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Coping with Nausea and Vomiting From Chemotherapy

Many people fear that they will have nausea and vomiting while receiving chemotherapy. However, these side effects are less common and often less severe than most people think. Effective antivomiting drugs can prevent or lessen nausea and vomiting in most people.

It is important that you tell your doctor or nurse if you have these symptoms, especially if the vomiting lasts more than a day or if you cannot keep liquids down. You may feel sick a few hours after chemotherapy. Some people also have delayed side effects, feeling nauseous and vomiting a few days after treatment. This is still related to treatment, so be sure to tell your healthcare team.

Antinausea and Antivomiting Drugs    TOP

There are several drugs available that are used to prevent or treat nausea and vomiting (called antiemetics). If you are taking chemotherapy drugs that carry a high risk of nausea and vomiting, you may receive treatment in advance of chemotherapy. Drugs can be given by mouth, injection, patch, or as a suppository.

Vomiting results from a complex set of nerve pathways between the brain and digestive system. Drugs work on these different pathways to ease symptoms. Examples include:

  • 5-hydroxytryptamine-3, dopamine, NK-1, and serotonin antagonists.
  • Cannabinoids—May be an option if other methods fail. Cannabinoids are also used to stimulate your appetite. Proper nutrition is important during cancer treatment.
  • Corticosteroids
  • Antacids

Remember that different drugs work for different people and finding the right combination can take some time. Your healthcare team will work with you to find the right combination.

Make arrangements with your insurance company in advance. Some drugs may not be covered under your current plan. If not, make sure to discuss your options with your healthcare team.

Tips for Coping    TOP

In addition to taking your medication, here are some steps that you can take to reduce nausea and vomiting:

  • Food and drink tips:
    • Eat and drink slowly.
    • Drink small amounts throughout the day. Good choices include water, unsweetened fruit juices, such as apple or grape juice, and light-colored, decaffeinated sodas, such as ginger ale. Keep in mind you should drink sodas that have lost their fizz.
    • Try to eat smaller meals spread throughout the day, instead of 3 big meals. Examples of foods that you may be able to tolerate well include: broiled or baked skinless chicken, cooked cereal, such as oatmeal, crackers, pretzels, pasta, white rice, and skinless, boiled potatoes.
    • Chew your food well.
    • Avoid sweet, fried, or fatty foods.
    • Take a short rest after you eat, but avoid lying flat for at least 2 hours.
    • Eat foods cold or at room temperature so you will not be bothered by strong smells.
    • If nausea is a problem in the morning, try eating dry foods, such as cereal, toast, or crackers.
    • Prepare and freeze meals in advance for days when you do not feel like cooking. You can also ask friends or family to cook meals for you.
  • Other home care tips:
    • Try to avoid other strong odors, like tobacco smoke.
    • Wear loose comfortable clothes.
    • If you are feeling nauseated, take deep breaths.
    • Try to to get involved in enjoyable activities, like watching your favorite show or talking with friends.
    • Try to take short walks outside. Light exercise will help clear your mind and boost your energy.
    • Use relaxation techniques, like meditation.

RESOURCES:

American Cancer Society
https://www.cancer.org
National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

References:

Chemotherapy and you. National Cancer Institute website. Available at: https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Accessed November 9, 2017.
Coping with nausea and vomiting from chemotherapy. Cancer Care website. Available at: https://media.cancercare.org/publications/original/7-ccc_nausea_chemo.pdf. Accessed November 9, 2017.
Managing nausea and vomiting at home. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/nausea-and-vomiting/nausea-and-vomiting.html. Updated February 13, 2017. Accessed November 9, 2017.
Medications to prevent and treat nausea and vomiting. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/nausea-and-vomiting/nausea-and-vomiting-drugs.html. Updated February 13, 2017. Accessed November 9, 2017.
Toxicities of chemotherapeutic agents. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 23, 2017. Accessed November 9, 2017.
Last reviewed November 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 11/9/2017

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