Nausea and Cisplatin Chemotherapy

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This video provides helpful tips for managing nausea during treatment.

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It explains how to effectively use common anti-nausea medications like Compazine and Zofran, including when to take them and what to expect, and their potential side effects.

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‍Read the full video transcript below:

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This video is an overview of cancer-related nausea for patients receiving cisplatin chemotherapy. Nausea is a fairly common side effect of chemotherapy and an occasional side effect of radiation. 

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The goal with any treatment-related nausea is prevention, to decrease the chance of malnutrition or dehydration, and to preserve a person's ability to continue participating in all daily activities, including cancer treatment.

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Some chemotherapy drugs are more likely to cause nausea than others. Your medical team will customize your treatment plan to reduce the chance you experience severe nausea. 

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Cisplatin has a very high chance of causing nausea when no anti-nausea medication is utilized. It may occur more than 24 hours after the medication is administered. To prevent nausea, your care team may recommend nausea prevention medications prior to starting chemotherapy that could continue at home a couple of days after chemotherapy infusion.

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Some common nausea prevention medications include: Emend (aprepitant), Aloxi (palonosetron), and Decadron (dexamethasone). Please discuss which medications and schedule are most appropriate for you with your treatment team. 

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There are other factors that place an individual at greater risk of experiencing nausea, including: female gender, younger age, history of motion sickness, nausea with pregnancy, minimal use of alcohol, or anxiety.

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What if you experience nausea during treatment, even though you're using preventative medication? This may happen, and if it does, you can use prescribed anti-nausea medication as needed.Common anti-nausea medications are Compazine (prochlorperazine) and Zofran (ondansetron). 

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Compazine can be taken every six (6) hours as needed, and Zofran can be taken every eight (8) hours as needed. 

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It's important to know that you'll need to wait three (3) days before using Zofran if Aloxi was given prior to chemotherapy administration. The reason is, Aloxi is a long-acting anti-nausea medication in the same drug class as Zofran. Aloxi is better able to provide extended anti-nausea effect because it stays in your system for several days. 

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Zofran use can begin on or after day four of each chemo cycle. If nausea is difficult to control, it's acceptable to take both Compazine and Zofran on an alternating schedule every four (4) hours. 

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Anti-nausea medications do have side effects. 

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Zofran can cause constipation. Patients who take Zofran for an extended period of time may need to use over-the-counter stool softeners. 

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Dexamethasone is a steroid medication which can elevate blood glucose levels. Frequent monitoring of blood sugar levels or adjustment in diabetic medication may be necessary in individuals diagnosed with diabetes. Dexamethasone may be better tolerated when taken with meals since it can also cause an upset stomach. If indigestion is a contributing factor to nausea, anti-acid medication may be prescribed. 

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In addition to using medication, changes to eating habits can also help with nausea control. 

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Eating smaller amounts of food more frequently throughout the day may reduce nausea while still allowing for adequate calorie intake. Avoid heavy, greasy foods or foods high in fat since they are more likely to trigger nausea. Remain upright for two (2) hours after eating to allow for complete digestion. Remember to drink plenty of fluids to prevent dehydration and help preserve normal kidney function.

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This is not medical advice for individual patients and is meant for educational purposes only. 

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Talk to your doctor before making any medical decisions.

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