7 Things to Know About Antiemetic OTC Drugs

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Medically reviewed by, Russell Braun RPH

What is an antiemetic drug?

The word emesis means the act or process of vomiting. Therefore, antiemetic drugs are ones that are used to prevent or stop vomiting.

Many antiemetic drugs are available over the counter (OTC). This means you can buy these drugs without a prescription from your doctor.

What about nausea?

Nausea is often part of the cycle of events that leads to vomiting, although not all bouts of nausea lead to vomiting. Due to this association most of the drugs used to treat vomiting will help lessen the feeling of nausea. In most cases the two symptoms are treated in the same way.

#1 When to use OTC drugs

Treating nausea and vomiting with OTC antiemetics is most appropriate when it is due to:

  • Motion sickness
  • Bad smell or odor
  • Overeating

Motion sickness

Many times travel in a car, boat or plane may induce a feeling of sickness. This is due to signals coming from your inner ears and eyes. When the signals from the ears and eyes do not match up, motion sickness can ensue. It can come on suddenly and may be preceded by dizziness.

Reading while riding in an automobile is a common cause of motion sickness. Your inner ear is detecting motion, but your eyes are focused on something. This crosses up the signals going to your brain. It is common for opening a window or looking off in the distance to make the motion sickness to go away.

If simple measures do not make the nausea go away, then over the counter products are the next step. Especially when used ahead of time, symptoms can typically be prevented all together.

Bad smell or odor

Overpowering odors can make your body prematurely go into a self defense mode. The body naturally tries to eliminate toxins through vomiting. Removing toxic or poisonous substances prevents them from harming you. When you sense a very bad smell, the body may think it needs to enact this defense mechanism.

Typically removing the source of the smell will make the nausea and vomitting cease. However, if the nausea persists this may be a good time for an over the counter medication for short term use.

Overeating

Overeating is a far too common problem for most in the western world. Portion sizes have increased at many restaurants in recent decades. Appetizers, entrees and desert can lead to a feeling of nausea simply from consuming too much food.

Obviously the best way to treat this is to stop eating so much at each meal. Using medication for overeating is typically not advised. Excessive vomiting can become problematic because too much stomach acid can do damage to the esophagus and throat. In that case over the counter medication might be necessary.

#2 When to ask your doctor before using OTC’s

While antiemetic medications can help decrease nausea severity, the nausea may be a sign of a larger problem that needs to be treated by a healthcare professional. Some examples include:

  • Food poisoning
  • Concussion
  • Heart attack
  • Virus
  • Medications
  • Surgery
  • Pregnancy

Food poisoning

Certain foods have toxins in them or may grow bacteria if left unattended that will produce toxins. Those toxins cause the nausea and vomiting known commonly as food poisoning. Typically, the symptoms resolve in a course of one to two days. Your doctor may want to ensure you have eliminated all the offending foods before any medications are used.

Concussion

Anytime that a concussion is thought to have occurred, nausea and vomiting may ensue. Typically this is more serious if it happens right after the injury. Many people with concussions will have nausea and possible vomiting in the days or weeks afterword. Anytime this occurs you should discuss with your doctor.

Heart attack

Most people think chest pain with heart attack. While that is true for most people, unexplained nausea and vomiting can also be a heart attack sign. This is much more common for women. Seek medical attention right away if you have chest pain, nausea/vomiting, shortness of breath and back, arm or jaw pain.

Virus

Viruses commonly cause nausea and vomiting. When there is diarrhea in addition to nausea and vomiting, a virus is typically the cause. Outbreaks are also common so if you know of others being sick, you may have been infected.

Medications

Medications are a very common source of nausea and vomiting. In some cases this is because of how they interact with parts of the brain that control nausea and vomiting. Some of the most widely use drugs over the counter for pain called NSAIDs irritate the lining of the stomach which generates nausea.

You should never rule out medications as a potential source of nausea and vomiting. Talk to your doctor or pharmacist about things you can do to lessen symptoms, such as taking medication with food.

Surgery

The trauma of surgery and drugs used for anesthesia are very likely to cause nausea and vomiting. In almost all cases drugs will be given before surgery to try and prevent symptoms. You should ask your doctor what you should do after going home if nausea and vomiting persist.

Pregnancy

The majority of all pregnancies will have some form of nausea. Vomiting is common as well but not as frequent as nausea. The hormonal changes occurring during pregnancy are the main trigger. If you think you may be pregnant you should discuss nausea and vomiting treatment with your doctor before using any OTC treatments.

#3 Who should not use OTC products

People with chronic medical conditions should check with their doctor or pharmacist to see if over the counter nausea and vomiting medicines are safe to use.

Vomiting that last for prolonged periods of greater than 24-48 hours can be dangerous due to dehydration. However, understanding how to use OTC antiemetics properly is key.

In addition to prolonged vomiting other signs you need to seek medical attention include:

  • Severe abdominal pain
  • Being severely dehydrated, example not producing urine or are lethargic
  • Blood present in vomit
  • Having trouble breathing
  • Heart is racing

#4 What is the best over the counter nausea medicine?

The type of antiemetic drug that is best will depend on what is producing your symptoms. Another key is the type of drug that has worked for you in the past. Some people will respond to a certain class of drug better than others. Factors like genetics, metabolism and body composition can all add to these differences.

Neurotransmitters that communicate signals from the brain to the stomach are the targets of most antiemetic drugs. The following are the different types of OTC antiemetic drugs:

  • Antihistamines
  • Bismuth subsalicylate
  • Phosphorated carbohydrate solution
  • Vitamin B-6 pyridoxine

Antihistamines

Antihistamines work on the signals that are being passed by the ear to the brain, which makes them particularly good for motion sickness. Taking them 30 to 60 minutes before the motion related event is the best way to prevent symptoms.

Meclizine

Available as genericBrand names: Antivert, D-vert
Dose25mg to 50mg 1 hour before motion event
Side effectsDrowsiness, blurred vision, dry mouth, urinary retention
Ask doctor firstLung disease, glaucoma, urinary retention, enlarged prostate

Dimenhydrinate

Available as genericBrand names: Dramamine
Dose50mg 1 hour before motion event
Side effectsDrowsiness, blurred vision, dry mouth, urinary retention
Ask doctor firstLung disease, glaucoma, urinary retention, enlarged prostate
Dramamine Original Formula Motion Sickness Relief | 36 Count

Bismuth subsalicylate

Bismuth subsalicylate works on the stomach lining to decrease the flow of fluids into your bowel. In addition the salicylate component is similar to aspirin. It can work to reduce inflammation and kill bacteria that can add to nausea and vomiting.

Pepto Bismol Liquid, 12 fl oz, 2 Pack, Nausea, Heartburn, Indigestion, Upset Stomach, and Diarrhea Relief, Original Flavor
Available as genericBrand names: Pepto-Bismol, Kaopectate
Dose30ml every 30 minutes x 2. No more than 8 doses per day
Side effectsDark, blackish stool, changes in tongue color
Ask doctor firstPregnant women, patients on blood thinners, diabetics patients with gout
Do not use in children under 12 years of age

Phosphorated carbohydrate solution

Phosphorated carbohydrate solutions provide a soothing effect on the digestive tract. They contain concentrated sugar and phosphoric acid.

Available as a genericBrand names: Emetrol
Dose15ml – 30ml every 15 minutes as needed, max of 5 doses
Side effectsDiarrhea, abdominal pain
Ask doctor firstDiabetics

Vitamin B-6 Pyridoxine

The B vitamins have many important functions in energy production in the body. Pyridoxine in particular has also been shown to be beneficial for treating nausea and vomiting. This is a good option in pregnant women as well as there are no concerns with pyridoxine during pregnancy.

Available as a genericBrand names: Vitamin B6
Dose25mg every 6 hours, max 200mg per day
Side effectsHeadache, loss of appetite
Ask doctor firstKidney problems
Nature Made Vitamin B6 100 mg Tabs, 100 ct

Other important things to remember

  1. Drink plenty of water or electrolyte solutions.
  2. If you vomit up the drug it is not likely to have an effect, you may need a patch or injection.
  3. Don’t mix antiemetics unless asking your doctor, as ingredients may overlap.
  4. Generics will be a cheaper option and have the same effects.

#6 Prescription antiemetic drugs

Nausea and vomiting problems that can’t be treated by OTC remedies will likely require a prescription medication. Your doctor has many options to choose from including:

Serotonin receptor blockers

  • Zofran (ondansetron)
  • Anzemet (dolasetron)
  • Kytril (granisetron)
  • Aloxi (palonosetron)

Dopamine receptor blockers

  • Compazine (prochlorperazine)
  • Reglan (metoclopramide)
  • Inapsine (droperidol)

Corticosteroids

  • Deltasone (prednisone)
  • Decadron (dexamethasone)

Neurokinin receptor blockers

  • Emend (aprepitant)
  • Varubi (rolapitant)

Cannabinoids

  • Marinol (dronabinol)

#7 Natural antiemetic products

Acupressure wristbands

A small study looking at acupressure wristbands in pregnant women did have a positive effect on nausea. This may be a good option for expectant mothers who don’t want to use other drug options.

Available brands:

  • Sea-band
  • BioBands

Ginger

Ginger is available in many forms and has been shown in studies to have beneficial effects on nausea and vomiting. Though large studies are still needed it does provide an option for people who have tied other drugs with little benefit.

Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!

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