Chemotherapy nausea and vomiting: Prevention is best defense
How do doctors prevent nausea and vomiting?
Most people undergoing chemotherapy receive anti-nausea (anti-emetic) medications to prevent nausea and vomiting. These drugs, given alone or in combination, can be taken in pill form or administered through a vein in your arm. Your doctor advises which to use based on the treatment you're receiving.
Anti-nausea medications are typically given before treatment begins and on a scheduled basis for several hours or days after treatment. You may receive additional medications if you develop nausea and vomiting after chemotherapy.
Your doctor determines which anti-nausea medications to use based on your specific situation, for example, what type of chemotherapy drugs you're receiving. Drugs used to prevent nausea and vomiting include:
- Aprepitant (Emend)
- Dolasetron (Anzemet)
- Dronabinol (Marinol)
- Droperidol (Insapsine)
- Granisetron (Kytril)
- Haloperidol (Haldol)
- Methylprednisolone (Medrol)
- Metoclopramide (Reglan)
- Nabilone (Cesamet)
- Ondansetron (Zofran)
- Palonosetron (Aloxi)
- Prochlorperazine (Procomp)
Drugs used to treat anxiety associated with chemotherapy nausea include:
- Alprazolam (Niravam, Xanax)
- Lorazepam (Ativan)
Doctors take this proactive approach to prevent nausea and vomiting because these side effects can be difficult to control once they begin. Nausea and vomiting can make you feel miserable, add to your fatigue and distress, and make you reluctant to stick to your treatment schedule. If you're unsure about taking anti-nausea medication when you aren't feeling nauseated, talk to your doctor about the risks and benefits of these drugs.
What additional measures can you take to prevent nausea and vomiting?
You can take steps to reduce your risk of nausea and vomiting. For example:
- Eat small meals. Stagger small meals throughout the day rather than eating fewer, larger meals. If possible, don't skip meals. Eating a light meal a few hours before treatment also may help.
- Eat what appeals to you. It's best, however, to avoid foods that are sweet, fried or fatty. In addition, cool foods may give off less bothersome odors. Cook and freeze meals in advance of treatment to avoid cooking when you're not feeling well. Or have someone else cook for you.
- Drink lots of fluids. Try cool beverages such as water, unsweetened fruit juices, tea or ginger ale that's lost its carbonation. It may help to drink small amounts throughout the day, rather than larger amounts less frequently.
- Avoid unpleasant smells. Pay attention to what smells trigger nausea for you. For some, a specific smell, such as the smell of something frying or a greasy smell, may cause nausea. Other people may experience nausea when smelling any strong odor. Limit exposure to unpleasant smells. Fresh air may help.
- Make yourself comfortable. Rest after eating, but don't lie flat for a couple of hours. Try wearing loosefitting clothing and distracting yourself with other activities.
- Use relaxation techniques. Examples include meditation and deep breathing.
These self-care measures may help you prevent nausea and vomiting, but they can't take the place of anti-nausea medications. If you begin to feel nauseated despite the medications, call your doctor. Treatments may include additional medications, though your individual treatment will depend on what's causing your signs and symptoms.Previous page
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- Antiemesis. Fort Washington, Pa: National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. http://www.nccn.org/professionals/physician_gls/PDF/antiemesis.pdf. Accessed March 11, 2011.
- Nausea and vomiting. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/patient/allpages. Accessed March 11, 2011.
- Eating hints: Before, during and after cancer treatment. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/eatinghints/AllPages. Accessed March 11, 2011.