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What injection is used for nausea and vomiting?

3 min read

In population studies, over 50% of adults reported at least one episode of nausea in the preceding 12 months [1.10.1]. When symptoms are severe, a common question is: what injection is used for nausea and vomiting to provide fast relief?

Quick Summary

Various injectable medications, known as antiemetics, are used to control nausea and vomiting. These drugs work by targeting different receptors in the body and are selected based on the cause of the symptoms.

Key Points

  • Multiple Classes Exist: Several classes of injectable medications, including serotonin (5-HT3) antagonists, dopamine antagonists, and antihistamines, are used to treat nausea and vomiting [1.3.4, 1.5.5, 1.6.5].

  • Serotonin Antagonists: Drugs like ondansetron (Zofran®) are a common first-line treatment for nausea caused by chemotherapy and surgery [1.3.2].

  • Dopamine Antagonists: Metoclopramide (Reglan®) is effective but has a risk of movement-related side effects, limiting long-term use [1.8.4].

  • Rapid Onset: Intravenous (IV) injections offer the fastest relief, with drugs like ondansetron and metoclopramide working within minutes [1.11.1, 1.11.2].

  • Cause Matters: The choice of injection depends on the cause of the nausea, such as motion sickness, surgery, or chemotherapy [1.3.5, 1.6.5].

  • Professional Administration: These are prescription medications that must be administered by a healthcare professional in a clinical setting [1.2.1].

  • Side Effects Vary: Common side effects range from headache and constipation (ondansetron) to significant drowsiness (promethazine) [1.8.1, 1.6.1].

In This Article

Understanding Nausea and Vomiting

Nausea is the unpleasant sensation of needing to vomit, and vomiting (emesis) is the forceful expulsion of stomach contents. These symptoms can arise from numerous causes, including surgery, chemotherapy, motion sickness, pregnancy, and gastrointestinal issues [1.3.1, 1.3.2, 1.6.2]. In a clinical setting, when oral medications are not feasible due to vomiting, injectable antiemetics are administered for rapid effect. These drugs work on the central nervous system and the gastrointestinal tract to block the signals that trigger nausea and vomiting [1.3.4, 1.5.5].

Common Classes of Injectable Antiemetics

Several classes of drugs are available in injectable form to manage nausea and vomiting. A healthcare provider will choose the most appropriate one based on the patient's condition, the cause of the nausea, and other medical factors.

Serotonin (5-HT3) Receptor Antagonists

This is one of the most common and effective classes of antiemetics. They work by blocking serotonin, a natural substance in the body that can cause nausea and vomiting [1.2.1, 1.2.3]. These drugs are widely used for preventing and treating nausea associated with chemotherapy, radiation, and surgery [1.3.2].

  • Ondansetron (Zofran®): Widely used for post-operative nausea and vomiting (PONV) and chemotherapy-induced nausea and vomiting (CINV) [1.3.2, 1.4.3]. When given intravenously, it starts working within minutes [1.11.3].
  • Granisetron (Kytril®): Similar to ondansetron, it is used for PONV and CINV [1.2.3, 1.3.5].
  • Dolasetron (Anzemet®): Used to prevent and treat nausea and vomiting after surgery [1.2.1]. The intravenous form is recommended only for PONV due to cardiac risks at higher doses [1.4.4].
  • Palonosetron (Aloxi®): A second-generation 5-HT3 antagonist with a longer half-life, making it effective for delayed nausea and vomiting [1.4.5].

Dopamine Antagonists

These medications block dopamine receptors in an area of the brain called the chemoreceptor trigger zone (CTZ), which helps to reduce nausea signals [1.5.5]. They are effective but can have more side effects than 5-HT3 antagonists.

  • Metoclopramide (Reglan®): This drug increases stomach and intestinal contractions, helping to empty the stomach [1.2.2]. It is used for gastroparesis, PONV, and CINV [1.3.1]. Onset of action is 1 to 3 minutes when given intravenously [1.11.2]. Long-term use is cautioned against due to the risk of tardive dyskinesia [1.8.4].
  • Prochlorperazine (Compazine®): Belongs to the phenothiazine group and acts by blocking the vomiting center in the brain. It can be given as an intramuscular injection [1.3.5, 1.5.5].
  • Droperidol (Inapsine®): A butyrophenone that is a very effective antiemetic, though its use has decreased due to side effects like disorientation and potential for heart rhythm disturbances (QT prolongation) [1.8.4, 1.5.5].

Antihistamines

Certain first-generation antihistamines have antiemetic properties and are particularly useful for nausea caused by motion sickness or vertigo [1.6.5]. They work by calming the nervous system and blocking histamine receptors [1.6.1].

  • Promethazine (Phenergan®): An antihistamine that can be given as an intramuscular injection to prevent and control nausea, vomiting, and motion sickness [1.6.2, 1.6.3]. It is known to cause significant drowsiness [1.6.1].

Corticosteroids

Corticosteroids like dexamethasone are often used in combination with other antiemetics, particularly 5-HT3 antagonists and NK-1 antagonists, to prevent CINV [1.7.1, 1.7.4]. The exact mechanism for their antiemetic effect isn't fully understood but is thought to be related to their anti-inflammatory properties [1.7.2]. Dexamethasone remains a backbone of many antiemetic regimens for chemotherapy patients [1.7.3].

Comparison of Common Antiemetic Injections

Medication Class Common Drugs Primary Use Common Side Effects
5-HT3 Antagonists Ondansetron, Granisetron CINV, PONV [1.3.2, 1.2.3] Headache, constipation, dizziness, potential for QT prolongation [1.8.1, 1.8.4]
Dopamine Antagonists Metoclopramide, Prochlorperazine Gastroparesis, PONV, CINV [1.3.1] Drowsiness, restlessness, risk of extrapyramidal symptoms (e.g., tardive dyskinesia) [1.8.4, 1.9.1]
Antihistamines Promethazine Motion sickness, post-operative nausea [1.6.2] Drowsiness, dizziness, dry mouth, blurred vision [1.6.1]
Corticosteroids Dexamethasone CINV (often in combination) [1.7.1] Insomnia, agitation, increased appetite (usually with longer use) [1.7.3]

Important Considerations

All injectable antiemetics are prescription medications and must be administered by a healthcare professional [1.2.1, 1.6.1]. It is crucial to inform your doctor about your medical history, including any heart conditions, kidney disease, or allergies, as well as any other medications you are taking, to avoid potential drug interactions and serious side effects [1.2.1, 1.2.2]. For example, combining 5-HT3 antagonists with other drugs that affect serotonin can lead to a rare but serious condition called serotonin syndrome [1.8.1].

Conclusion

Multiple types of injections are available to effectively treat nausea and vomiting. Serotonin (5-HT3) antagonists like ondansetron are a first-line choice for chemotherapy and post-operative symptoms, while dopamine antagonists like metoclopramide are also effective but carry different side effect profiles [1.8.4, 1.9.1]. Other options like antihistamines and corticosteroids serve important roles for specific causes. The choice of injection depends on the underlying reason for the nausea, the patient's overall health, and the need for rapid symptom control.

For more information on specific medications, you can visit MedlinePlus.

Frequently Asked Questions

Ondansetron (brand name Zofran®) is one of the most common injections for nausea, especially for preventing nausea and vomiting caused by chemotherapy or surgery [1.3.2, 1.4.3].

When administered intravenously (IV), anti-nausea medications work very quickly. Metoclopramide takes about 1-3 minutes to start working, while ondansetron starts working within minutes of infusion [1.11.2, 1.11.3].

Ondansetron is a serotonin 5-HT3 antagonist that blocks serotonin, while metoclopramide is a dopamine antagonist that helps speed up stomach emptying [1.3.4, 1.2.2]. Ondansetron is often preferred due to metoclopramide's risk of movement disorders (tardive dyskinesia) with prolonged use [1.9.3, 1.8.4].

Yes, antihistamine injections like promethazine (Phenergan®) are used to prevent and treat motion sickness [1.6.2].

Common side effects of an ondansetron injection include headache, constipation, drowsiness, and pain or redness at the injection site. More serious side effects can include changes in heartbeat and serotonin syndrome [1.8.1, 1.8.3].

While nausea and vomiting are common in pregnancy, the use of injectable medications is carefully considered by a doctor. Ondansetron is sometimes used off-label, but any medication during pregnancy requires a thorough risk-benefit assessment by a healthcare provider.

No, all injectable medications for nausea and vomiting are prescription-only and must be administered by a qualified healthcare professional [1.2.1, 1.2.2, 1.6.2].

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.