Some antiemetics previously thought to cause birth defects appear safe for use by pregnant women in the treatment of morning sickness and the more serious hyperemesis gravidarum.[1][2]
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 form, orally dissolving tablet form, orally dissolving film, sublingual, 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.
Dopamine antagonists act on the brainstem and are used to treat nausea and vomiting associated with cancer, radiation sickness, opioids, cytotoxic drugs and general anaesthetics. Side effects include muscle spasms and restlessness.
Amisulpride (Barhemsys), administered by intravenous injection.
Aprepitant (Emend) is a commercially available NK1 receptor antagonist
Casopitant is an investigational NK1 receptor antagonist
Rolapitant (Varubi) another recently approved drug from this class
Antihistamines (H1 histamine receptor antagonists) are effective in many conditions, including motion sickness, morning sickness in pregnancy, and to combat opioid nausea. H1 receptors in central areas include area postrema and vomiting center in the vestibular nucleus. Also, many of the antihistamines listed here also block muscarinic acetylcholine receptors.
Mirtazapine (Remeron) is an antidepressant that also has antiemetic effects.[3][4] It is a potent histamine H1 receptor antagonist, Ki=1.6 nM,[5] and also exhibits notable 5-HT3 antagonism.[4]
Promethazine (Pentazine, Phenergan, Promacot) can be administered via a rectal suppository, intravenous injection, oral tablet or oral suspension for adults and children over 2 years of age.
Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents. These may cause changes in perception, dizziness, and loss of coordination.
Dronabinol (Marinol/Syndros) is a Schedule II drug in the U.S. when in an oral solution (Syndros),[8] and Schedule III when in sesame oil and encapsulated in a soft gelatin capsule (Marinol).[9]
Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe and the US as of June 25, 2018[update][citation needed]
Midazolam (Versed) is given at the onset of anesthesia and has been shown in recent trials to be as effective as ondansetron, but most effective when used in combination with ondansetron.[10]
Lorazepam (Ativan) is said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine. [citation needed]
Dexamethasone (Decadron) is given in low dose at the onset of a general anesthetic as an effective antiemetic. It is also used in chemotherapy as a single drug as well as with other antiemetics such as 5-HT3 receptor antagonists and NK1 receptor antagonist, but the specific mechanism of action is not fully understood.[11]
^Schaefer, Christof; Scialli, Anthony; Rost van Tonningen, Margreet (2001). "Antiemetics and hyperemesis gravidarum". Drugs During Pregnancy and Lactation: Handbook of Prescription Drugs and Comparative Risk Assessment. Gulf Professional Publishing. ISBN978-0-444-50763-1.
^Pae C-U (2006). "Low-dose mirtazapine may be successful treatment option for severe nausea and vomiting". Progress in Neuro-Psychopharmacology and Biological Psychiatry. 30 (6): 1143–5. doi:10.1016/j.pnpbp.2006.03.015. PMID16632163. S2CID31784303.
^ abKast RE, Foley KF (July 2007). "Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects". European Journal of Cancer Care. 16 (4): 351–4. doi:10.1111/j.1365-2354.2006.00760.x. PMID17587360.
^National Institute of Mental Health. PDSD Ki Database (Internet) [cited 2013 Sep 27]. Chapel Hill (NC): University of North Carolina. 1998-2013. Available from: "PDSP Database - UNC". Archived from the original on 2013-11-08. Retrieved 2013-12-01.
^Abdel-Aziz H, Windeck T, Ploch M, Verspohl EJ (2006-01-13), "Mode of action of gingerols and shogaols on 5-HT3 receptors: binding studies, cation uptake by the receptor channel and contraction of isolated guinea-pig ileum", Eur J Pharmacol, 530 (1–2): 136–43, doi:10.1016/j.ejphar.2005.10.049, PMID16364290
