Frequently Asked Questions About Nausea and Vomiting Treatments

Antiemetic drugs are medicines that help to cope with nausea. They are also called anti-nausea medicines.

The mechanism of the medicines from the group is aimed at the stopping of nausea which is achieved through the blocking of serotonin, dopamine, H 1-histamine and M-cholinergic receptors.

Anti-nausea medications are used for various conditions in which nausea is present including:
– Digestive tract diseases;
– Sea or air sickness;
– Meniere's disease;
– Appendicitis;
– Due to the chemotherapy course;
– Overeating and eating fatty foods;
– Psychogenic reactions: stress, neurosis, anxiety;
– Side effects of drugs;
– Solar or heat stroke;
– Fever;
– Food allergy.

You may wonder why we hadn’t listed poisoning or pregnancy since these are situations in which vomiting is quite common. But only a medical specialist can decide whether a pregnant woman can use any medicines against nausea primarily in the first three months of gestation and in general it is highly not advised. As for poisoning, nausea and vomiting contribute to the washing out of hazardous substances in the body so it’s not advised to use anti-nausea medicines unless prescribed by a medical specialist.

An anti-nausea effect can have substances that affect the various elements of nervous regulation. They are chosen by the cause of nausea:
– When vomiting is induced by local irritation of the stomach, enveloping and astringent agents, as well as local anesthetics, are effective;
– Some neurotropic drugs reduce the excitability of the emetic center and trigger zone. The latter contains dopamine, cholinergic (muscarinic), histamine (H1) and serotonin receptors - their blockade causes the effect. These medicines are effective for nausea of any nature including vestibular vomiting (sea sickness);
 – An important role in the mechanism of nausea and the action of antiemetics is played by serotonin (5-HT3) receptors. The action on serotonin (5-HT3) receptors is related to the action of ondansetron, tropisetron, which are helpful in vomiting induced by anticancer drugs (chemotherapy). It became possible to significantly raise the dosage of the latter with the use of potent antiemetics. Metoclopramide also supresses serotonin (5-HT3) receptors, while simultaneously blocking dopamine (D2) receptors;
Cholinolytics, H1-antihistamines (diphenhydramine, promethazine, Dimenhydrinate by R.P.G. Pharmaceuticals, etc.) are used in the prophylaxis and treatment of sea and air sickness, Meniere's disease. Effective antiemetic agents are neuroleptics from the group of phenothiazine and butyrophenone, which act on dopaminergic systems. Perphenazine, prochlorperazine, trifluoperazine, thiethylperazine, and others have a high antiemetic activity in the range of phenothiazine derivatives, and haloperidol and others in the series of butyrophenones;
– There are also combined action medications such as Metoclopramide found under different trade names. It is a selective blocker of dopamine and serotonin receptors. He is more active than others. The formulation has an anti-emetic and anti-hiccups effect. It normalizes the gastrointestinal tract function and facilitates healing of ulcers. As an antiemetic, Metoclopramide is appointed for cardiac glycoside intoxication; prevention of side effects of antibiotic cytostatics in individuals with gastritis, and for other causes including nausea induced by chemotherapy, after surgery, or the symptom associated with migraines.

There are different medications that help to cope with nausea and their contraindications for use also differ. Some of them although are common and they include:
– Intolerance of the formulation’s components, i.e. allergic reactions occurring after the pills use;
– Young age (different medicines are not allowed for children aged less than 2 years or older);
– Pregnancy;
– Bleeding of the stomach;
– Obstruction of the bowel;
– Digestive tract perforation;
– Dyskinesia induced by neuroleptics;
– Epilepsy;
– Parkinson's disease;
– Same-time use with Levodopa or dopaminergic agonists;
– Established methemoglobinemia related to the use of Metoclopramide;
– Increased convulsive readiness.

As we have already mentioned, there are different anti-nausea formulations with different mechanisms of action but there are some common adverse reactions that may develop:
– Dry mouth, nose and throat;
– Loss of appetite;
– Sleepiness;
– Accommodation disturbance;
– Facial flushing;
– Shortness of breath;
– Confusion;
– Convulsions (in kids);
– Hallucinations;
– Weakness;
– Fatigue;
– Impaired concentration;
– Headache;
– Lightheadedness;
– Anxiety;
– Nervousness;
– Drowsiness;
– Insomnia;
– Rarely - weakening of night and color vision, impaired accommodation;
– Low arterial tension;
– Rapid heartbeat.

The above-listed symptoms are commonly eliminated with the dosage lowering.

Allergic reactions (skin rash, swelling of the tongue, lips, or face). If they occur, the therapy must be discontinued and another medication is chosen.

In long-term use of Metoclopramide in senior individuals, the symptoms of Parkinsonism may appear. It can also cause gynecomastia (a growth in the breasts in men), galactorrhea (milk dripping from the breasts) or period disorders; with the appearance of these symptoms, Metoclopramide is withdrawn.

Yes, it is possible to combine anti-nausea drugs with other medications but some of them are incompatible with certain drugs so you must discuss the possibility of their use with the other therapy that you undergo.

In general anti-nausea medications are highly not recommended for women who expect a baby because they can severely damage the fetus. It is especially contraindicated to take any medications during the first months of gestation. In the last two trimesters, the medications can be taken only if a physician approves and believes that the risk is lower than the benefit (for instance, Metoclopramide is one of the potentially allowed medicines but only in extreme life-threatening vomiting).

Pregnant women can use certain anti-nausea medications but only based on herbs and only if their doctor approves. They can be based on artichoke leaves or other choleretic agents that accelerate bile movement and contribute to its rapid outflow. As a result, the stomach and liver are unloaded, and nausea disappears.

It is also allowed to use herbal soothing teas based on mint, valerian, calendula, and other herbs. But it is better to check in advance the reaction of the organism that occurs when it is used and consult a specialist. Please note that even herbal medicines must be used very cautiously and only after the approval of your doctor. Even herbal teas during pregnancy must be used in limited amounts not to interfere with the fetus development.

There are medications that can be given to kids but it’s preferable to stick to herbal medications or medicines that improve digestion. Or, if the nausea is intense, consult a pediatrician.

The recommended medicines include:
– Diosmectite (brand names Smecta, Smecdral) is one of the primary medications for even babies in nausea and poisoning;
– Domperidone (Motilium) in a form of suspension is given to babies and older kids for lowering of nausea and vomiting;
– Pancreatic enzymes in pills. They contain enzymes that help digest food and can be used in kids with indigestion, nausea, and if appointed by a pediatrician for intestinal infections;
– Dimenhydrinate can be given to kids older than two years for sea and air sickness.