Nausea and/or vomiting is one of the most feared complications of chemotherapy from a patient standpoint. Different chemotherapy drugs may cause varying degrees of nausea, while biologic drugs in general will not cause nausea. Some chemotherapy drugs such as cisplatin, carboplatin, and dacarbazine may cause delayed nausea which occurs several days after the date that chemotherapy is given.
With current anti nausea medication (when used in effective regular schedules) many patients can receive their chemotherapy with minimal amounts of nausea. It is important to remember that if your medication regimen is not working, changes need to be made to the regimen. These changes include:
- Making sure you take your anti nausea medication on a schedule regardless of whether you are experiencing nausea at that time
- If you cannot swallow pills, use a patch, suppository, or lozenge. If these do not work, it is time for IV antinausea therapy given either in a clinic or hospital.
- Increasing the frequency of your anti nausea medication
- Adding another medication from another class of anti nausea agents
Classes of anti nausea medication
Corticosteroids (Decadron, or dexamethasone)
These are one of the cheapest and most effective drugs to prevent nausea; important side effects with short term use are elevated blood sugar (especially in diabetics) and insomnia. They have many long term side effects if used chronically (development of diabetes, fat redistribution, skin thinning, osteoporosis, cataracts, glaucoma).
Serotonin Receptor Antagonists (Zofran, Kytril, Sancuso patch, Aloxi, Anzemet)
These agents have very few practically seen side effects and are often given those with chemotherapy as iv, and after chemotherapy as pills. Sancuso is a patch delivery system that eliminates the need to remember to take your pills after chemotherapy to prevent nausea. Of course, the only downside is the patch falls often and you don’t realize it.
Neurokinin Receptor Antagonists (Emend)
This is one of the newest antinausea medications that is used in combination with Decadron and serotonin receptor antagonists. Really not many side effects practically seen.
Dopamine Receptor Antagonists (Compazine, Reglan)
These are supplemental antinausea medications that can be useful. Compazine is available in suppository form. Taking too much of these medications can produce muscle twitches and sedation.
Histamine Receptor Antagonists (Phenergan)
Another nice supplemental antinausea medication that can be useful. Taking too much of this medication can produce muscle twitches and sedation.
Benzodiazepines (Ativan, Xanax)
Supplemental antinausea medications. Taking these medications can produce sedation.
Supplemental antinausea medication. It is a derivative of marijuana. This medication can produce both sedation and confusion.
Other things you can do
Acupuncture (this really does work, and has evidence to back this up)