6 Suppl. 1: 9–14

    Article  PubMed  CAS  Google Scholar 

  44. Berberoglu S. Prevention of emesis by tropisetron in children receiving combined chemotherapy with cisplatin. Pediatr Hematol Oncol 1995 Sep–Oct; 12: 479–83

    Article  PubMed  CAS  Google Scholar 

  45. Cefalo G, Rottoli L, Armiraglio A, et al. Tropisetron (ICS 205-930) in pediatric oncology: first results in patients refractory to antiemetic metoclopramide-based treatments. Am J Pediatr Hematol Oncol 1994 Aug; 16: 242–5

    Article  PubMed  CAS  Google Scholar 

  46. Gershanovich M, Kolygin B, Pirgach N. Tropisetron in the control of nausea and vomiting induced by combined cancer chemotherapy in children. Ann Oncol 1993; 4 Suppl. 3: S35–37

    Article  Google Scholar 

  47. Otten J, Hachimi-Idrissi S, Balduck N, et al. Prevention of emesis by tropisetron (Navoban) in children receiving cytotoxic therapy for solid malignancies. Semin Oncol 1994 Oct; 21 Suppl. 9: 17–9

    PubMed  CAS  Google Scholar 

  48. Rosso P, Cordero di Montezemolo L, Vivenza C, et al. Efficacy of tropisetron (Navoban) in controlling emesis induced in children by anti-cancer therapy. Tumori 1994 Dec 31; 80: 459–63

    PubMed  CAS  Google Scholar 

  49. Jiménez M, León P, Gimeno J, et al. A randomized comparison of intravenously administered chlorpromazine plus dexamethasone vs ondansetron vs tropisetron in the prevention of chemotherapy-induced emesis in children [abstract]. Pediatr Res 1997 Sep; 42: 399

    Article  Google Scholar 

  50. Stiakaki E, Savvas S, Lydaki E, et al. Efficacy of ondansetron and tropisetron in the control of nausea and vomiting induced by combined cancer chemotherapy in children [abstract]. Pediatr Res 1997 May; 41: 775

    Article  Google Scholar 

  51. Garbe C, Drechsler S, Fiedler H, et al. Dose comparison of tropisetron (Navoban) 5 mg and 10 mg orally in the prophylaxis of dacarbazine-induced nausea and emesis. Semin Oncol 1994 Oct; 21 Suppl. 9: 12–6

    PubMed  CAS  Google Scholar 

  52. Kobayashi K, Ishihara Y, Nukariya N, et al. Effects of antiemetic drug (tropisetron) on quality of life during chemotherapy: use of diary-type questionnaire and application of summary measures for assessment in a randomized, multicentre study. Respirology 1999; 4: 229–38

    Article  PubMed  CAS  Google Scholar 

  53. deBruijn KM. The development of tropisetron in its clinical perspective. Ann Oncol 1993; 4 Suppl. 3: S19–23

    Article  Google Scholar 

  54. Bateman DN, Rawlins MD, Simpson JM. Extrapyramidal reactions with metoclopramide. BMJ 1985 Oct 5; 291: 930–2

    Article  PubMed  CAS  Google Scholar 

  55. Novartis. Navoban. Product Information. ABPI Compendium of Data Sheets and Summaries of Product Characteristics 1998–99. Datapharm Publications Limited, London

  56. Gralla RJ, Osoba D, Kris MG, et al. Recommendations for the use of antiemetics: evidence-based clinical practice guidelines. J Clin Oncol 1999; 17: 2971–94

    PubMed  CAS  Google Scholar 

  57. Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC). Prevention of chemotherapy- and radiotherapy-induced emesis: results of the Perugia Consensus Conference. Ann Oncol 1998; 9: 811–9

    Article  Google Scholar 

  58. Gralla RJ. Antiemetic therapy. Semin Oncol 1998 Oct; 25: 577–83

    PubMed  CAS  Google Scholar 

  59. Fauser AA, Fellhauer M, Hoffmann M, et al. Guidelines for anti-emetic therapy: acute emesis. Eur J Cancer 1998; 35(3): 361–70

    Article  Google Scholar 

  60. Hainsworth JD, Hesketh PJ. Single-dose ondansetron for the prevention of cisplatin-induced emesis: efficacy results. Semin Oncol 1992; 19 (6 Suppl. 15): 14–9

    CAS  Google Scholar 

  61. Italian Group for Antiemetic Research. Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. N Engl J Med 1995; 332: 1–5

    Article  Google Scholar 

  62. Roila F, Tonato M, Cognetti F, et al. Prevention of cisplatin-induced emesis: a double-blind multicenter randomized crossover study comparing ondansetron and ondansetron plus dexamethasone. J Clin Oncol 1991; 9: 674–8

    Google Scholar 

  63. Dilly SG, Friedman C, Yocum K. Contribution of dexamethsone to antiemetic control with granisetron is greatest in patients at high risk of emesis [abstract]. Proc Am Soc Clin Oncol 1994; 13: 436

    Google Scholar 

  64. Kris MG, Pendergrass KB, Navari RM, et al. Prevention of acute emesis in cancer patients following high-dose cisplatin with the combination of oral dolasetron and dexamethasone. J Clin Oncol 1997; 15: 2135–8

    PubMed  CAS  Google Scholar 

  65. Lofters WS, Pater JL, Zee B, et al. Phase III double-blind comparison of dolasetron mesylate and ondansetron and on evaluation of the additive role of dexamethasone in the prevention of acute and delayed nausea and vomiting due to moderately emetogenic chemotherapy. J Clin Oncol 1997; 15: 2966–73

    PubMed  CAS  Google Scholar 

  66. Peterson C, Hursti TJ, Börjeson S, et al. Single high-dose dexamethasone improves the effect of ondansetron on acute chemotherapy-induced nausea and vomiting but impairs the control of delayed symptoms. Support Care Cancer 1996; 4: 440–6

    Article  PubMed  CAS  Google Scholar 

  67. Sekine I, Nishiwaki Y, Kakinuma R, et al. A randomized crossover trial of granisetron and dexamethasone versus granisetron alone: the role of dexamethasone on day 1 in the control of cisplatin-induced delayed emesis. Jpn J Clin Oncol 1996; 26: 164–8

    Article  PubMed  CAS  Google Scholar 

  68. Silva RR, Basconi R, Giorgi F, et al. Granisetron plus dexamethasone in moderately emetogenic chemotherapy: evaluation of activity during three consecutive courses of chemotherapy. Support Care Cancer 1996; 4: 287–90

    Article  PubMed  CAS  Google Scholar 

  69. Ruff P, Paska W, Goedhals L, et al. Ondansetron compared with granisetron in the prophylaxis of cisplatin-induced acute emesis: a multicentre double-blind, randomised, parallel-group study. Oncology 1994; 5: 113–8

    Article  Google Scholar 

  70. Navari R, Gandara D, Hesketh P, et al. Comparative clinical trial of granisetron and ondansetron in the prophylaxis of cisplatin-induced emesis. J Clin Oncol 1995; 13: 1242–8

    PubMed  CAS  Google Scholar 

  71. Hesketh P, Navari R, Grote T, et al. Double-blind, randomized comparison of the antiemetic efficacy of intravenous dolasetron mesylate and intravenous ondansetron in the prevention of acute cisplatin-induced emesis in patients with cancer. J Clin Oncol 1996; 14: 2242–9

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Kerryn Simpson, Caroline M. Spencer & Karen J. McClellan

Authors
  1. Kerryn Simpson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Caroline M. Spencer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen J. McClellan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kerryn Simpson.

Additional information

Various sections of the manuscript reviewed by: H. Link, Department of Internal Medicine, Westpfalz-Klinikum, Kaiserslautern, Germany; M. Marty, Department of Medical Oncology, Institut Gustave Roussy, Villejuif Cedex, France; G. Schlimok, Medizinische Klinik, Krankenhauszweckverband Augsberg Zentralklinikum, Augsberg, Germany; S. Gregoretti, School of Medicine, Department of Anesthesiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA; X. Garcia del Muro, Institut Català d’Oncologia, Hospital Duran I Reynals, Department of Medical Oncology, Barcelona, Spain; V. Harvey, Auckland Hospital, Department of Oncology, Auckland, New Zealand; S.J.P. Van Belle, Department of Medical Oncology, University Hospital Ghent, Ghent, Belgium.

Data Selection

Sources: Medical literature published in any language since 1995 on tropisetron, identified using Medline and EMBASE, supplemented by AdisBase (a proprietary database of Adis International, Auckland, New Zealand). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company developing the drug.

Search strategy: Medline search terms were ‘tropisetron’ or ‘ICS-205-930’. EMBASE search terms were ‘tropisetron’. AdisBase search terms were ‘tropisetron’ or ‘ICS-205930’. Searches were last updated 28 April, 2000.

Selection: Studies in patients with chemotherapy-induced nausea and vomiting who received tropisetron. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic and pharmacokinetic data are also included.

Index terms: chemotherapy, nausea and vomiting, emesis, tropisetron, pharmacodynamics, pharmacokinetics, therapeutic use.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Simpson, K., Spencer, C.M. & McClellan, K.J. Tropisetron. Drugs 59, 1297–1315 (2000). https://doi.org/10.2165/00003495-200059060-00008

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200059060-00008

Keywords

Search

Navigation