-  Withdraw antagonist medications : Labetalol, Bisoprolol, Reserpine, Amitriptyline + derivatives, Imipramine + derivatives, Doxepin, Amoxapine, Loxapine, Maprotiline, Trazodone, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Ephedrine, Cocaine, Bethanidine, Debrisoquine, Bretylium, Guanethidine, Phenothiazines, Thioxanthenes, Butyrophenones, Amphetamine + related compounds, Tyramine, Beta-sympathomimetics, Dobutamine, Dopamine, Metaraminol, Doxazosin mesilate. See mechanism.

-  Make sure WBC > 2400/ul or Granulocytes > 2000/ul and Platelets > 60.000/ul. Exclude DIC (disseminated intravascular coagulation).

-  Administer lugol’s solution 1 drop 2-3 times a day, 3 days before and 7 days after injecting the MIBG to prevent free iodine uptake by the thyroid gland.

-  If required in previous days, treat hypertension with propranolol or angiotensin-converting enzyme inhibitors or phenoxibenzamine. If they have no effect, give alternatively calcium channel blockers.