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Chemo-induced Nausea And Vomiting, Ambulatory Care

Nausea and vomiting

are common side effects of chemotherapy (chemo). They may be worse with certain kinds of chemo. Your risk for nausea and vomiting depends on the dose (amount) of chemo you get and the frequency (timing) of your treatment. It also depends on the way chemo is given (by mouth or IV). Nausea and vomiting can lead to fatigue, trouble focusing, loss of appetite, and weight loss.

Contact your healthcare provider for the following symptoms:

  • Nausea and vomiting medicines are not working
  • Vomiting that prevents you from keeping any food or liquids down
  • Inability to take your medicines
  • Weight loss
  • Questions or concerns about your condition or care

Different types of chemo-induced nausea and vomiting:

  • Acute nausea and vomiting happens within a few minutes to a few hours after you get chemo. It is usually worst during the first 4 to 6 hours after treatment and goes away within 24 hours.
  • Delayed nausea and vomiting usually does not start until 24 hours or more after you get chemo. It can last for several days.
  • Anticipatory nausea and vomiting is a learned response to chemo. It occurs because of previous experiences with chemo that led to nausea and vomiting. Your brain expects that nausea and vomiting will happen again, even before the treatment is given. It can occur while you are preparing for the next treatment, during treatment, or after.

Treatment for chemo-induced nausea and vomiting:

  • Take medicines for nausea and vomiting exactly as directed, even if you do not have symptoms. You may need to continue to take these medicines as long as chemo is likely to cause nausea and vomiting. For example, you may need to take these medicines for several days after your last dose of chemo.
  • You may need to try different medicines or take more than one kind. There may be some medicines that work better for you than others. You may also need more than one kind of medicine to prevent or control your nausea and vomiting.
  • Alternative treatments , such as guided imagery or progressive muscle relaxation may also help. Ask for more information about these and other alternative treatments.

Manage chemo-induced nausea and vomiting:

  • Avoid eating foods that can make nausea and vomiting worse. These include high-fat, fried, high-fiber, salty, sweet, and spicy foods.
  • Avoid strong food odors. You may need to ask others to cook for you so that you can avoid the odor of food as it is cooking.
  • Eat small, frequent meals throughout the day instead of large meals. You may have less nausea and vomiting with small meals.
  • Eat bland foods. Bland foods may be easier for you to tolerate. Examples include clear broths, baked chicken, potatoes, rice, crackers, pretzels, and dry toast. Other bland foods include applesauce, bananas, sherbet, and yogurt.
  • Find the best time for you to eat or drink on the days you have chemo treatment. You may find it helpful to have a light meal or snack before chemo. Wait at least 1 hour after chemo to eat or drink.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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