That awful churning in your stomach, the clammy sweat, the feeling that you just can’t keep anything down… we’ve all been there, haven’t we? Whether it’s a nasty stomach bug, the relentless waves of morning sickness, or the after-effects of a necessary medical treatment, nausea and vomiting can truly knock you off your feet. It’s more than just uncomfortable; sometimes, it can lead to bigger problems if it goes on for too long. That’s where antiemetic drugs can be a real help.
So, What Exactly Are Antiemetic Drugs?
Let’s break down that term. “Anti-” simply means “against,” and “-emetic” comes from “emesis,” which is our medical way of saying vomiting. So, antiemetic drugs are medications designed to help prevent or stop nausea and vomiting. Think of them as your body’s allies when that queasy feeling takes over.
You might find some of these over-the-counter (OTC) at your local pharmacy, while others need a prescription from a doctor like me. Because there are so many reasons why you might feel nauseous or vomit, different types of antiemetics work best for different situations.
When Might We Talk About Using Antiemetic Drugs?
Vomiting isn’t always a bad thing. Sometimes, it’s your body’s smart way of getting rid of something harmful, like spoiled food or a virus. But when vomiting is severe, or it just won’t stop, it can cause real issues. We’re talking about things like:
- Dehydration (this is a big one!)
- Losing your appetite and not getting enough nutrients (malnutrition)
- Feeling weak and tired
- In rare cases, more serious problems like damage to your esophagus (the tube from your mouth to your stomach) or even bone fractures from forceful vomiting.
So, in certain situations, we’ll definitely want to consider antiemetics.
Tackling Ongoing Nausea and Vomiting
If you’re dealing with nausea and vomiting that’s persistent or really severe, an antiemetic might be part of the plan. This is common for:
- Chemotherapy-induced nausea and vomiting (CINV): Many folks undergoing chemotherapy experience this. It can be tough, and managing it is a priority. We often use antiemetics before treatment starts to prevent it. The same goes for radiation therapy to certain parts of the body.
- Pregnancy-related nausea and vomiting (“morning sickness”): Oh, this one is so common. For some, it’s mild, but for others, it can be quite debilitating. There are safe options we can discuss, including for a more severe form called hyperemesis gravidarum.
I always tell my patients, especially those undergoing cancer treatment or who are pregnant, to talk with us before trying anything on their own. We might even use a couple of different types of antiemetics together for the best effect, particularly for CINV.
Preventing Short-Term Nausea and Vomiting
Sometimes, we know nausea and vomiting are very likely to happen, even if just for a short while. In these cases, we can be proactive:
- Postoperative nausea and vomiting (PONV): Anesthesia and some pain medications used during and after surgery can, unfortunately, make you feel queasy. It’s pretty standard for us to give an antiemetic beforehand to try and stop this before it starts.
- Motion sickness and vertigo: If you know you’re prone to feeling sick on a boat or a winding car ride, or if vertigo triggers nausea for you, taking an antiemetic ahead of time can make a world of difference.
There might be other times I’d suggest an antiemetic too. It really depends on your specific situation.
What Are the Different Kinds of Antiemetic Drugs?
It’s not a one-size-fits-all situation. There are several “families” of antiemetic drugs, and each works a bit differently.
Serotonin Antagonists
These are quite common and specifically target nausea and vomiting. You might hear names like:
- Ondansetron (Zofran®)
- Granisetron (Kytril®)
- Palonosetron (Aloxi®)
They’re often our go-to for preventing CINV, radiation-induced nausea, and PONV.
Antihistamines
You know antihistamines for allergies, right? Well, some of them also do a good job with nausea and vomiting, especially from motion sickness or vertigo. Examples include:
- Dimenhydrinate (Dramamine®)
- Diphenhydramine (Benadryl®)
- Meclizine (Antivert®, Bonine®)
- Doxylamine succinate (often combined with vitamin B6, this is a first choice for morning sickness)
- Promethazine (Phenergan®)
Glucocorticoids
These are a type of steroid, like dexamethasone. We often use them to prevent CINV and PONV, sometimes along with other antiemetics. One thing to know is they’re better at preventing nausea than stopping it once it’s started.
Anticholinergics
These drugs block a chemical messenger in your body called acetylcholine. Scopolamine (often a patch you wear behind your ear) is the main one we use as an antiemetic, particularly for motion sickness and PONV.
Neurokinin-1 (NK-1) Receptor Antagonists
These work by blocking a substance in your brain that triggers nausea. They’re effective for CINV and PONV. Some names you might encounter:
- Aprepitant (Emend®)
- Fosaprepitant (Emend®)
- Rolapitant (Varubi®)
Dopamine Antagonists
These medications are also used for other conditions, like certain mental health issues, but some can help with nausea and vomiting when other antiemetics haven’t done the trick for CINV, or to help with PONV. Examples include:
- Metoclopramide (Reglan®)
- Prochlorperazine (Compro®)
- Olanzapine (Zyprexa®)
Cannabinoids
These are derived from or mimic compounds found in the cannabis plant.
- Dronabinol (Marinol®)
- Nabilone (Cesamet®)
These are typically considered if other antiemetics haven’t worked for CINV. We’re still learning a lot about how these work best.
How Do I Take Antiemetic Drugs?
They come in a few different forms, which is handy:
- Pills you swallow or chew
- Given directly into a vein (IV)
- As an injection into a muscle
- Skin patches (like scopolamine)
- Rectal suppositories (a pill that dissolves in the rectum)
What About Side Effects?
Like any medication, antiemetics can have side effects. It really depends on the specific drug. I always make sure to go over these with my patients. Some common ones, but this isn’t a full list:
- Serotonin antagonists: Headache, dizziness, constipation.
- Antihistamines: Drowsiness is a big one.
- Glucocorticoids: Can sometimes cause trouble sleeping, feeling agitated, or mood changes.
- Anticholinergics: Dry mouth, blurry vision, drowsiness.
- NK-1 receptor antagonists: Headaches, dizziness. Rarely, some people can have a serious allergic reaction.
- Dopamine antagonists: Dizziness, headache. Sometimes they can cause movement issues, like muscle stiffness or involuntary movements, especially with long-term use.
- Cannabinoids: Dizziness or lightheadedness, low blood pressure, and sometimes an uneasy feeling (dysphoria).
If you start an antiemetic and notice any side effects that bother you, please let your doctor know. We can often find an alternative or adjust things.
Can I Take Antiemetics If I’m Pregnant?
This is such an important question. If you’re pregnant and struggling with nausea and vomiting, please talk to your obstetrician-gynecologist (Ob/Gyn) or family doctor. There are dietary changes we might suggest first. If those don’t cut it, we can discuss medications.
Many studies show certain antiemetics are generally safe during pregnancy. But for others, the information isn’t as clear. It’s a conversation we’ll have together to weigh the benefits and any potential risks for you and your baby. And always, always check with your doctor before starting any new medication when you’re pregnant.
What If I Miss a Dose?
If you miss a dose, especially if you’re taking it to prevent something like CINV, it’s best to call your doctor or pharmacist. They’ll tell you the best way to get back on track. Don’t just double up on your next dose unless they specifically tell you to.
Key Things to Remember About Antiemetic Drugs
Here’s a quick recap:
- Antiemetic drugs are medications that help prevent or treat nausea and vomiting.
- They’re used for various reasons, from motion sickness and morning sickness to side effects of chemotherapy (CINV) or surgery (PONV).
- There are many different types, and the best one for you depends on the cause of your nausea.
- Always talk to your doctor before starting an antiemetic, especially if you’re pregnant or have other health conditions.
- Side effects can occur, so discuss any concerns with your healthcare provider.
- Don’t suffer in silence! If nausea and vomiting are affecting your life, we have ways to help.
You’re not alone in dealing with these unpleasant symptoms. We’re here to figure out the best approach to help you feel better.