Antiemetics and Antinauseants
Drug Safety Update
August 2012: Ondansetron (Zofran) important new intravenous dose restrictions for high doses used in the management of chemotherapy induced nausea and vomiting
August 2013: Ondansetron for intravenous use posology in patients aged 65 years and older - new advice on dilution and administration when being used for the management of chemotherapy induced nausea and vomiting
August 2013: Metoclopramide - risk of neurological side effects
May 2014: Domperidone - risk of cardiac side effects
December 2019: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
January 2020: Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
July 2023: Hyoscine hydrobromide patches (Scopoderm 1.5mg Patch or Scopoderm TTS Patch): risk of anticholinergic side effects, including hyperthermia
Effective in treating nausea and vomiting resulting from many underlying causes. Use second line for PONV.
| Pack |
|---|
| 100 tablet (10 x 10 tablets) |
| Pack |
|---|
| 5 ampoule |
Licensed for motion sickness also used off licence for hypersalivation
Releases 1mg hyoscine over 72hours
| Pack |
|---|
| 2 patch |
| Pack |
|---|
| 12 tablet |
| Pack |
|---|
| 10 ampoule |
See the Kent and Medway Promethazine Position Statement for guidance
| Pack |
|---|
| 56 tablet |
| 16 tablet |
| Pack |
|---|
| 56 tablet |
| 14 tablet |
| 10 tablet |
| 30 tablet |
| 100 tablet |
| Pack |
|---|
| 100 ml |
| Pack |
|---|
| 10 ampoule |
| Pack |
|---|
| 28 tablet (2 x 14 tablets) |
| Pack |
|---|
| 150 ml |
| Pack |
|---|
| 10 ampoule |
First-line for PONV
| Pack |
|---|
| 10 tablet |
| 30 tablet |
| Pack |
|---|
| 10 tablet |
| Pack |
|---|
| 10 tablet |
| Pack |
|---|
| 10 tablet |
| Pack |
|---|
| 50 ml |
| Pack |
|---|
| 5 ampoule |
| Pack |
|---|
| 5 ampoule |
Useful for the treatment of vertigo
| Pack |
|---|
| 28 tablet (2 x 14 tablets) |
| 84 tablet (6 x 14 tablets) |
Buccastem can be purchased OTC for nausea & vomiting in previously diagnosed migraine
| Pack |
|---|
| 8 tablet |
| Pack |
|---|
| 100 ml |
| Pack |
|---|
| 10 ampoule |
Approved for use in nausea & vomiting in pregnancy (NVP) only.
Please note that it is licensed for this indication and it is listed as one of the available first line options within the RCOG NVP 2024 guidance to be considered. However, it should be noted that the evidence for its use at is weak and it is a higher cost option than existing alternatives. Choice of antiemetic should be based on patient-clinician discussion and there may be a preference to use an existing option that is more cost-effective and for which there is more experience in use. See local trust guidance.
| Pack |
|---|
| 20 tablet (2 x 10 tablets) |
| Pack |
|---|
| 100 tablet (10 x 10 tablets) |
| 30 tablet (3 x 10 tablets) |
| Pack |
|---|
| 200 ml |
Used in palliative care
| Pack |
|---|
| 84 tablet (3 x 28 tablets) |
| Pack |
|---|
| 10 ampoule |
Used for nausea & vomiting associated with cancer chemotherapy or palliative care.
Dexamethasone injection is usually prescribed in terms of dexamethasone base - see IV guide for more details.
| Pack |
|---|
| 30 tablet |
| 50 tablet |
| 100 tablet |
| 500 tablet |
| 28 tablet |
| Pack |
|---|
| 100 tablet |
| 50 tablet |
| Pack |
|---|
| 10 ampoule |
- On Formulary Preferred
- On Formulary Second Line
- On Formulary Third Line
- Specialist Initiation
- Secondary Care Only
- Not Approved for Formulary