A guide for patients and carers
Treatments that may cause nausea and vomiting . 2
Physical reasons that may cause nausea and vomiting . 2
Things you might like to do for yourself . 5
This information leaflet is about ways to help prevent or reduce nausea (feeling sick) and vomiting (being sick), which can sometimes be caused by cancer or its treatment. It covers the medicines that are commonly used, which are known as anti-emetic drugs (or anti-sickness), as well as containing other ideas to help you manage these side effects. This information should ideally be read with our general information about chemotherapy or radiotherapy.
The reasons why a person can feel sick or vomit are complicated. Within the body, nausea and vomiting are controlled by an area of the brain known as the vomiting centre. This area may be stimulated to cause nausea or vomiting by nerves within the stomach or other parts of the brain. Psychological and emotional factors can also influence whether a person feels sick.
Some types of chemotherapy can affect the vomiting centre or the
gut and cause nausea and / or vomiting.
Radiotherapy to the brain, stomach, bowel, or close to the liver may
lead to nausea and vomiting.
Morphine based medicines
These are used as painkillers. Some of these drugs can cause
and vomiting Sights and smells Other medication Constipation Anxiety - feeling anxious Anticipatory nausea - previous episodes of nausea and vomiting.
How anti-emetics workThe type of anti-sickness treatment you receive will depend on the cause.
Sometimes there is more than one cause of nausea and vomiting and more than one treatment may be needed. The drugs also work in different ways and are often used together to best effect.
Many different types of drugs are used to control nausea and vomiting. Some of these work on the brain by preventing the stimulation of the vomiting centre. Others work on the gut by speeding up the rate at which the stomach empties which helps move food through the intestines more quickly. The most effective way of controlling nausea and vomiting is by treating the cause, if possible.
Common anti-emetic tablets
Aprepitant (Emend) Dexamethasone Ondansetron (Zofran) Lorazepam Domperidome (Motillium) Cyclizine (Valoid) Levomepromazine (Nozinan) Haloperidol (Haldol) Metoclopramide (Maxolon) Prochlorperazine (Stemetil)
Possible side effectsSome anti-emetic drugs cause side effects. Different drugs will have different side effects and each person may react differently. Some of the more common effects are listed below:
(cyclizine, aprepitant, ondansetron) - This can be
relieved by drinking plenty of fluids, eating a high fibre diet and
taking gentle exercise. Sometimes you may need to take laxatives
to stimulate the bowel.
(ondansetron, cyclizine, aprepitant) - Let us know if
you get headaches whilst having one of these drugs as part of
your anti-emetic therapy.
Flushing of the skin
(ondasetron, dexamethasone) - Can cause
flushing or a warm sensation.
(cyclizine, haloperidol, levopromazine, aprepitant,
lorazepam) - May cause drowsiness in some people. It is important
to allow yourself plenty of time to rest, especially if you are having
chemotherapy or radiotherapy as part of your treatment.
- Can be caused by dexamethasone. It may help to
make sure that you always take the tablets with or after food.
- Can be caused by aprepitant.
- Dexamethsone may make it difficult for you to go
to sleep. This problem can be reduced by ensuring that you take
your last dose of the day at 2pm.
Urinary tension, blurred vision and dry mouth can all be
caused by cyclizine.
Things you might like to do for yourself
Diet - prepare small meals and eat little and often Relaxation - use relaxation tapes Avoid fried foods, fatty foods or foods with a strong smell Eat cold or warm food if the smell of hot food makes you feel
Eat several small snacks and meals each day and chew food well Peppermints or peppermint tea may help some people Sip drinks slowly Ginger biscuits or ginger beer Don't drink a lot just before you have something to eat
My Anti-sickness therapy diaryHow to use the diary
After you have taken each dose of your anti-sickness tablets, write
down the time you took them and the dose you took.
If you experience any side effects or have any questions for your
doctor or nurse, write them down in the'notes' section provided.
Please see below for an example of how to fill in the diary for your
anti-sickness regime.Anti-sickness diary example
How we produce our informationAll of our leaflets are produced by staff at The Clatterbridge Cancer Centre and this information is not sponsored or influenced in any way. Every effort is made to ensure that the information included in this leaflet is accurate and complete and we hope that it will add to any professional advice you have had. All our leaflets are evidence based where appropriate and they are regularly reviewed and updated. If you are concerned about your health in any way, you should consult your healthcare team.
We rely on a number of sources to gather evidence for our information. All of our information is in line with accepted national or international guidelines where possible. Where no guidelines exist, we rely on other reliable sources such as systematic reviews, published clinical trials data or a consensus review of experts. We also use medical textbooks, journals and government publications.
References for this leaflet can be obtained by telephoning 0151 482 7722.
If you need this leaflet in large print,
If you have a comment, concern, compliment
or complaint, please call 0151 482 7927.
The Clatterbridge Cancer Centre NHS Foundation TrustClatterbridge Road, Bebington,
Drug Category Reference State Toxicology Laboratory, Washington State Patrol Trade Names DRE Category Pharmacological Category Notes from the Lab Diabetics & Stimulant users who do not eat can be positiveMild stimulant compared to other ADHD drugs Used to treat obesity; metabolizes to methamphetamine Generally not impairing; Lab does not routinely reportAnti-convulsant;
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