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Types of anti sickness drugs
Useful information for cancer patients
Contents
This information is about the types of
drugs used to control sickness in cancer
care. There are sections on
• Drugs used to control sickness
• How anti sickness drugs work
• Specific anti sickness drugs
How anti sickness drugs work
Anti sickness drugs work by either
• Blocking the vomiting centre in the brain. The
vomiting centre is the part of the brain that
controls being sick.
• Blocking receptors in your gut that trigger nausea
in the brain
• Acting directly on your stomach by increasing the
rate at which it empties and moves food into your
bowel
You can view this information in a larger
print on our website.
Specific anti sickness drugs
There are lots of different types of drugs doctors use
for sickness. Here are some of the most common
Drugs used to control sickness
Over the past 20 years, the drugs used for cancer
sickness have got much better. These drugs are called
anti sickness drugs, anti nausea drugs or anti emetics.
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There are many different types of anti sickness
medicines. Your doctor decides which drugs to give
you based on whether your sickness is caused by
your cancer or its treatment, and your past medical
history such as epilepsy or Parkinson's disease, or
have problems with your heart, liver or kidneys.
If you still feel sick after taking your drugs, talk to your
doctor or nurse. Adding another type of anti sickness
drug may help or they may suggest that you change
to a different drug.
If you have any side effects that you think are due to
the anti sickness drugs, talk this over with your doctor
or nurse. Again, you may need a different type of
drug.
Metoclopramide (Maxolon)
Prochlorperazine (Stemetil)
Domperidone (Motilium)
Serotonin blockers
Anti anxiety drugs
Antihistamines
Steroids
Drugs to reduce intestinal liquid
Nabilone
Aprepitant and fosaprepitant
Other medicines
All these anti sickness drugs come in different
formulations. That means some are tablets, capsules
or liquid. Some are injected into a vein, or a muscle,
or just under the skin. If you are being sick a lot, a
useful way of taking anti sickness medicine is through
a syringe driver (a battery or clockwork operated
pump).
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Metoclopramide (Maxolon)
Metoclopramide (Maxolon) works by blocking the
vomiting centre. It also acts directly on the wall of the
gut. It encourages the stomach to empty its contents
into your bowel. Maxolon helps to get rid of the heavy
feeling that you can have when you feel sick. You can
have metoclopramide as a tablet, a liquid or an
injection. You usually take this for up to 5 days.
Prochlorperazine (Stemetil)
Prochlorperazine (Stemetil) belongs to the group of
drugs called phenothiazines. It is widely used.
Phenothiazines drugs act by blocking the vomiting
centre in the brain. Other drugs in this group are
perphenazine, trifluoperazine and chlorpromazine.
Chlorpromazine tends to make you drowsy, so is
used less often. You can have prochlorperazine as a
tablet that dissolves when you put it between your
gum and upper lip. This is useful if you are feeling too
sick to swallow, or find it hard to swallow tablets.
Prochlorperazine also comes as an ordinary tablet
and as a suppository.
Domperidone (Motilium)
Domperidone (Motilium) is like metoclopramide, it
speeds up the emptying of your stomach. It also acts
on a part of your brain called the chemoreceptor
trigger zone. It can work well for sickness from
various causes. An advantage of domperidone is that
it comes in a suppository. This is useful if you feel too
sick to swallow tablets. You usually only take
domperidone for up to a week.
Serotonin blockers
These drugs block receptors in the gut and brain that
send messages to the chemoreceptor trigger zone
and the vomiting centre. They are also called 5HT3
blockers.
Serotonin blockers work very well for some types of
sickness. They work best when you have steroids at
the same time. There are several drugs in this group,
including ondansetron (Zofran) and granisetron
(Kytril). Palonosetron (Aloxi) is a new type that also
belongs to this group. This drug works for a longer
period. These drugs come as tablets or injections.
Ondansetron is also available as a tablet that melts on
your tongue. And granisetron also comes as a patch
you put on your skin.
Anti anxiety drugs
Some anti anxiety drugs (tranquillisers) can reduce
sickness. Lorazepam (Ativan) is the drug from this
group that doctors most often use for chemotherapy
sickness. You will probably have it with other types of
anti sickness drugs.
You may have lorazepam to help treat anticipatory
nausea and vomiting. In this case, you may take it the
evening before and the morning of your
chemotherapy.
Antihistamines
Cyclizine is an antihistamine that doctors often use for
sickness. It is very soluble and mixes safely with other
drugs in a syringe driver to treat people who find
swallowing difficult for any reason.
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Steroids
Steroids can help to control sickness. They can help
particularly with sickness from
• Increased pressure in the skull (from a brain
tumour or secondary cancer in the brain)
• A blockage in the gut
• Some types of chemotherapy (when used with
other anti sickness drugs)
Steroids reduce swelling so they can help to lower
pressure in the skull, which causes sickness. They may
reduce swelling around a tumour blocking the gut
and help to allow fluids to pass through. This relieves
the vomiting that bowel obstruction can cause.
Steroids will only work for a limited time. But they
may help until you have other treatment. Or they can
help to make you more comfortable.
Dexamethasone is a steroid that you may have as an
injection into a vein just before chemotherapy. You
may have steroid tablets to take at home for a couple
of days after chemotherapy. Dexamethasone can
cause difficulty with sleeping and so it is better not to
take it in the evening if possible.
Drugs to reduce intestinal liquid
If you have a blockage in the gut you may have drugs
to reduce the amount of liquid in your intestines.
These drugs encourage the body to reabsorb fluids
from the digestive system. This reduces the build up
of fluid above the blockage. If there is less of a build
up, you won't feel so sick or need to be sick as often.
Buscopan (hyoscine butylbromide) reduces intestinal
liquid and is an anti spasm (cramps) drug. It helps to
reduce cramps by relaxing the smooth muscle in the
bowel and slowing down the movement of the
bowel.
Nabilone
Nabilone is a man made drug developed from
cannabis (marijuana). It is licensed for treating severe
sickness from chemotherapy that is not controlled by
other anti sickness drugs. It works very well for some
people, but can cause drowsiness or dizziness in
others. This can last for a couple of days after you've
stopped taking it.
Aprepitant (Emend) and fosaprepitant (Ivemend)
Aprepitant (Emend) is a newer drug which works by
blocking a substance in the body called neurokinin.
You might have it with steroids and serotonin
blockers to help control sickness caused by cisplatin
based chemotherapy. You take a tablet one hour
before chemotherapy and then one tablet a day for
the next 2 days. Fosaprepitant (Ivemend) is a similar
drug to aprepitant. This is only available as an injection
into the bloodstream through a cannula. It is also
used for sickness caused by cisplatin based
chemotherapy.
Other medicines
Sedatives can help to control sickness. Some anti
psychotic medicines such as levomepromazine
(Nozinan) can also help to control sickness, but may
make you drowsy unless they are used at a low dose.
Of course, this can be a helpful effect if you take them
at night.
Haloperidol (Haldol) is another sedative that is
particularly good for sickness due to medicines. So
doctors often use it for sickness related to morphine.
It is also used for sickness related to any imbalance of
chemicals inside the body – such as high blood
calcium levels (hypercalcaemia), or kidney or liver
failure. It is also used for sickness due to a blocked
bowel.
Octreotide (Sandostatin) can help to relieve the
sickness you get from a blockage in the gut by
reducing the amount of liquid produced in the bowel.
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Notes
For more information, visit our website http://www.cruk.org/about-cancer
You will find a wide range of detailed, up to date information for people affected by
cancer, including a clinical trials database that you can search for trials in the UK.
Our information is based on the best current scientific evidence and reviewed
regularly by leading clinicians and experts in health and social care.
For answers to your questions about cancer call our Cancer Information Nurses on
0808 800 4040 9am till 5pm Monday to Friday.
Adapted from Cancer Research UK’s website in February 2015. Cancer Research UK’s website is not designed to
provide medical advice or professional services and is intended to be for educational use only. The information
provided through Cancer Research UK’s website and our nurse team is not a substitute for professional care and
should not be used for diagnosing or treating a health problem or disease. If you have, or suspect you may have, a
health problem you should consult your doctor. Copyright Cancer Research UK 2015. Cancer Research UK is a
registered charity in England and Wales (1089464), Scotland (SC041666) and in the Isle of Man (1103)
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