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Many drugs or combination of drugs are available to help prevent and control vomiting. These may also control nausea.
Your body has several different pathways that trigger nausea and vomiting. Anti-nausea and vomiting drugs (sometimes called anti-emetics) have been developed to target and block these pathways. Some of these drugs target the vomiting center in the brain, while others work as rescue therapy if the initial nausea medicine doesn’t work. Based on this knowledge, and the treatment’s potential to cause nausea and vomiting, your doctor will recommend certain anti-nausea and vomiting medicines. You might have to try a few different drugs to find the ones that work best for you.
Anti-emetic drugs are grouped by how they work in the body on different types of nausea and vomiting. It's important to remember that the groups of drugs work differently. One drug might not work as well for you as it does for someone else, depending on the type of nausea and vomiting you might have.
The drug names given above are only examples. This is not a complete list of the drugs in each group.
Many of these drugs can be expensive and you might need pre-approval from your health insurance before they will be covered. Others are available as generic drugs and cost a lot less than the name brands. Don’t be afraid to ask your cancer care team about the cost of these drugs, what your options are, and what you might have to pay out of pocket.
It's important to think about how many pills you may need to get you through your treatment. Be sure you talk to your insurance company about how many pills are covered for each prescription, and let your doctor know if you think you might not have enough to get you through until your next appointment.
There are many ways to take anti-nausea and vomiting medicines. For instance, you may be able to take them:
Your doctor will consider the following things when deciding the best way to give your anti-emetics:
If the drugs used at first don’t work, your doctor can switch you to another drug or add a new drug. Another option is to give the drugs a different way (by a different route). Taking pills by mouth is often the best, easiest, and cheapest way to prevent nausea and vomiting. But if you’re already vomiting, or you can’t swallow and keep things down, the medicine might need to be given another way.
Let your doctor know if you are still having problems despite treatment. Don’t let nausea and vomiting make you feel bad and keep you from getting the nutrition your body needs during treatment. There’s no reason for you to have uncontrolled nausea and vomiting. There are many drugs that can be used to prevent and treat these side effects.
The specific anti-emetic given and how often you take it is based on how likely the chemo or other drug is expected to cause nausea and vomiting. It’s easier to prevent nausea and vomiting than it is to stop it once it starts. No one drug can prevent or control treatment-related nausea and vomiting 100% of the time. This is because treatments act on the body in different ways and each person responds to chemo and to anti-nausea and vomiting drugs differently.
To choose the best treatment plan for you, the doctor will:
Anti-nausea and vomiting medicines are often given on a regular schedule around the clock. Your doctor might encourage you to take them on a schedule even if you don't have any nausea or vomiting. Sometimes, you may take the medicine on an "as needed" schedule. This means you take the medicine at the first sign of nausea to keep it from getting worse. Ask your cancer care team how you should take these drugs.
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 your 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 radiation. Anti-nausea and vomiting medicines may be given by mouth or into a vein, or both.
To choose the best treatment plan, the doctor will:
Anti-nausea and vomiting medicines are often given on a regular schedule around the clock. your doctor may encourage you to take them on a schedule even if you don’t have any nausea or vomiting. Sometimes you may take the medicine “as needed.” This means you take the medicine at the first sign of nausea to keep it from getting worse. Ask your cancer care team how you should take your anti-nausea and vomiting medicines.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Blanchard EM, Hesketh PJ. Nausea and vomiting. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:2078-2085.
Brant JM, Stringer LH. Chemotherapy-induced nausea and vomiting. In Brown CG, ed. A Guide to Oncology Symptom Management. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2015:171-196.
Hainsworth JD. Nausea and vomiting. In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:599-606.e3.
Hesketh PJ et al. Antiemetics: ASCO guideline update. Journal of Clinical Oncology. 2020;38(24). Accessed at https://ascopubs.org/doi/10.1200/JCO.20.01296 on September 10, 2020.
National Cancer Institute (NIH). Treatment-related nausea and vomiting (PDQ®)- Health Professional Version. 2018. Accessed at https://www.cancer.gov/about-cancer-treatment/side-effects/nausea/nausea-hp-pdq on September 6, 2019.
National Comprehensive Cancer Network (NCCN). Antiemesis. 2019. Version 1.2019. Accessed at https:// www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf on September 9, 2019.
Last Revised: March 12, 2021