There are many anti-nausea medications that have become available in recent decades. Your doctor will decide which (if any) medications to prescribe, based on the type of chemotherapy you are receiving and the anticipated severity of nausea and vomiting side effects. Your age, gender and other health conditions may also be a factor in your doctor’s recommendation.
If you are receiving treatment in a clinic or hospital, you will usually receive anti-nausea drugs intravenously (delivered through a needle into a vein). Some anti-nausea medications are also available in pill or liquid form or as a suppository (a soft preparation containing medication that dissolves in the rectum).
After chemotherapy, you may also be given anti-nausea medications to take at home. It’s important to understand how these drugs should be taken. Some medications are designed to be taken regularly for several days, whether you feel nauseated or not. Other medications are meant to be taken only when you feel symptoms. If you have any questions about when you should take your anti-nausea medication, be sure to contact your health care team.
Types of Anti-Nausea Drugs
Medications such as lorazepam (Ativan and others) or diazepam (Valium and others) are used to help block nausea and vomiting. These sedatives can be given intravenously and in pill form. Benzodiazepines such as lorazepam and diazepam do not stop nausea and vomiting directly, but they help other anti-nausea medicines work effectively and relieve the anxiety that people can feel when they believe they’re about to experience these symptoms.
To avoid becoming dependent on such medications, a careful schedule should be worked out with your doctor or nurse. They can also effectively relieve the anxiety that people can feel when they believe they’re about to experience these symptoms.
Corticosteroids, which are related to the natural hormone cortisol, are widely used to help prevent nausea and vomiting caused by chemotherapy. They have been successfully used for many years, especially to prevent delayed nausea and vomiting. Corticosteroids such as dexamethasone (Decadron, Hexadrol and others) can be given in different forms and are often combined with other anti-nausea drugs for maximum benefit.
Serotonin antagonists are often used to counter nausea and vomiting resulting from chemotherapy drugs that can cause stronger nausea or vomiting, such as cisplatin (Platinol and others) and cyclophosphamide (Cytoxan, Neosar and others). Serotonin antagonists stop serotonin (a substance occurring naturally in the brain) from sending a signal that causes vomiting. These drugs are usually administered intravenously before chemotherapy begins.
One of these drugs, palonosetron (Aloxi), was specifically tested to work for days after a single injection. It can prevent both acute and delayed nausea and vomiting. Other similar serotonin antagonists include ondansetron (Zofran and others), granisetron (Kytril) and dolasetron (Anzemet). Like palonosetron, dolasetron is given as an injection. Ondansetron is given in tablet or liquid form, and granisetron is given either via an injection or in tablet form.
Aprepitant (Emend) works in the vomiting center of the brain to prevent nausea and vomiting caused by chemotherapy. It blocks the action of substance P, a peptide that triggers nausea and vomiting reflexes. Aprepitant is sometimes given in combination with corticosteroids and serotonin antagonists. It is available as a capsule and is taken before a chemotherapy session and for two days afterward. A related drug, fosaprepitant dimeglumine (Emend for Injection), gives patients receiving chemotherapy another option for preventing nausea and vomiting. It is delivered intravenously and converted to aprepitant in the body.
Cannabinoids contain the active ingredient found in marijuana. For a number of years doctors have prescribed dronabinol (Marinol) as an anti-vomiting medication. In 2006, the U.S. Food and Drug Administration approved nabilone (Cesamet), which can control chemotherapy-related nausea and vomiting in cancer patients who have not been adequately helped by other anti-nausea medications. Cannabinoids can be taken in combination with, but not as a replacement for, other types of anti-nausea drugs. These pill forms of cannabinoids are made with the same safety and purity standards for all prescription drugs.
They are safer to use than other commercially available forms of marijuana products as they are the specific sub-types of cannabis that most suppress nausea and vomiting. Smoked cannabis is best avoided since the burning process irritates the mouth and throat and can introduce sources of infection at a time when the system is least able to fight it off.