What Is the Best Medicine for Nausea? (2024)

Nausea is an uncomfortable, queasy feeling in your stomach with or without the urge to vomit. The best medicine for nausea varies by the underlying cause but may involve over-the-counter (OTC) drugs like Dramamine (dimenhydrinate) and Pepto-Bismol (bismuth subsalicylate) or prescription medications like Zofran (ondansetron) and Bonine (meclizine).

What Causes Nausea?

Nausea is a queasy sensation including an urge to vomit. There are many causes of nausea, each of which may be treated differently.

The causes of nausea can be broadly described as:

• Gastrointestinal: Including conditions like peptic ulcer disease, gastroparesis, celiac disease, Crohn's disease, gastroesophageal reflux disease (GERD), and bowel obstruction
• Food poisoning: Most commonly caused by bacteria like Campylobacter jejuni, Salmonella, and Escherichia coli
• Pregnancy: Including"morning sickness" is common during earlypregnancyand a severe form called hyperemesis gravidarum
• Disequilibrium: Including motion sickness and vertigo (caused by problems with the organs ofthe inner earorthe balance center of the brain)
• Central nervous system: Such as brain tumors, increased intracranial pressure (ICP), and certain types of stroke
• Medications: Including chemotherapy, general anesthesia, and Ergomar (ergotamine) used to treat migraine
• Acute infections: Like gastroenteritis ("stomach flu"), appendicitis, hepatitis, pancreatitis, and meningitis
• Metabolic disorders: Such as diabetic ketoacidosis and Addison's crisis
• Gynecologic: Including menstrual cramps and hormonal fluctuations during menopause
• Psychiatric: Commonly associated with severe depression and anxiety

Because the causes of nausea are many, the treatment approaches can vary. The focus of treatment is generally twofold: to resolve or manage the underlying condition and to treat nausea symptomatically with medications, lifestyle, and other therapies.

Best OTC Medicine for Nausea

There are six over-the-counter (OTC) drugs commonly used to treat nausea, each with its specific indications and actions. In addition to the brand name products, there are also generics that may come in tablet, capsule, chewable, gummy, or liquid formulations.

Bismuth Subsalicylate

Bismuth subsalicylate, sold under the brand names Pepto-Bismol and Kaopectate, is an antacid andantidiarrheal drug that helps ease other gastrointestinal symptoms, including nausea.

Bismuth subsalicylate works by reducing inflammation and irritation of the stomach while reducing the spasms that contribute to nausea. It may be used to ease nausea symptoms related to food poisoning, stomach flu, GERD, and other conditions.

Antihistamines

Antihistamines are drugs that treat allergies by reducing a chemical called histamine.

However, certain antihistamines can ease vertigo-related nausea by blocking not only histamine but also a chemical called acetylcholine, both of which stimulate the "vomiting center" of the brain (called the chemoreceptor trigger zone).

Doing so can ease symptoms of motion sickness and vertigo.

There are several OTC antihistamines available for such use, including:

• Dramamine (dimenhydrinate)
• Dramamine Less Drowsy (meclizine)
• Bonine (meclizine)
• Benadryl (diphenhydramine)

Emetrol

Emetrol (phosphoric acid/dextrose/fructose) is an OTC antacid that has been available to consumers since 1949. It appears to ease nausea symptoms by slowing muscle contractions of the stomach that contribute to nausea

Best Prescription Medicine for Nausea

There are no less than a dozen prescription drugs classified by the U.S. Food and Drug Administration (FDA) as antiemetics, meaning that their mechanism of action is to alleviate emesis (nausea).

Anticholinergics

Transderm Scop (scopolamine) is an anticholinergic drug used to prevent nausea and vomiting. It is applied to the skin with an adhesive patch. Anticholinergics work by blocking the transmission of acetylcholine which activates the vomiting center of the brain.

Anticholinergics like scopolamine are effective for motion sickness and the prevention of nausea related to general anesthesia.

Dopamine Antagonists

Reglan (metoclopramide) is a dopamine antagonist used to treat nausea and vomiting due to GERD, diabetic gastroparesis, and chemotherapy. Dopamine antagonists work by blocking dopamine, another chemical messenger that can stimulate the vomiting center.

Antipsychotics

Some antipsychotic drugs used to treat psychiatric disorders exert potent antiemetic properties that can prevent or treat nausea related to general anesthesia. They do so in the same way as dopamine agonists; by blocking the action of dopamine.

Options include:

• Phenergan (promethazine)
• Compro (prochlorperazine)
• Zyprexa (olanzapine)

Phenergan is particularly useful because it is also classified as an antihistamine.

Selective Serotonin Receptor (5-HT3) Antagonists

Selective serotonin receptor (5-HT3) antagonists work by blocking serotonin. This is a chemical messenger that stimulates a specific part of the vomiting center that involves with nerve called the vagal nerve.

The vagal nerve is linked to nausea in two ways: it responds to the disruption of nerves associated with balance, and to any toxin or condition that affects the motility of the gastrointestinal tract.

5-HT3 antagonists work by blocking communications between the vagal nerve and the vomiting center, easing or preventing nausea.

5-HT3 antagonists used for nausea include:

• Zofran (ondansetron)
• Sancuso (granisetron)
• Aloxi (palonosetron)
• Anzemet (dolasetron)

5-HT3 antagonists are effective for the prevention of chemotherapy-related nausea and for the prevention and treatment of nausea caused by general anesthesia.

Zofran is also considered one of the more effective antiemetics for the treatment of severe gastroenteritis (stomach flu).

Other Prescription Drug Options

There are other prescription antiemetic drugs with different mechanisms of action that can be used to treat specific types of nausea:

• Emend (aprepitant), classified as a neurokinin-1 antagonist, is used to prevent anesthesia- or chemotherapy-induced nausea.
• Declan (pyridoxine/doxylamine) is used to treat nausea and vomiting in pregnant women with morning sickness when other non-drug treatments fail.
• Corticosteroid drugs like dexamethasone and methylprednisolone help reduce postoperative inflammation that contributes to nausea and vomiting.
  

Anti-Nausea Medications for Kids

Anti-nausea medications have a place in treatment for children, but it is best to speak to a healthcare provider before starting. Anti-nausea drugs have different age cut-offs, doses, and side effects, so it's critical that the medication is appropriate and safe for the child's specific age and health condition.

Motion Sickness

Anti-nausea medications and the recommended age cut-offs (see package label or speak to your healthcare provider or pharmacist for actual doses):

• Dramamine for Kids (dimenhydrinate): Used for kids 2 years and older
• Benadryl (diphenhydramine): Used for kids 6 and older
• Dramamine Less Drowsy (meclizine): Used for kids 12 and older
• Phenergan (promethazine)
• Transderm Scop (scopolamine)
  

Post-Operative Nausea and Vomiting (PONV)

Commonly prescribed medications for the prevention of PONV are:

• Zofran (ondansetron)
• Dexamethasone
• Reglan (metoclopramide)

These medications can also be used for nausea associated with chemotherapy.

Anti-Nausea Medication in Pregnancy

Nausea during pregnancy, or morning sickness, is treated using different techniques to reduce the symptoms and to make pregnancy more comfortable. Morning sickness is different in every person.

Mild to Moderate Morning Sickness

You can try the following methods to help relieve motion sickness symptoms:

• Lifestyle and diet changes: Eating bland foods and drinking plenty of water. Get enough rest and avoid exhaustion.
• Acupressure and acupuncture: Applying pressure to specific points on the body (acupressure) or receiving acupuncture treatment may help some pregnant people.
• Avoid triggers: Triggers can vary from person to person. Know those triggers, and avoid smells or situations that trigger nausea.
• Vitamin B6 supplements: Studies suggest vitamin B6 may reduce nausea during pregnancy.

Severe or Chronic Morning Sickness

In severe cases of morning sickness, see your healthcare provider for medications safe in pregnancy. Commonly prescribed medications include:

• Dramamine (dimenhydrinate)
• Phenergan (promethazine)
• Declan (pyridoxine/doxylamine)
• Zofran (ondansetron)
  

Always talk to your healthcare provider before starting a new treatment during pregnancy.

When to See a Healthcare Provider

In mild cases, nausea should resolve on its own. The use of OTC medications can help prevent or treat nausea related to certain triggers, like motion sickness. In other cases, such as for nausea related to a medication or illness, you may need to get a prescription from a healthcare provider for the right treatment.

Summary

Nausea is a common and uncomfortable feeling. However, there are several OTC and prescription products available that are effective at preventing or treating nausea, depending on its cause.

If you know what's causing your nausea, ask your pharmacist or healthcare provider about which medicine will be most appropriate for you. You can also read the product labels for available OTC medicines to understand their uses better.

The author would like to recognize and thank Norma Ponce, PharmD, MHA for contributing to this article.