NCCN Guidelines for Patients
Nausea and Vomiting, Version 1.2016
Preventing and treating
How are nausea and vomiting treated?
Some medication might not work for you. Be honest
with your medical team about how you are feeling.
Sharing your side effects and tracking how you feel,
let’s say in a journal or app, may help find the pattern.
You want to pay close attention to when you are
nauseated or actually vomit.
See Guide 3
for a list
of common anti-nausea and vomiting drugs you may
hear about from your doctor, pharmacist, or even
other people you know with cancer.
Getting the medicine
Keep in mind, like any drug, they are many types
and even certain ways they are given. For example,
your doctor may suggest granisetron or ondansetron
with or without dexamethasone for radiation-induced
nausea and vomiting. If you have acute (or sudden)
nausea and vomiting, you may be given ondansetron,
granisetron, dolasetron, or palonosetron to prevent
it. Your doctor will go with what is proven to work in
preventing the type of nausea and vomiting. He or
she will move on to the next drug or combination of
drugs if the first try didn’t work.
Some drugs come in different forms. This includes
pills, liquid [injected into a vein (IV) or muscle (IM;
uscular], rectal suppository (inserted into the
rectum), or transdermal (patch on the skin). The
treatment may be taken at a certain time of the day.
This might be in the AM or PM, once a day, or more
than once a day. Usually, the drugs are given before
your cancer treatment. For example, for anticipatory
nausea and vomiting, your doctor can consider giving
you an anxiety-reducing drug (benzodiazepine). You
would take it the night before chemotherapy and
2 hours before chemotherapy. If you have
questions about how much or when to take any type
of anti-nausea or vomiting drugs, ask your doctor or
pharmacist for more information.
Other therapy for nausea and vomiting
Other ways to prevent nausea and vomiting are
complementary therapy. They can be used with the
drug or alone to help treat nausea and vomiting.
Complementary therapies are meant to be used
alongside standard therapies, most often to prevent
or reduce side effects. They can be very helpful for
coping with side effects like nausea. Some types of
complementary therapy used to treat nausea and
– breathing exercises,
focusing the mind (meditation), or tensing and
relaxing the muscles.
– trance-like state of deep relaxation
guided by a trained specialist.
– focusing on positive images
in your mind.
– therapy using music.
Acupuncture and acupressure
(acupuncture) or pressure (acupressure) for
Let the doctor know . . .
You may think about trying
complementary therapy. Let your doctor
and pharmacist know if you want to use
other types of complementary therapies
like nutritional supplements, vitamins,
or herbs. These therapies may not help
and can interfere with some cancer