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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

again 1

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

vomiting are:

Relaxation techniques

– breathing exercises,

focusing the mind (meditation), or tensing and

relaxing the muscles.


– trance-like state of deep relaxation

guided by a trained specialist.

Guided imagery

– focusing on positive images

in your mind.

Music therapy

– therapy using music.

Acupuncture and acupressure

– needles

(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