How do doctors prevent nausea and vomiting?
Most people undergoing chemotherapy receive anti-nausea (anti-emetic) medications to prevent nausea and vomiting.
These drugs, given alone or in combination, can be taken in pill form or administered through a vein in your arm. Your doctor advises which to use based on the treatment you're receiving.
Medications used to prevent nausea and vomiting include:
- Alprazolam (Niravam, Xanax)
- Aprepitant (Emend)
- Diphenhydramine (Benadryl)
- Dolasetron (Anzemet)
- Dronabinol (Marinol)
- Droperidol (Inapsine)
- Fosaprepitant (Emend)
- Granisetron (Kytril)
- Haloperidol (Haldol)
- Lorazepam (Ativan)
- Methylprednisolone (Medrol)
- Metoclopramide (Reglan)
- Nabilone (Cesamet)
- Olanzapine (Zyprexa)
- Ondansetron (Zofran)
- Palonosetron (Aloxi)
- Promethazine (Phenergan)
Your doctor chooses anti-nausea medications based on how likely your chemotherapy drugs are to cause nausea and vomiting. You may take as few as one to as many as four medications, depending on your situation.
Your doctor will give you some medications before the chemotherapy and then will instruct you on which medications to take on a regular schedule on the days after the chemotherapy and which medications to take only if you feel nauseated.
Doctors take this proactive approach to prevent nausea and vomiting because these side effects can be difficult to control once they begin. Nausea and vomiting can make you feel miserable, add to your fatigue and distress, and make you reluctant to stick to your treatment schedule.
What additional measures can you take to prevent nausea and vomiting?
You can take steps to reduce your risk of nausea and vomiting. For example:
- Eat small meals. Stagger small meals throughout the day rather than eating fewer, larger meals. If possible, don't skip meals. Eating a light meal a few hours before treatment also may help.
Eat what appeals to you. It's best, however, to avoid foods that are sweet, fried or fatty. In addition, cool foods may give off less bothersome odors.
Cook and freeze meals in advance of treatment to avoid cooking when you're not feeling well. Or have someone else cook for you.
- Drink lots of fluids. Try cool beverages, such as water, unsweetened fruit juices, tea or ginger ale that's lost its carbonation. It may help to drink small amounts throughout the day, rather than larger amounts less frequently.
- Avoid unpleasant smells. Pay attention to what smells trigger nausea for you and limit your exposure to unpleasant smells. Fresh air may help.
- Make yourself comfortable. Rest after eating, but don't lie flat for a couple of hours. Try wearing loosefitting clothing and distracting yourself with other activities.
- Use relaxation techniques. Examples include meditation and deep breathing.
These self-care measures may help you prevent nausea and vomiting, but they can't take the place of anti-nausea medications.
If you begin to feel nauseated despite the medications, call your doctor. Treatments may include additional medications, though your individual treatment will depend on what's causing your signs and symptoms.
May. 17, 2014
See more In-depth
- Antiemesis. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Dec. 26, 2013.
- Nausea and vomiting. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/Patient. Accessed Dec. 26, 2013.
- Eating hints: Before, during and after cancer treatment. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/eatinghints/page1/AllPages. Accessed Dec. 26, 2013.
- Niederhuber JE, et al., eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed Dec. 26, 2013.
- Basch E, et al. Antiemetics: American Society of Clinical Oncology clinical practice guidelines update. Journal of Clinical Oncology. 2011;29:4189.
- Hesketh PJ. Prevention and treatment of chemotherapy-induced nausea and vomiting. http://www.uptodate.com. Accessed Dec. 6, 2013.
- Molassiotis A, et al. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: Results from a European prospective observational study. Journal of Pain and Symptom Management. In press. Accessed Dec. 26, 2013.
- Kamen C, et al. Anticipatory nausea and vomiting due to chemotherapy. European Journal of Pharmacology. 2014;722:172.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 16, 2014.