These drugs should only be used when the cause of vomiting is known. Drug treatment for vertigo is often not the most effective |
management strategy, and long treatment should generally be avoided. |
|
Antihistamines |
GREEN Cyclizine tablets 50mg |
GREEN Doxylamine and pyridoxine 10mg/10mg tablets (Xonvea®) |
(Indicated in the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative |
management. Suitable for initiation in Primary or Secondary care) |
Phenothiazines and related drugs |
Symptomatic relief of nausea from underlying disease, drug treatment, and Ménière’s disease. |
Caution: prochlorperazine may cause dystonic reactions in the elderly. |
|
GREEN Prochlorperazine |
tablets 5mg |
buccal tablets 3mg |
syrup 5mg/5mL |
suppositories 5mg |
injection 12.5mg/mL |
|
GREEN Levomepromazine (methotrimeprazine) |
tablets 25mg * |
injection 25mg/mL |
* 25mg tablet to be quartered for 6mg dose |
BLACK Levomepromazine tablets 6mg |
|
For the prevention and treatment of post operative nausea and vomiting: |
RED Droperidol injection 2.5mg/mL |
|
Domperidone and metoclopramide |
Symptomatic relief of nausea from underlying disease or drug treatment. Avoid use of metoclopramide in children and those |
under 20 years of age because of risk of dystonic reactions. |
|
**New updated advice for Domperidone** |
Following a European review, the Medicines and Healthcare products Regulatory Agency (MHRA) is advising that domperidone |
should not be used by people who have serious underlying heart conditions. It should only be used in the relief of symptoms of |
nausea and vomiting and at the lowest effective dose for the shortest possible duration. Adults should take no more than three |
10mg tablets per day. Domperidone should no longer be used to treat other conditions such as heartburn, bloating or relief of |
stomach discomfort. MHRA Drug Safety Update 2019: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications |
in adults and adolescents |
MHRA Drug Safety Update - Domperidone: risks of cardiac side effects |
|
GREEN Domperidone |
tablets 10mg |
suspension 5mg/mL |
GREEN Metoclopramide | tablets 10mg | syrup 5mg/mL | injection 10mg/2mL | | |
Use of domperidone as a galactogogue during breastfeeding or expressing breastmilk |
Domperidone as a galactogogue aids the initiation and maintenance of breast milk supply to meet the needs of a baby receiving breast milk, when non-drug methods have failed. A health professional should be involved in any decision to use domperidone. Domperidone is most likely to be needed for mothers whose babies are on the neonatal unit. |
See Infant feeding manual guidance [page 16] |
GREEN Domperidone 10mg tablets |
|
|
5HT3 antagonists |
Nausea and vomiting |
GREEN Ondansetron |
tablets 4mg, 8mg |
injection 8mg/4mL |
|
RED Ondansetron - See MHRA Drug Safety Update January 2020 |
(Off licence use in hyperemesis, consultant initiation only) |
tablets 4mg, 8mg |
injection 8mg/4mL |
|
Second line |
RED Granisetron |
tablets 1mg |
injection 1mg, 3mg |
|
For post-operative nausea and vomiting in adults (not licensed for use in children) – see PONV guidelines. |
RED Dolasetron |
injection 12.5mg/0.625mL |
|
Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer |
chemotherapy and moderately emetogenic cancer chemotherapy |
RED Netupitant/palonosetron capsules (Akynzeo®) |
oncology use only |
|
Aprepitant |
Aprepitant is a neurokinin 1 receptor antagonist, is licensed for the prevention of acute and delayed nausea and vomiting |
associated with cisplatin-based cytotoxic chemotherapy; |
it is given with dexamethasone and a 5HT3 antagonist. such as ondansetron. Cancer network guidelines specify when this |
medicine can be given, and these should be followed at all times. They are available online,click here to access them. |
RED Aprepitant |
capsules 80mg, 125mg |
|
For vestibular disorders and hypersalivation |
GREEN Hyoscine hydrobromide |
injection 400 microgram |
tablets (sublingual) 300 microgram |
patch 1mg/72 hours |
AMBER Glycopyrronium Liquid 1mg/5mL* (prescribe as Colonis Pharma Ltd brand) |
(Tablets removed from formulary due to cost effectiveness of liquid June 2017) |
*Use: Hypersalivation in adults and children [Non-Parkinson's disease] |
*Use: Hypersalivation/Sialorrhoea in adults with Parkinson's Disease |
Other drugs for Ménière’s disease |
GREEN Betahistine |
tablets 8mg, 16mg |
GREEN Cinnarizine |
tablets 15mg |
|
|
All material in this section is aimed at health care professionals, but is information currently held in the public domain, |
members of the public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service |
Email: info.elmmb@nhs.net |
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All rights reserved. Disclaimer/Terms and conditions |
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