Nausea is best described as a discomfort sensed in your stomach. It may be accompanied by a strong urge to vomit. These signs may be triggered by the intake of a few foods, medicines or due to some other clinical conditions. At times, being seated at the front seat of your car may cause this. It is a common practice to take over-the-counter (OTC) medicines to treat nausea. Knowledge of these medicines can help you choose the right type of drugs.
Nausea can occur due to multiple reasons. The main reasons for nausea to occur however are microbial infections, intake of certain medicines, sea or motion sickness, consumption of specific food items, ulcers or heartburn (clinically called as gastroesophageal reflux disease – GERD).
Some harmful bacteria present in your foods can cause food poisoning effects, which may also lead to nausea. In some cases, presence of virus in foods can cause nausea. If you are consuming a few drugs – especially, chemotherapeutic drugs as part of cancer treatment, you are likely to experience stomach upset and nausea. Sea or motion sickness often is a result of an unpleasant ride. The bumpy movements of such rides may confuse your brain with signals not in line with your senses. These experiences often lead to drowsiness and nausea.
Intake of foods containing high levels of spices or oil is known to trigger nausea. Also, if you have any food allergies, consuming such allergic foods can result in discomforts in the stomach. Sores or ulcers on the walls of your intestine can result in irritation in your stomach. Medical conditions such as heartburn can push the contents up your food pipe from your stomach. This condition can result in a feeling of nausea.
Drugs available as over-the-counter (OTC) medications to treat nausea
Drugs sold for treating nausea (as well as a few other associated symptoms such as vomiting) are known as antiemetic medicines. Many drugs belonging to this category can be purchased through over-the-counter (OTC) mode. The most common drugs taken include bismuth subsalicylate, scopolamine (available as patches), meclizine hydrochloride, dimenhydrinate, etc.
Bismuth subsalicylate
This drug is taken for the treatment of nausea, stomach upset and heartburn. It is usually consumed in an oral form. Dosage of this medication depends on your medical condition, your body’s response, age, body weight amid other factors. This medication may interact with carbonic anhydrase inhibiting medications and few corticosteroids. Also, as the odds of internal bleeding are high, you need to exert needful caution if you are taking blood thinning drugs or antiplatelet medications. In general, it is a good practice to tell your pharmacist about the medicines you already consume before starting to take this drug.
This medication is unlikely to cause any major side effects. A few of its usual side effects are darkened stools, discoloration of tongue, etc. These effects are not adverse by nature, and may cease to show up once you discontinue its dosage. However, if you spot signs of dehydration (like dryness of lips, decreased output of urine, feeling of persistent thirst, etc.), it is highly recommended to consult your treating doctor. If you have allergies to anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, etc., you may need to share more information about such hypersensitivity.
Scopolamine (skin patches / transdermal)
This is a topical patch used for the prevention of nausea; it is mainly used to avoid nausea caused by sea or motion sickness. Its main function is to set right the balance among a few transmitters in the brain – such as norepinephrine, acetylcholine, etc. Once your brain stops receiving a few messages, the triggers for nausea or vomiting may cease to show up.
Once stuck onto your skin, medicine from this skin patch gets released over a prolonged period of 48 to 72 hours. You may need to use the patch at least 3 to 4 hours prior to your journey. The patch is usually placed on a hairless part of your body. The most preferred spot is the area behind your ears. It is not advised to use multiple patches at the same time. If you are pursuing longer journeys – which span several days – you may need to replace the old patch with a new strip after 72 hours. However, during the course of your journey if you have overcome the feeling of nausea or vomiting, you need not replace the patch.
This drug can trigger a few adverse side effects such as widening of your pupils or blurring of eyesight. This drug may be harmful to your eyes. Hence, after using the patch, you need to wash your hands to avoid any traces of the drug. Other side effects include excessive sweating, difficulties while passing stool, itchiness, etc. You are likely to experience headache or an overall weakness soon after you have stopped using the patch. These signs only mean your body is coming to terms with the absence of the drug. If you sense these effects to persist for long, or if the signs are turning more severe or acute, you may need to consult a qualified medical practitioner. Also, if you have a medical history of hypertension, cardiac dysfunction, respiratory disorders (such as bronchitis, asthma, etc.), you need to inform your pharmacist about such conditions.
Meclizine hydrochloride
This drug belongs to a class of medications called as antihistamines. It is widely used both for prevention as well as treatment of dizziness, nausea and vomiting. It is administered to people who are likely to develop uneasiness and discomforts while traveling. This drug is taken at least an hour prior to starting your journey. If you have prior medical conditions such as ulcers or internal blocks in intestines, renal disorders, etc., you need to share such details with your pharmacist. Most common side effects of this drug are weariness, dehydration, etc. Elderly people may develop acute signs such as confusion, incontinence (troubles while urinating) or excessive dizziness. In some instances, risks of falling are more pronounced among elders. On the other hand, this drug is known to cause restlessness if administered onto children aged 12 years or less.
This medicine may interact with antihistamines – especially those administered topically, and drugs which can trigger dizziness. So, if you are taking opioids-based cough or pain relieving medications (such as hydrocodone, codeine, etc.) or anxiety reducing and sleep inducing drugs (like lorazepam, etc.), you need to inform your pharmacist beforehand.
Dimenhydrinate
This medication also belongs to the antihistamine family of drugs. It is primarily used for the treatment of dizziness, nausea and vomiting. The dosage administered depends on your body weight, age, how your body responds to this drug as well as your medical condition. As a treatment for motion sickness, it is advised to consume this medication at least 60 minutes prior to the start of travel.
If you have a clinical history of high intraocular pressure (also called as glaucoma), convulsions, an extra-sensitive thyroid gland, enlargement of prostate or hepatic dysfunction, you need to inform the pharmacist about such conditions. This drug may pass through breastmilk. Hence, if you are nursing or breastfeeding a baby, you need to talk to your pharmacist or a medical practitioner about it. This drug may interact with muscle relaxing drugs as well as marijuana and alcohol. It can also interact with skin creams such as diphenhydramine, etc.
Its common side effects are dryness of mouth, inability to pass stool, blurring of eyesight, etc. But, if you experience signs such as faster pulse rate, problems with urination, mood based disorders (such as nervousness or being in a confused state of mind), you need to take needful medical help.
You need to be careful with the dosages; this is because, an overdose can trigger several adverse outcomes. In case of a likely overdose of this drug, adults may experience acute levels of dizziness, widening of pupils and convulsions. Among children, an overdose can lead to hallucinations, irritation or nervousness. If you suspect a likely overdose of this drug, it is recommended to contact 911 or the local poison control center without any delay.
General precautions to be taken prior to intake of OTC drugs to treat nausea
It is necessary to carefully read all the instructions printed on the label before starting a course of such drugs. It is also extremely important to take dosages as specified on the label. Some people incorrectly assume that taking stronger dosages of the medications may yield faster results. However, it can be near-fatal or at times, even fatal to consume stronger doses of these OTC medications.
Also, most medications may interact with co-administered drugs. Hence, if you are already consuming any medications, it is important to share the list of such drugs with your pharmacist. You may need to ask your pharmacist if it is safe to consume the OTC medications for nausea along with the drugs you already consume.
If your OTC drug contains subsalicylate, it is not a good practice to combine it with diabetic drugs, medicines to treat autoimmune medical conditions such as arthritis, anticoagulants or blood thinners as well as drugs prescribed for the treatment of gout.
On the other hand, if your OTC drug to treat nausea is an antihistamine, you need to check with your doctor for possible drug interactions. It is not a good practice to administer antihistamines with muscle relaxants, anxiety reducing medications or sleep-inducing pills. You also need to know that allergy medications or drugs taken for common cold may also contain antihistamines. So, intake of such drugs along with antihistamine-based drugs to treat nausea may lead to an overdose. In fact, a few drugs may generate effects very similar to those caused by antihistamines. Common side effects are dizziness, dehydration, dryness of oral parts, etc. It is a good practice to talk to your pharmacist before starting a course of antihistamines to treat nausea.
If you have a few other medical conditions, it is not recommended to take OTC antihistamine drugs. Such medical conditions are enlargement of your prostate gland, eye related disorders such as glaucoma, hypertension, cardiac dysfunction and thyroid-based disorders.
You need to take needful precautions before starting a course of these OTC drugs. Drugs based on salicylate may trigger allergies in some people. So, if you have known allergies to salicylate or medicines like aspirin, you need to keep your pharmacist informed. It is not a good practice to administer bismuth salicylate to children aged 12 years or less. Also, if younger adults or children have medical conditions such as chickenpox or flu, it is dangerous to administer these drugs. In such cases, it is likely that children may get affected by Reye syndrome; a near-fatal medical condition.
But, how can I prevent nausea?
If nausea is a regular occurrence, you need to stay aware of the reasons why you get it often. It is a simple thing to know the triggers and stay away from them. For example, you may need to avoid environment with excessive humidity or heat. You can also stay away from places with lights flickering frequently – such as a movie hall or a dance floor; these may cause acute spells of headache. A headache or migraine is often seen as a precursor to nausea. Your therapist may also tell you to avoid pursuing very long voyages or journeys by ships. If such voyages are unavoidable, you are advised to take antiemetic medications ahead of such journeys. It is also considered safe to avoid strong aromas or fragrances – especially in your cuisine or in body deodorants.
You can also take your meals in small parts. It is a proven fact that consumption of frequent but smaller portions of foods can reduce the signs of nausea to a greater extent. Keep away from greasy, oily and fatty foods. Soon after a meal, never exert yourself by performing strenuous exercises or physical activities. Make it a habit to consume foods which are unlikely to trigger nausea. Common foods of this kind include toast, crackers, cereals, broth, etc.
In sum, the most common medicines available to treat nausea are bismuth subsalicylate, scopolamine, meclizine hydrochloride, dimenhydrinate, etc. Of these, bismuth subsalicylate is taken for treating nausea, stomach upset as well as heartburn. Its dosage depends on age, body weight, your clinical condition among several other factors. Scopolamine is a patch used onto your skin to prevent a spell of nausea. It is commonly used to treat sea or motion sickness. It can strike the right balance of a few neurotransmitters like norepinephrine in your brain. As your brain stops getting triggers that may cause nausea, such signs may cease to occur.
Education: Doctor of Physical Therapy (DPT) from New York University. Experience: 5 years of experience writing for physiotherapy and sports medicine blogs, providing expert insights on injury prevention and rehabilitation.
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