Nausea and vomiting are common problems encountered by cancer patients. Many chemotherapy regimens can cause nausea/vomiting. Chemotherapy drugs that are highly associated with nausea and vomiting include: adriamycin (Doxorubicin), oxaliplatin (Eloxatin), cisplatin (Platinol), cyclophosphamide (Cytoxan), epirubicin (Ellence), and dacarbazine (DTIC).

Helpful tips for nausea and vomiting

If you notice a pattern to your nausea, such as it happens the third day after chemotherapy, you may want to take anti nausea medicine before the nausea starts.

Try bland foods, flat soda, ginger ale. Avoid spicy or fatty foods. Milk products may bother your stomach as well.

Over the counter antacid medications, such as omeprazole (Prilosec) 20 mg a day may help with nausea.

Some patients note sucking on hard candy while receiving chemotherapy may help.

Avoid strong smells if possible.

Promethazine (Phenergan) can be given as a topical gel if you cannot keep a tablet down, but this has to be made by a compounding pharmacy, and can be more expensive. Prochlorperazine (Compazine) is available as a suppository. Ondansetron (Zofran) is available as an oral disintegrating tablet.

If you feel dehydrated, (dizzy, weak, weight loss) let us know and we can hydrate you in the infusion room with intravenous fluids.

If you are having a difficult time with nausea and vomiting contact us, we are always happy to see you in the office or give advice over the phone.

Common anti nausea drugs:

Ondansetron (Zofran) 8 mg tablets. Take 1 tablet every 6 hours as needed. Side effects include constipation and headache. Because this medicine does not tend to cause sedation, try ondansetron first if you experience nausea. Some patients can be become constipated from this medicine. If this occurs, you may need to start a Senna (Senokot) laxative, 1 to 2 tablets daily as needed.

Compazine (Prochlorperazine) 10 mg tablets. Take 1 tablet every 6 hours as needed. Side effects include drowsiness and sedation. Rare side effects include fever, rigidity, sweating, hallucinations. If these occur, discontinue this medication and seek medical attention.

Dexamethasone (Decadron) 8 mg tablets. Take 1 tablet every 12 hrs as needed for nausea. Side effects include jitteriness, insomnia and high blood sugars.

Promethazine (Phenergan) 25 mg tablets. Take 1 tablet every 6 hours as needed. Side effects include drowsiness and sedation. Rare side effects include fever, rigidity, hallucinations. If these occur, discontinue this medication and seek medical attention.

OTHER MEDICATIONS THAT CAN HELP WITH NAUSEA:

Granisetron (Kytril): This is a serotonin receptor blocker. It does not have as much sedation as prochlorperazine (compazine) or promethazine (phenergan). Side effects include headache and constipation. Dosing is 1 mg every 12 hrs as needed.

Metoclopramide (Reglan): Dosing is 5 mg tablets, 1 to 2 every 6 hrs as needed.

Lorazepam (Ativan): This is a benzodiazepine medication similar to valium. Side effects include sedation and somnolence. Dosing is 0.5 to 1 mg every 4 hrs as needed.

Dronabinol (Marinol): This is a marijuana derivative that can help with nausea and also improve appetite in cancer patients. Keep refrigerated. Side effects include sedation and lethargy. Dosing is 5 to 10 mg every 3 hrs as needed.

Scopalamine transdermal patch q 72 hrs: This is an antihistamine patch that is placed behind the ear and changed every three days as needed. Side effects include drowsiness, dry mouth.

Olanzapine (Zyprexa): Side effects include sedation. Rare side effects include fever, rigidity, elevated blood pressures, sweating. Stop the medicine and seek medical attention should these symptoms occur. Dosing is 5 mg every 12 hrs as needed.

Omeprazole (Prilosec): This is an over the counter medicine that blocks the production of acid in the stomach and sometimes can help nausea. Side effects include diarrhea. Dosing is 20 mg daily.