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Tropisetron is an alternative to standard (metoclopramide-based) antiemetic regimens and other serotonin (5-HT)3 receptor antagonists in patients receiving emetogenic cancer chemotherapy.The drug may be preferred over standard antiemetic regimens in patients receiving highly emetic drugs. Metoclopramide is associated with a significant risk of extrapyramidal effects, which have been reported only in isolated recipients of tropisetron. Tropisetron has also been more effective than standard regimens in some trials.Available data suggest that tropisetron and other 5-HT3 receptor antagonists are similarly effective in patients receiving chemotherapy regimens not including cisplatin. In the 2 comparative trials conducted to date, ondansetron and granisetron, respectively, have been reported to completely prevent vomiting in more patients than tropisetron. However, the clinical relevance of the differences is poorly defined.