Medicines for nausea and vomiting

Also called anti-sickness medicines or antiemetics

There are a variety of medications that can be used to ease nausea (feeling sick) and vomiting (being sick), which work in different ways to one another. The choice of medicine will depend on what has caused your nausea and vomiting.

Nausea and vomiting can be caused by a number of things such as pregnancy, motion sicknesses, Ménière's disease, migraines, some medicines including chemotherapy. Taking a medicine to treat nausea and vomiting may not always be the best option, talk to your doctor or pharmacist first. Read more about nausea and vomiting.

There are a variety of medicines to treat nausea and vomiting. These medicines are called anti-sickness medicines or antiemetics. The choice of treatment depends on various factors, such as:

  • what has caused your nausea and vomiting
  • whether you have any other medical conditions or taking any other medicines
  • whether you are pregnant
  • your age
  • possible side-effects of the medicines.

There are a large number of conditions that can cause nausea and a range of preferred treatments that could be prescribed. The following is a guide.

Motion sickness

Medications for motion sickness are usually given before you start travelling to prevent you becoming sick, rather than after nausea or vomiting develops. A commonly used medicine to prevent motion sickness is hyoscine (also called scopolamine), which is a patch that you apply to the skin, behind the ear, at least 5 hours before the journey. It can cause drowsiness, so avoid using it if you are driving. Read more about hyoscine.

Cyclizine and meclozine are available as tablets and should be taken a few hours before departing. They can make some people feel drowsy, sleepy or tired. Do not drive until you know how the medication affects you. Read more about cyclizine and meclozine.

Vertigo and nausea associated with Ménière's disease

Betahistine is commonly used to relieve the symptoms associated with Ménière's disease such as dizziness, vertigo, loss of balance and ringing in your ears (tinnitus). It is unlikely to stop all these symptoms, but it may reduce how often these occur and their severity. Your doctor may advise you to try betahistine for 6 to 12 months to see if it helps to reduce your symptoms. If it does, it can then be continued. Read more about betahistine.

Other medicines that can be used include cyclizine and prochlorperazine. Prochlorperazine is usually used for severe symptoms where other medicines have not been effective.

Nausea and vomiting associated with migraine

Most people with migraine headaches, get nausea or vomiting. Medicines most commonly used to ease these symptoms are metoclopramide, domperidone and prochlorperazine. They can be helpful to treat migraine even if you don't experience nausea or vomiting and can be used together with other pain relievers and triptans.

Seek medical advice before taking anti-sickness medicines as they are not suitable for some people. As with pain relievers, anti-sickness medicines work better if taken as soon as your migraine symptoms begin. Read more about migraine and medicines for migraine.

Nausea and vomiting during pregnancy

During early pregnancy, it is common to experience nausea and vomiting. This is often referred to as "morning sickness" but symptoms can occur at any time of the day and may persist for the duration of the pregnancy. These symptoms are generally mild and do not need medication.

Severe vomiting in pregnancy is known as hyperemesis gravidarum. It is much worse than regular pregnancy sickness. There are a variety of anti-sickness medicines that you may be offered such as cyclizine, promethazine, prochlorperazine, metoclopramide, ondansetron and steroids. Not all of these medicines are licensed for use in pregnancy, but there is no evidence that they are harmful to your baby.

Always check with your doctor, midwife or pharmacist before taking any medicine or supplement when you are pregnant. 

Nausea and vomiting caused by chemotherapy

Some types of chemotherapy (also called chemo) can cause nausea and vomiting. Depending on the type of chemo, these feelings can occur while you are getting chemo, right after, or many hours or days later. Not everyone feels sick after chemo – how likely you are to have nausea and vomiting while getting chemo depends on many things such as:

  • the types of medication given
  • the dose (high doses of chemo are more likely to cause nausea and vomiting)
  • when and how often the medication is given; for example, if doses of a chemo medicine that causes nausea and vomiting are given close together, there’s less time for the person to recover from the effects of the last dose before the next one is given
  • how the medicines are given; for instance, chemo given into a vein (intravenous, or by IV) may cause nausea and vomiting much faster than a medicine given by mouth. This is because the medicine given by IV is absorbed faster
  • individual differences – not every person will have the same response to a dose or type of chemo.

Medicines to prevent and treat nausea and vomiting have greatly improved over the past decade. It’s easier to prevent nausea and vomiting than it is to stop it once it starts. No one anti-sickness medication can prevent or control chemo-related nausea and vomiting 100% of the time. This is because chemo acts on the body in different ways and each person responds to chemo and to anti-nausea/vomiting medicines differently. Your doctor will discuss the best options for you and work on a treatment plan that best suits your needs.

References

  1. Drugs used in nausea and vertigo New Zealand Formulary
Credits: Sandra Ponen, pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 18 Apr 2019