Nausea Meds...Help!

Lena_Margaret

Yuck, I am having a tough time with nausea. My team is wonderful and helping me figure it out. But, in the mean time: I am fighting a tough battle with nausea.

My guess is that Carbo is blasting me very hard. I figure that because it is trashing my RBC's, WBC's, platelets, and the like. I have had 2 units of PRBC's and will start iron infusions this week. The good? I can visibly see reduction of the tumors with this quite difficult regimen.

I am using: Zofran and Compazine. I have used Zofran and Phenergan, which works but knocks me for a loop. I have tried a number of different combo's. I am down to trying the new Sancuso patch. Anyone with experience?

And, yes, I am using the old: ginger tea, peppermint tea, over the counter ideas also.

mara51506

Can they prescribe emend for you. That's what I got and it worked for me.

Southernsurvivor

Hi Lena Margaret,

I have had a lot of experience with nausea as I have stomach mets. I have also been on Carboplatin and it did kick my butt. (I was on a feeding tube at the time, so was also very weak to start with.)

I have used the Sancuso patch, actually while I was on Gemzar and Carboplatin, as I couldn't swallow any pills (or food!) and it did work for me. Now I take Promethazine tablets, which work much better than Zofran for me.

Good luck - I hope you find the one that works best for you!

Sheri

Bestbird

I am sorry to hear you are dealing with nausea, and you've received excellent input from Mara51506 and Sheri.

Below from my MBC Guide is a list of possible therapies.You (and others) are welcome to request a complimentary copy of the 120+ page booklet by visiting the top of this page:https://community.breastcancer.org/forum/8/topics/831507?page=2#idx_32 I hope you feel much better soon!

• Chewing Gum
• Ginger
• Massage
• Queasy Pops
• Sea Bands
• Chewing Gum (especially mint) can help to ease feelings of nausea.
• Ginger: Adding a quarter to a half teaspoon of ground ginger to hot water or food may help ease nausea.Additionally, ginger capsules are sold in grocery stores are pharmacies, and taking them as suggested on the label may help.Some people have reported that drinking ginger ale also helps, and others have found relief from eating candied ginger.
• Massage: Clinical studies show that massage can alleviate symptoms such as nausea, stress/anxiety, insomnia, pain, fatigue, and depression.From: http://www.mskcc.org/cancer-care/herb/massage-ther...
• Queasy Pops are lollipops especially manufactured to combat nausea, and are popular with some cancer patients.
• Sea Bands, which are elastic bands worn on the wrist that apply pressure to specific acupressure points for nausea.According to their website, Sea-Bands have been clinically proven to relieve motion sickness and morning sickness in addition to helping with post-operative and chemotherapy-induced nausea.

dDugs that reduce nausea:

Patients may need to try several different medications before they find one that works well for them. Some of the most common anti-nausea/vomiting medicines (grouped by drug type) are listed below.

• Antacids
• Anti-Anxiety Drugs
• Cannabinoids (including the newly-approved drug Dronabinol)
• Dopamine Antagonists
• Neurokinin 1 (NK1) Receptor Antagonists
• Olanzapine
• Serotonin 5-HT(3) Antagonists
• Steroids

• Antacids (H2 Blockers or proton pump inhibitors) may help.Common antacids include Prilosec and Tagament.These drugs decrease stomach acid and may help against queasiness.
• Anti-anxiety drugs such as Lorazepam (Ativan) and Alprazolam (Xanax) may alleviate nausea.
• Cannabinoids such as Dronabinol (Marinol) and Nabilone (Cesamet) which contain the active ingredient in marijuana, have helped some patients. They may be used to treat nausea and vomiting from chemotherapy when the usual anti-nausea drugs do not work, and may also be used to stimulate appetite.
• Dopamine Antagonists include Prochlorperazine (Compazine), Droperidol (Inapsine), Haloperidol (Haldol), Metoclopramide (Reglan), and Promethazine (Phenergan). These drugs are often used "as needed" to prevent nausea and vomiting.The patient will take the medicine at the first sign of nausea to keep it from getting worse. These drugs can also cause unplanned movements called extrapyramidal effects such as restlessness, tremors, sticking out the tongue, muscle tightness, and involuntary muscle contractions or spasms. Patients should let their doctor know right away if this happens. These side effects can usually be stopped with other medicines such as diphenhydramine (Benadryl). In some cases, it may be necessary to stop the drug and try another one.
• Neurokinin 1 (NK1) Antagonists such as oral Emend (Aprepitant), Fosaprepitant (the IV form of Emend), Varubi (Rolapitant) and Akynzeo (NEPA or Netupitant).Emend is especially good for treating delayed nausea and vomiting.When given intravenously as Fosaprepitant, one dose covers the next 3 days.When taken by mouth, the drug may be repeated for a total of 3 days.Varubi is an oral drug that was FSA-approved in 2015.Akynzeo is a "combination" drug comprised of the 5-HT(3) receptor antagonist Aloxi plus an NK1 antagonist.
• Olanzapine: This is an antipsychotic drug with relatively few side effects.It can be used "off label" to control nausea after other medications have failed to do so.
• Serotonin (5-HT3) Antagonists such as Ondansetron (Zofran), Palonosetron (Aloxi), Dolasetron (Anzemet) and Granisetron (Kytril or Sancuso) are given before chemotherapy to help prevent or minimize nausea, and then often are recommended a few days afterward. Palonosetron is usually given once before starting a 3-day cycle of chemotherapy; and its effects last longer than the other drugs in this group. This also makes Palonosetron a good drug to prevent delayed nausea and vomiting. These drugs are often given along with a steroid (below).

Lena_Margaret

MANY thanks to all of you: Mara51506 and Sheri, and Bestbird for all this excellent input. I did not know about the queasy pops. I am glad to see good input on the Sancuso patch, thanks Sheri. I am the first person at my cancer center to try it. So, that is good news.

Best bird, you are always a valuable source of info. Bless you!

Mara, I have used emend in the past, but for some reason (heart issues maybe?) my cancer center is wary of using it. Maybe it is due to the Herceptin and Perjeta possible heart function issues? I have heard multiple comments about my team's concern about making sure they don't cause heart problems. So...

Phenergan works but just literally knocks me out. It makes me nervous to rely on something that hits me that hard. I am not adverse to using Marinol, but my insurance doesn't cover it, sadly. I am having difficulty eating and weight loss. So...It would be a good drug to use regularly.

I will be on ginger hunt tomorrow: ginger beer (like root beer, not alcohol), ginger root for making tea. And, I will search for ginger capsules. I am game to give most anything a go at this point.

While I am glad that the carbo is likely the culprit, I am sad others have been affected by it like I have.

Bless you all!

Zillsnot4me

I made ginger "tea"and added a sleepy time tea bag. It was good hot or cold. I used fresh ginger root for the "tea". The smell of mint gum helped. It's a miserable feeling. Good luck!

intothewoods

I sympathize! I'm on day 7 after my chemo (doxil and cytoxan) and have been experiencing constant nausea (but no vomiting) since day 4. I was just about to email my onc about it to see if they suggest anything. I take anti nausea/vomiting meds on days 2 and 3 and feel fine. MIne isn't severe but not fun. A good thing (I guess) is that I feel better if I eat something but I feel like I'l eating and craving carbs all day long! Tthis last one was #4 and I don't remember the nausea to this degree with the first 3.

intothewoods

I sympathize! I'm on day 7 after my chemo (doxil and cytoxan) and have been experiencing constant nausea (but no vomiting) since day 4. I was just about to email my onc about it to see if they suggest anything. I take anti nausea/vomiting meds on days 2 and 3 and feel fine. MIne isn't severe but not fun. A good thing (I guess) is that I feel better if I eat something but I feel like I'l eating and craving carbs all day long! This last treatment was #4 and I don't remember the nausea to this degree with the first 3.

Rosevalley

Do you have access to CBD oil made from pot it helps. You put the drops of the tincture under your tongue. I use it and zofran. Two for one punch. Good luck nausea is miserable.

intothewoods

Rosevalley, thank you. Ihave actually smoked some and it helps. I'm also going to try acupuncture and if that doesn't help use more zofran which I have taken days two and three

:-)

sharethehope

I to would recommend acupuncture & massage. Also, the lowly green pea. Yes, green peas help w/nausea. If U like them just incorporate them into your diet more often.

gp193

My wife is currently on gem/carbo and she receives Aloxi by IV before the chemo drugs. It seems to work well. Besides that, she takes Reglan, Zofran and compazine. I hope you find something that helps!