Anti Nausea Drugs, Classifications, Indications, Side Effects, Brand Generic OTC
Table of Contents
Anti Nausea Drugs (Antiemetics)
Anti-nausea drugs, also called antiemetics, are medications that prevent or relieve nausea and vomiting. They work by blocking signals in the brain or digestive tract that trigger these symptoms.
Anti Nausea Medications Over the Counter (OTC)
Below is a list of non prescription over the counter Anti Nausea Medicines:Meclizine
- Brand names: Bonine®, Dramamine® Less Drowsy
- Use: Motion sickness, vertigo
- Note: Less drowsy than dimenhydrinate
Dimenhydrinate
- Brand names: Dramamine® Original Formula
- Use: Motion sickness, nausea
- Note: Antihistamine; may cause significant drowsiness
Diphenhydramine
- Brand name: Benadryl®
- Use: Off-label for nausea, motion sickness
- Note: Very sedating; commonly used for allergies too
Bismuth Subsalicylate
- Brand names: Pepto-Bismol®, Kaopectate®
- Use: Nausea due to indigestion, diarrhea, food poisoning
- Note: Avoid in children/teens with viral illness (Reye’s syndrome risk)
Phosphorated Carbohydrate Solution
- Brand name: Emetrol®
- Use: Nausea due to stomach flu, overeating, or GI upset
- Note: Safe for children; sugar-based syrup
Ginger (herbal supplement)
- Brand names: Gravol® Natural Ginger, other store brands
- Use: Mild nausea, especially in pregnancy or motion sickness
- Note: Natural option with minimal side effects
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Quick Treatment Tips:
- Meclizine and dimenhydrinate are most commonly used for motion sickness.
- Pepto-Bismol is ideal for nausea due to GI upset or food poisoning.
- Diphenhydramine helps when sedation is also desired.
- Emetrol is safe for children and pregnancy (check labels).
- Always check for interactions, age limits, and drowsiness warnings.
Types of Anti-Nausea (Antiemetic) Drugs
| Class | Mechanism of Action | Common Drugs | Common Uses |
| 5-HT₃ Antagonists | Block serotonin (5-HT₃) receptors in GI tract & CTZ |
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| Dopamine (D2) Antagonists | Block dopamine receptors in the chemoreceptor trigger zone (CTZ) |
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| Antihistamines (H1 Blockers) | Block histamine receptors in the vestibular system |
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| Anticholinergics | Block muscarinic receptors in the CNS and vestibular apparatus |
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| NK1 Receptor Antagonists | Block neurokinin-1 (substance P) receptors in brain |
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Chemo-induced N/V (often in combination therapy) |
| Cannabinoids | Act on cannabinoid receptors (CB1) in CNS |
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| Benzodiazepines | Enhance GABA effect; reduce anxiety-related N/V |
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Anticipatory N/V (e.g., pre-chemo anxiety) |
| Corticosteroids | Unknown antiemetic mechanism; may reduce inflammation in CTZ |
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Often used with chemo agents in antiemetic regimens |
N/V – Nausea Vomiting
CTZ -The Chemoreceptor Trigger Zone (CTZ) is a key brain region that detects toxins and triggers nausea and vomiting.
The dopamine D2 receptor plays a key role in triggering nausea and vomiting by influencing the chemoreceptor trigger zone (CTZ) and the gastrointestinal (GI) tract.
The histamine H1 receptor plays a key role in triggering nausea and vomiting, particularly in motion sickness, vertigo, and inner ear disorders.
NK1 (Neurokinin-1) receptors play a key role in triggering nausea and vomiting, particularly in chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV).
CTZ -The Chemoreceptor Trigger Zone (CTZ) is a key brain region that detects toxins and triggers nausea and vomiting.
The dopamine D2 receptor plays a key role in triggering nausea and vomiting by influencing the chemoreceptor trigger zone (CTZ) and the gastrointestinal (GI) tract.
The histamine H1 receptor plays a key role in triggering nausea and vomiting, particularly in motion sickness, vertigo, and inner ear disorders.
NK1 (Neurokinin-1) receptors play a key role in triggering nausea and vomiting, particularly in chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV).
Quick Treatment Tips:
- 5-HT₃ antagonists = best for chemo/post-op nausea
- D2 blockers = helpful for GI or migraine-induced nausea
- Antihistamines/Anticholinergics = go-to for motion sickness & vertigo
- Cannabinoids & NK1s = specialty use for chemo patients
- Always assess cause of nausea for best treatment selection
- Watch for QT prolongation (especially ondansetron) and EPS with dopamine antagonists
Anti-Nausea Drugs Formulations, Brands, and Generics
| Generic Name | Brand Name(s) | Dosage Forms |
| Ondansetron | Zofran® | Tablets, ODT (orally disintegrating), oral solution, IV, IM |
| Metoclopramide | Reglan® | Tablets, oral solution, IM, IV |
| Prochlorperazine | Compazine® | Tablets, rectal suppository, IM, IV |
| Promethazine | Phenergan® | Tablets, oral syrup, rectal suppository, IM, IV |
| Meclizine |
| Tablets, chewable tablets |
| Dimenhydrinate | Dramamine® Original | Tablets, chewable, injectable |
| Diphenhydramine | Benadryl® | Capsules, tablets, liquid, injectable |
| Scopolamine | Transderm Scop® | Transdermal patch |
| Aprepitant | Emend® | Capsules, oral suspension |
| Fosaprepitant | Emend® IV | IV injection |
| Dronabinol | Marinol® | Capsules, oral solution |
| Nabilone | Cesamet® | Capsules |
| Emetrol | (Phosphorated carbohydrate) | Oral syrup |
| Bismuth Subsalicylate | Pepto-Bismol® | Tablets, chewable tablets, oral suspension |
| Ginger (herbal) | Gravol® Natural, others | Capsules, tablets, chews, teas |
Anti Nausea Drugs Side Effects and Contraindications
Ondansetron (Zofran) Side Effects
- Headache
- Constipation
- Dizziness
- QT interval prolongation (cardiac risk)
Ondansetron (Zofran) Contraindications
- Known hypersensitivity to ondansetron
- Caution in electrolyte imbalances (e.g., hypokalemia)
- Congenital long QT syndrome
Metoclopramide (Reglan) Side Effects
- Drowsiness
- Fatigue
- Diarrhea
- Extrapyramidal symptoms (EPS)
- Tardive dyskinesia (with long-term use)
Metoclopramide (Reglan) Contraindications
- History of tardive dyskinesia
- GI obstruction or perforation
- Seizure disorders
- Pheochromocytoma
Prochlorperazine (Compazine) Side Effects
- Drowsiness
- Dizziness
- Dry mouth
- EPS (Extrapyramidal Symptoms)
- Blurred vision
Prochlorperazine (Compazine) Contraindications
- Children under 2 years or under 20 lbs
- Severe CNS depression
- Bone marrow suppression
- Coma
Promethazine (Phenergan) Side Effects
- Sedation
- Dizziness
- Dry mouth
- Confusion
- EPS (rare)
Promethazine (Phenergan) Contraindications
- Children <2 years (risk of fatal respiratory depression)
- Severe respiratory disease
- Coma
- Hypersensitivity to phenothiazines
Meclizine (Bonine, Antivert) Side Effects
- Drowsiness
- Dry mouth
- Headache
- Blurred vision
Meclizine (Bonine, Antivert) Contraindications
- Hypersensitivity to meclizine
- Caution in asthma, glaucoma, and enlarged prostate
Dimenhydrinate (Dramamine) Side Effects
- Drowsiness
- Dry mouth
- Constipation
- Blurred vision
Dimenhydrinate (Dramamine) Contraindications
- Hypersensitivity to diphenhydramine compounds
- Caution in glaucoma, enlarged prostate, asthma
Scopolamine (Transderm Scop) Side Effects
- Dry mouth
- Drowsiness
- Blurred vision
- Confusion, especially in elderly
Scopolamine (Transderm Scop) Contraindications
- Glaucoma (narrow-angle)
- Hypersensitivity
- Caution in elderly and those with urinary retention
Bismuth Subsalicylate (Pepto-Bismol) Side Effects
- Black tongue/stool
- Constipation
- Tinnitus (in overdose)
Bismuth Subsalicylate (Pepto-Bismol) Contraindications
- Allergy to salicylates (aspirin)
- Children or teens with viral illness (Reye’s syndrome risk)
- Bleeding disorders
Anti-Nausea vs Vertigo Medications (Common Drugs)
1. Anti-Nausea (Antiemetic) Drugs
- Purpose: Prevent/treat nausea & vomiting (e.g., motion sickness, chemo, pregnancy).
- Key Targets: Gut, brainstem (vomiting center), inner ear.
2. Vertigo Medications
- Purpose: Treat dizziness, imbalance, spinning sensations (e.g., BPPV, Ménière’s disease).
- Key Targets: Inner ear (vestibular system), brain.
| Drug | Used For Nausea? | Used For Vertigo? |
| Ondansetron (Zofran) | ✅ Yes | 🚫 No |
| Metoclopramide (Reglan) | ✅ Yes | 🚫 No |
| Aprepitant (Emend) | ✅ Yes | 🚫 No |
| Prochlorperazine (Compazine) | ✅ Yes | 🚫 Rarely |
| Promethazine (Phenergan) | ✅ Yes | ✅ Sometimes |
| Meclizine (Antivert) | ✅ Yes | ✅ Yes |
| Dimenhydrinate (Dramamine) | ✅ Yes | ✅ Yes |
| Scopolamine patch | ✅ Yes | ✅ Yes |
| Diazepam/Lorazepam | 🚫 Not first-line | ✅ For vertigo |
Which to Choose for Nausea or Vertigo?
- For nausea without vertigo – Ondansetron, metoclopramide.
- For vertigo with nausea – Meclizine, betahistine.
- For motion sickness – Scopolamine, dimenhydrinate.
- For severe vertigo (Ménière’s) – Betahistine + diuretics.
Overlap Drug for Both Nausea and Vertigo: Meclizine and scopolamine (work for both)
Anti-Nausea Drugs Interactions
| Generic Name | Brand Name(s) | Drug Class | Common Interactions |
| Ondansetron | Zofran® | 5-HT3 antagonist | SSRIs/SNRIs → ↑ serotonin syndrome QT-prolonging drugs → ↑ arrhythmia risk CYP3A4 inhibitors → ↑ ondansetron levels |
| Metoclopramide | Reglan® | Dopamine antagonist | Antipsychotics → ↑ EPS/tardive dyskinesia MAOIs → hypertensive crisis CNS depressants → ↑ sedation Anticholinergics → ↓ efficacy |
| Promethazine | Phenergan® | Antihistamine / Phenothiazine | CNS depressants → ↑ sedation/respiratory depression MAOIs → seizures/toxicity QT-prolonging meds → ↑ cardiac risk |
| Prochlorperazine | Compazine® | Dopamine antagonist | CNS depressants → ↑ sedation Antihypertensives → ↑ hypotension Levodopa → ↓ effect QT-prolonging drugs → ↑ arrhythmia risk |
| Meclizine | Bonine®, Antivert® | Antihistamine | CNS depressants → ↑ drowsiness Other anticholinergics → additive effects Glaucoma meds → ↑ intraocular pressure |
| Dimenhydrinate | Dramamine® | Antihistamine | Similar to meclizine: avoid CNS depressants, anticholinergics; caution in elderly |
| Scopolamine | Transderm Scop® | Anticholinergic | Other anticholinergics → ↑ side effects CNS depressants → ↑ sedation/confusion Glaucoma meds → ↑ risk of angle-closure glaucoma |
| Bismuth Subsalicylate | Pepto-Bismol® | Salicylate / Antidiarrheal | Warfarin → ↑ bleeding Aspirin → additive toxicity Tetracyclines → ↓ antibiotic absorption |
Anti Nausea (Antiemetic) Medications for Special Populations
Anti Nausea Drugs for Pregnancy
- Doxylamine + Pyridoxine (Diclegis, Bonjesta) First-line for pregnancy-related nausea (Category A). Safe and well-studied.
- Ginger (OTC supplement) Often recommended, especially early pregnancy; evidence supports safety and efficacy.
- Metoclopramide (Reglan®) Used when others fail. Safe for short-term use. Monitor for extrapyramidal symptoms.
- Ondansetron (Zofran®) Controversial; avoid in 1st trimester due to possible risk of cleft palate. May be used after 1st trimester with caution.
- Promethazine (Phenergan®) Used when first-line fails. Risk of sedation and hypotension.
Diclegis generic:
The generic name for Diclegis is doxylamine succinate and pyridoxine hydrochloride.Diclegis dosage:
Diclegis is typically dosed at 2 delayed-release tablets at bedtime, with the option to increase to 4 tablets daily as needed.Diclegis Coupon:
Patients can often find Diclegis coupons or savings cards on the manufacturer’s website or through prescription discount programs. Check Coupon SavingDiclegis side effects:
Common side effects of Diclegis include drowsiness, dry mouth, dizziness, and fatigue.Diclegis ingredients:
Diclegis contains 10 mg of doxylamine succinate and 10 mg of pyridoxine HCl in each delayed-release tablet.Diclegis for morning sickness:
Diclegis is an FDA-approved medication used to treat nausea and vomiting during pregnancy, commonly known as morning sickness.Diclegis pregnancy category:
Diclegis is classified as FDA Pregnancy Category A, indicating it is considered safe for use during pregnancy.Diclegis safety:
Diclegis is generally well-tolerated and safe for pregnant individuals when used as directed, especially in managing nausea and vomiting of pregnancy.Anti Nausea Drugs in Breastfeeding
- Doxylamine: May cause sedation in infant; generally avoided or used short-term with caution.
- Pyridoxine (B6): Safe. Common vitamin supplement.
- Ondansetron: Low levels in breast milk; considered safe.
- Meclizine: Safe in short-term use; may cause drowsiness in infant.
- Metoclopramide: May increase prolactin (milk supply); long-term use not recommended due to risk of depression/extrapyramidal effects in mother.
- Promethazine: Use caution; may reduce milk supply, cause sedation in infant.
Anti Nausea Drugs for Pediatrics / Kids
- Ondansetron (Zofran): Commonly used for nausea/vomiting (esp. due to gastroenteritis). Well tolerated. Approved ≥ 6 months.
- Dimenhydrinate (Dramamine): Approved for motion sickness in children ≥ 2 years. May cause drowsiness, paradoxical excitement.
- Promethazine: Contraindicated <2 years old due to respiratory depression risk. Use with caution ≥2 years.
- Metoclopramide (Reglan): Risk of extrapyramidal symptoms; avoid unless necessary.
- Scopolamine: Not recommended in young children; risk of anticholinergic toxicity.
Anti Nausea Drugs for Geriatrics / Elderly (65+)
- Meclizine / Dimenhydrinate: Use with caution: ↑ risk of sedation, confusion, falls, and anticholinergic effects.
- Promethazine: Caution due to sedation and hypotension; anticholinergic effects may worsen cognitive decline.
- Ondansetron: Generally well-tolerated. Watch for QT prolongation, especially in those with cardiac risk or polypharmacy.
- Scopolamine: Use with extreme caution: high risk of confusion, delirium, urinary retention, and glaucoma exacerbation.
- Metoclopramide: Avoid chronic use due to risk of tardive dyskinesia and extrapyramidal symptoms.
Scopolamine patch:
The scopolamine patch is a prescription transdermal medication used to prevent nausea and vomiting, especially from motion sickness or surgery.Scopolamine patch side effects:
Common side effects include dry mouth, drowsiness, blurred vision, dizziness, and sometimes confusion or hallucinations.Scopolamine patch OTC:
Scopolamine patches are not available over-the-counter and require a prescription in the U.S.Scopolamine patch dose:
Scopolamine standard dose is one 1.5 mg patch, delivering 1 mg over 72 hours. Scopolamine patch side effects after removal: After removal, some people may experience withdrawal symptoms like dizziness, nausea, headache, or mood changes.Scopolamine mechanism of action:
Scopolamine works by blocking muscarinic receptors in the central nervous system, inhibiting signals that trigger nausea and vomiting. Scopolamine drug class:It belongs to the class of anticholinergic (antimuscarinic) agents.
Scopolamine patch pregnancy: Use during pregnancy should be considered only if clearly needed, as data on safety is limited (category C).Scopolamine brand name:
Scopolamine brand name is Transderm Scop®.Scopolamine patch placement:
Scopolamine patch is placed behind the ear on clean, dry, hairless skin.Scopolamine patch age limit:
Scopolamine patch is not recommended for children under 18 years old due to safety concerns.Scopolamine withdrawal:
Abrupt discontinuation of Scopolamine may lead to withdrawal symptoms, including dizziness, restlessness, nausea, or insomnia.Scopolamine contraindications
Scopolamine is contraindicated in patients with angle-closure glaucoma, hypersensitivity to scopolamine, and caution is advised in elderly or cognitively impaired individuals.Scopolamine interactions:
Scopolamine may interact with CNS depressants, alcohol, antihistamines, and other anticholinergic drugs, increasing the risk of side effects like drowsiness and confusion.How Quickly Do Anti-Nausea Drugs Work?
Answer:- Fastest (15–30 min): Scopolamine patch, ondansetron (dissolvable tablets).
- Moderate (30–60 min): Metoclopramide (Reglan), dimenhydrinate (Dramamine).
- Slowest (1–2 hrs): Oral meclizine (Antivert).
Can You Take Anti-Nausea Drugs Every Day?
Answer: Some are safe for daily use (e.g., meclizine for vertigo), but others (like Reglan) can cause side effects with long-term use. Always consult a doctor.What Are the Side Effects of Anti-Nausea Drugs?
Answer:- Drowsiness (common with antihistamines like Dramamine).
- Dry mouth, constipation (scopolamine).
- QT prolongation (high-dose ondansetron).
Are There Natural Anti-Nausea Remedies?
Answer: Yes!- Ginger (tea, supplements).
- Peppermint oil (aromatherapy).
- Acupressure bands (Sea-Bands).
Can Anti-Nausea Drugs Be Used for Hangovers?
Answer: Yes, ondansetron (Zofran) or dimenhydrinate (Dramamine) can help, but hydration is key. SourceWhat’s the Strongest Anti-Nausea Drug?
Answer: For severe cases (chemo, surgery):- NK1 antagonists (Emend).
- Combination therapy (Zofran + dexamethasone).
