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Drugs to Treat Nausea and Vomiting

People who undergo chemotherapy and radiation treatments for cancer can sometimes face two unpleasant side effects: nausea and vomiting. Both are common, and if they are not controlled, they can lead to other problems, such as dehydration and weight loss, and may even interfere with cancer treatments. To curb these reactions, a class of stomach-settling medicines, called 5-HT3 antagonists (also known as "antiemitics"), are often given to people prior to chemotherapy or radiation.

Drugs in this class, when used alone or with other antiemetic medicines, are generally regarded as first choice option for preventing nausea and vomiting in people undergoing cancer treatments. The 5-HT3 antagonists accounted for nearly $700 million in U.S. sales in 2008, according to IMS Health, a healthcare information and consulting company. These drugs are also sometimes used to treat “morning sickness” many women experience during pregnancy, but there’s little evidence to support this use, so we recommend that you talk with your doctor about other options.

If you’re undergoing cancer treatment, the first thing you should know is that you don’t necessarily need to take a 5-HT3 antagonist. Some chemotherapy and radiation treatments carry a low risk of nausea and vomiting, so an antiemetic drug may not be needed. On the other hand, certain people are more vulnerable to developing nausea and vomiting, including women, especially those with a history of morning sickness during pregnancy, people over the age of 50, and those with a history of motion sickness or anxiety.

If you fall into one of those higher-risk groups or you are receiving chemotherapy or radiation treatment that is likely to cause nausea and vomiting, your doctor may recommend a 5-HT3 antagonist. The latest Consumer Reports Best Buy Drugs analysis finds that the three oral 5-HT3 antagonist—dolasetron (Anzemet), granisetron (Kytril and generic) and ondansetron (Zofran and generic) are roughly equivalent in effectiveness and safety, so price may be the deciding factor. We chose the following as Consumer Reports Best Buy Drugs if you need medication to control nausea and vomiting due to chemotherapy or radiation treatments:

  • Generic ondansetron tablet
  • Generic ondansetron dissolvable tablet

Ondansetron, either as a tablet or a dissolvable tablet, has been proven to significantly reduce nausea and vomiting associated with radiation treatments or chemotherapy drugs. Also, it is available as an inexpensive generic tablet that is just as effective and safe as higher priced brand-name medicines. Choosing generic ondansetron tablets could save you $100 or more per chemotherapy course compared with the most expensive brand-name 5-HT3 antagonists.

The dissolvable tablet formulation of ondansetron is an option if you have trouble swallowing pills. It is slightly less expensive than the generic tablets, so this option could save you even more money.

These drugs are generally well tolerated, but most people will experience at least one side effect. The most common include constipation, dizziness, fatigue, headache, muscle cramps, nervousness, and sleepiness.

You may also want to talk with your doctor about nondrug treatments that may help control your nausea and vomiting—such as hypnosis, biofeedback, guided imagery, acupuncture, and other techniques. Modifying your diet may also help. This includes eating small meals throughout the day, eating and drinking bland items that are easy on your stomach, such as ginger ale, toast, and crackers; and avoiding foods that are unappealing (which can change daily when you’re undergoing cancer treatments).

Last updated November 2009

Drugs to treat nausea and vomiting - Drug Comparison
CR Best Buy Generic Name and Dose 1,3 Brand name Number of doses per course of chemotherapy Average cost per course of chemotherapy2 Average cost per 5 consecutive courses of chemotherapy2 Compare Prices
  Dolasetron 100 mg tablet Anzemet One $106 $530
  Granisetron 1 mg tablet Generic Two $136 $680
  Granisetron 1 mg tablet Kytril Two $178 $890
  Granisetron 3.1 mg patch Sancuso One $484 $484
Ondansetron 8 mg tablet Generic Two to three $57 - $85 $285 - $425
  Ondansetron 8 mg tablet Zofran Two to three $121 - $181 $605 - $905
Ondansetron 8 mg orally disintegrating tablet Generic Two to three $50 - $76 $250 - $380
  Ondansetron 8 mg orally disintegrating tablet Zofran ODT Two to three $111 - $166 $555 - $830
1. As typically prescribed. The dose ranges are derived from the drugs' labeling.

2. Prices reflect nationwide retail average for July 2009, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite®. Wolters Kluwer Health is not involved in our analysis or recommendations.

3. Palonosetron (Aloxi) capsules are not available because the manufacturer decided not to market this formulation of the drug.