Managing Nausea and Vomiting

This resource will help you manage nausea (feeling like you’re going to throw up) and vomiting (throwing up).

About nausea and vomiting

Many people have nausea and vomiting while they’re getting treatment. This includes chemotherapy (chemo), radiation, targeted therapy, and some medicines.

While you’re getting chemo treatment, nausea and vomiting can be caused by:

• Chemo medicine that:
  • Affects the parts of your brain that control nausea.
  • Irritates the lining of your mouth, throat, stomach, or intestines.
  • Is combined with radiation therapy.
• The thought of having chemo.
• Stress.

You may have nausea and vomiting:

• Before your chemo treatment.
• Within 24 hours (1 day) following your chemo treatment, radiation therapy, or targeted therapy.
• After 24 hours following your chemo treatment, radiation therapy, or targeted therapy.
• After you have taken medicine to prevent it.

• When you feel nauseous.
• Whether you vomit.
• What you could eat or drink.
• Which nausea medicine you took.

Share this information with your care team. This will help them figure out what triggers your symptoms so they can adjust your treatment.

It’s important to manage your nausea and vomiting so you can eat and drink. If you don’t eat or drink enough, your body won’t get the vitamins and nutrients it needs to have energy and to heal.

How to manage nausea and vomiting

Take medicine

Your healthcare provider may give you medicine to help prevent or control nausea and vomiting. If they do, they’ll tell you when to take it. This may be before, during, or after your chemo treatment or radiation therapy.

Medicine does not work the same for everyone. If the medicine you’re taking does not control your nausea and vomiting, tell your healthcare provider. You may need to try a different medicine or take more than 1 type of medicine. Your healthcare provider will work with you to find the medicine that works best for you.

Medicine instructions

If your healthcare provider gives you a prescription for medicine to take at home, it’s important to follow their instructions for how to take it. They may tell you to take it on a regular schedule, even if you do not feel nauseous. Or, they may tell you to take it as soon as you start feeling nauseous. In either case, take it on time and do not wait.

Follow guidelines for eating and drinking

Guidelines for drinking

• Drink at least 8 to 10 (8-ounce) cups of liquids per day.
• Drink slowly and in small amounts.
• Do not drink anything for at least 1 hour before and 1 hour after you eat.
• Try drinking cool, clear, unsweetened fruit juices, such as grape juice or light-colored sodas that have lost their fizz.
• Avoid drinks that have caffeine. Caffeine can make you dehydrated and can make your nausea worse.

Guidelines for eating

• Eat small, frequent meals. Eat your meals slowly.
• Chew your food well and sit upright for 2 hours after eating. This can help with digestion.
• Avoid eating foods that have a strong smell. If you’re bothered by strong smells, try eating your foods at room temperature or cold.
• Avoid eating foods that are fried, greasy, creamy, rich, or spicy.
• Try eating dry foods (such as crackers, cereal, or toast) before getting out of bed in the morning. This can help prevent nausea or dry heaves.
• Suck on hard candy, such as mints, ginger, or tart candies.
• Eat a light meal before and after your chemo treatment.

Make sure to brush your teeth and keep your mouth clean. Rinse out your mouth after vomiting.

If you have any questions about eating or drinking, ask your healthcare provider to schedule an appointment with a clinical dietitian nutritionist for you. A clinical dietitian nutritionist can help you eat well during your treatment and make sure you’re getting the nutrients your body needs.

Use relaxation methods to manage stress

Here are some examples of things you can do to relax:

• Listen to music.
• Do deep breathing exercises.
• Do yoga.
• Meditate.
• Apply a damp washcloth with or without peppermint oil to the back of your neck for 30 minutes.
• Progressive Muscle Relaxation (PMR). This is similar to yoga and can help reduce tension in your body.
• Exercise at home.

Use acupressure and other complementary therapies

Acupressure is a healing practice that uses finger pressure on specific places on your body. Acupressure can help relieve muscle tension and increase blood circulation. It can also help relieve nausea and vomiting. To learn how to do acupressure on yourself, read Acupressure for Nausea and Vomiting or watch the video below.

Complementary therapies (such as acupuncture, massage, and music therapy) can be done along with traditional medical treatments to help you relax and control your nausea and vomiting. For more information or to schedule an appointment, contact MSK’s Integrative Medicine and Wellness Service at 646-449-1010.

When to call your care team

Call your care team if you:

• Vomit 3 to 5 times within a 24-hour period.
• Have trouble keeping liquids or medicines down.
• Still feel nauseous even after taking your medicine.
• Feel dizzy, weak, or confused.
• Have signs of dehydration, such as urinating (peeing) less than normal.
• Have any questions or concerns.