Nausea and Vomiting

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How are nausea and vomiting prevented and treated?

Prevention of nausea and vomiting is the goal of treatment. Today, many medicines can be used to control nausea and vomiting, and there are many treatment options.

Anti-nausea/vomiting medicine used with chemo treatment

No one drug can prevent or control chemo-related nausea and vomiting 100% of the time. This is because chemo drugs act on the body in different ways and each person responds to chemotherapy and the anti-nausea/vomiting (anti-emetic) drugs differently. To choose the best treatment plan, the doctor:

  • Considers how likely the chemo is to cause nausea and vomiting if no anti-nausea/vomiting treatment is given “See “The risk of vomiting, by specific chemo drug” section for more on this.)
  • Selects anti-nausea/vomiting medicines based on how much the chemo drugs are known to affect the vomiting center in the brain
  • Looks at nausea and vomiting you’ve had in the past
  • Reviews how well any anti-emetic medicines have worked for you before
  • Looks at the side effects of the anti-nausea/vomiting medicines
  • Uses the lowest effective dose of the anti-nausea/vomiting medicine before chemo or radiation therapy is given
  • Uses medicines to try to prevent (not just control) the nausea and vomiting
  • Carefully watches how you respond to the anti-emetic treatment
  • Makes drug changes as needed to keep you from having nausea and vomiting

The goal is to prevent nausea and vomiting, because it’s easier to prevent it than it is to stop it once it starts. To help the drugs work best against chemo-related nausea and vomiting:

  • Preventive treatment should start before the chemo is given.
  • It should continue for as long as the chemo is likely to cause vomiting, which may be up to 7 to 10 days after the last dose.

Anti-nausea/vomiting medicines are usually given on a regular schedule around the clock. This means you take them even if you don’t have any problems. Sometimes you may be asked to take a medicine on an “as needed” schedule. This means you take the medicine at the first sign of nausea to keep it from getting worse.

Because nausea and vomiting can happen for different reasons, different anti-nausea/vomiting medicines may be used together. In many cases, 2 or more medicines are used. Be sure you know how to take each drug. Ask your doctor or nurse how long after the last dose of chemo you should keep taking the medicine, so that you don’t stop taking it too soon.

Each time you start a new cycle of chemo, be sure to tell your cancer team what did and didn’t work the last time. If needed, this is the time to make changes to get better control of your nausea and vomiting so that it isn’t a problem for the next round. It’s also a chance for the doctor to be sure that there aren’t other factors besides the chemo adding to your nausea and vomiting.

Anti-nausea/vomiting medicines used for radiation therapy

When radiation treatment is likely to cause nausea and vomiting, your doctor will probably give you medicines to help prevent it each day before you get your radiation treatment. The anti-nausea/vomiting medicines (anti-emetics) may be given by mouth or into a vein, or both. If you have nausea or vomiting, be sure to tell your doctor so that it can be treated.

Last Medical Review: 02/27/2013
Last Revised: 03/27/2013