Nausea and vomiting: Information for clinicians

This information is sourced from NICE, PANG, Sottish Palliative Guidelines, the BMJ and  North West London ICS

Nausea and vomiting are really important symptoms to control. Without effective treatment people can rapidly decline; through an inability to eat resulting in weakness, fatigue and often depression.

Trying to elucidate the cause leads to better success in controlling symptoms. Often there are multiple minor causes that tip the threshold into feeling sick.

Red flags

Exclude acute or subacute bowel obstruction

Key clinical features  to assess in the community
  • Review underlying diagnosis (e.g. site of known tumours)
  • Medication review (see table below)
  • Overall condition: signs of dehydration or common infection (UTI, chest infection, oral candida) 
  • Abdominal and rectal exam for constipation, masses, bowel sounds, tender epigastrium
  • Assessment of anxiety levels as this is a common cause of nausea
An initial approach to treatment
  • Stop or reduce dose of offending drugs 
  • Blood tests for a metabolic cause 
  • Urinalysis to exclude infection
  • Antiemetics (metoclopramide is a good first antiemetic to try)
  • Consider more specific treatments according to cause - see table below
  • Nutritional and hydration advice can be very effective 
Top tips
  • Beware worsening colic (or vomiting) with prokinetics, if bowel obstruction is suspected
  • Levomepromazine has a broad spectrum of action but is sedating at doses > 12.5mg/24h 
  • Ondansetron can cause constipation
  • Metoclopramide can cause neurological side effects e.g. akathisia/restlessness 
  • Olanzapine is an alternative broad-spectrum antiemetic starting in doses of 2.5mg OD
  • Prochlorperazine (in buccal form Buccastem) is useful at home if no injections are available
  • Once people feel sick, retroperistalsis may have started, and subcut route better than oral
Specialist care
  • Advice on combination antiemetics
  • Abdominal CT scan and ultrasound are useful if symptoms persist

Specific treatments according to cause:

Cause

Clinical Features

Initial approach to treatment

Drugs e.g. opioids*, antibiotics, SSRIs, NSAIDs,  steroids, chemotherapy

 

*If dose of opioid is stable, it is unlikely to be the cause of nausea 

Constant background nausea 

Stop/reduce dose of offending drugs

Consider gastroprotection with PPI 

Haloperidol Oral/subcutaneous dose: 1.5 mg once or twice daily, up to 5 mg daily (lower starting dose 0.5 mg for frail people). Syringe pump:2.5mg–5 mg/24 hrs

Metoclopramide Oral/subcutaneous dose: 10 mg 3-4 x/24 hrs.   Syringe pump : 30–50 mg /24 hours

Ondansetron for chemo nausea. Oral/subcutaneous dose 4mg-8mg tds

Metabolic causes

renal failure, liver failure, hypercalcaemia, hyponatraemia

Co-existent delirium may suggest metabolic cause

Haloperidol as above

Hypercalcaemia will need IV hydration and bisphosphonates if appropriate to admit

 

Gastric stasis, and severe constipation

Large volume vomit, relief of symptoms after vomiting, oesophageal reflux, hiccups. 

Stop/reduce  anticholinergic drugs such as Buscopan, tricycyclic antidepressants, Oxybutinin

Use prokinetic antiemetics: e.g. Domperidone 10mg tds orally or Metoclopramide as above

Treat constipation

Erythromycin 250mg bd may help

Physical obstruction (from tumour or external compression) 

Vomiting pattern depends on level of obstruction

If possibility of reversal – use prokinetic Metoclopramide in a syringe pump as above. Dexamethasone e.g. 8mg subcutaneously may help nausea and reduce compression.

If likely irreversible – a combination of Cyclizine +/- Haloperidol in a syringe pump

CT may help to identify level/reversibility of blockage

Toxins

e.g. ischaemic bowel, tumour products, infection

 

Levomepromazine

Oral or subcutaneous dose: 6.25 mg 8 hourly. Syringe pump dose: 12.5 mg-25mg /24 hrs

Raised intracranial pressure

Effortless vomiting, often in the morning, associated with headache and papilloedema

Cyclizine Oral dose: 25–50 mg up to 150mg/24hrs Subcutaneous dose: 25mg up to 75mg/24 hrs

Syringe pump dose: Up to 75mg /24 hrs

CT head plus Dexamethasone /oncology review

Motion-associated nausea

Nausea or sudden vomiting on movement (eg turning in bed) 

For vestibular disturbance (eg diseases of the inner ear and motion sickness): Cyclizine as above

Anxiety-related nausea

Nausea may be triggered by a previous stimulus

CBT may help

Lorazepam 0.5mg orally can be tried

 

Sources

BMJ: Clinical Review Nausea and vomiting in palliative care

Published 3rd December 2015

PANG Guidelines Physical Symptoms and Signs - Nausea and vomiting

Published 16th October 2016

Scottish Palliative Care Guidelines - Nausea and vomiting

Published 15th April 2021

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Opening hours: Monday to Friday 9.00am to 6.00pm. Saturday 9.00am to 2.00pm

Watmans Pharmacy
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A community pharmacy which stocks common palliative medicines to support people being cared for at home

Address: 179 Bilton Road, Perivale, UB6 7HQ

Opening hours: Monday to Friday 8.30am to 6.30pm. Saturday 9.00am to 1.30pm

Wembley Pharmacy
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A community pharmacy which stocks common palliative medicines to support people being cared for at home

Address: 183 Ealing Road, Wembley, HA0 4LW

Opening hours: Monday to Saturday 9.00am to 10.00pm. Sunday 12.00pm to 5.00pm

Woods Chemist
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Woods Chemist

T. 020 77237720

A community pharmacy which stocks common palliative medicines to support people being cared for at home

Address: 27-29 Church Street, NW8 8ES

Opening hours: Monday to Friday 9.00am to 7.00pm. Saturday 10.00am to 4.00pm

Zahra Pharmacy
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A community pharmacy which stocks common palliative medicines to support people being cared for at home

Address: 72 High Street, Acton, W3 6LE

Opening hours: Monday to Friday 6.30am to 10.30pm. Saturday 8.00am to 8.00pm. Sunday 9.00am to 6.00pm

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