5-HT3 receptor antagonists
Drugs which bind to 5-HT3 receptors in the central nervous system and gastrointestinal tract are known to reduce nausea by inhibiting binding to the receptor which induces vomiting.
- Dolasetron (Anzemet) can be administered in tablet form or in an injection.
- Granisetron (Kytril, Sancuso) can be administered in tablet (Kytril), oral solution (Kytril), injection (Kytril), or in a single transdermal patch to the upper arm (Sancuso).
- Ondansetron (Zofran) is administered in an oral tablet, orally dissolving tablet, orally dissolving film, or in an IV/IM injection.
- Tropisetron (Setrovel, Navoban) can be administered in oral capsules or in injection form.
- Palonosetron (Aloxi) can be administered in an injection or in oral capsules.
- Mirtazapine (Remeron) is an antidepressant that has antiemetic effects and is also a potent histamine H1 antagonist.
Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting or for those who are unresponsive to other agents. These may cause changes in perception, dizziness, and loss of coordination.
- Cannabis - In the United States, this is a Schedule I drug.
- Dronabinol (Marinol) is a Schedule III drug in the United States.
- Synthetic cannabinoids such as nabilone (Cesamet), the JWH series, or 5F-PB-22.
- Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe, but is not legal in the United States.
- Midazolam given at the onset of anaesthesia has been shown in recent trials to be as effective as ondansetron.
- Lorazepam is said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran.
H1 histamine receptor antagonists are effective for many conditions including motion sickness, morning sickness in pregnancy, and to combat opioid nausea.
- Diphenhydramine (Benadryl)
- Dimenhydrinate (Gravol, Dramamine)
- Meclozine (Bonine, Antivert)
- Promethazine (Pentazine, Phenergan, Promacot) can be administered via a rectal suppository for adults and children over 2 years of age.
- Ginger contains the 5-HT3 antagonists gingerols and shogaols.
- Lemon essential oil is reported to be an effective anti-nausea agent. The oil can be consumed in a capsule or applied to the skin via a carrier oil.
- Emetrol is claimed to be an effective antiemetic.
- Propofol given intravenously has been used in an acute care setting in hospitals as a rescue therapy for emesis.
- Peppermint is claimed to help nausea or stomach pain when added into tea or peppermint candies.
- Ajwain is a popular nausea relieving spice in India, Ethiopia and Eritrea.