Nausea and vomiting management (Management of nausea and vomiting in palliative care)

Finding the cause of feeling or being sick in a serious illness and treating it with the right anti-sickness medicine and practical measures, so you feel more comfortable and can eat and drink more easily.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Finding the likely cause matters, because different causes of sickness need different anti-sickness medicines.
Medicines can be given as tablets, melt-in-the-mouth wafers, injections, suppositories, patches, or through a small pump under the skin if you cannot keep tablets down.
Practical steps help — small frequent meals, cool bland foods, sipping fluids between meals, fresh air and resting upright.
Tell your team if sickness is not controlled or you cannot keep medicines down; the plan can be changed and the route switched.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMedical treatment (anti-sickness medicines plus practical measures)

AnaestheticNot applicable

How long it takesOngoing; medicines are taken regularly, by mouth or another route if needed

Hospital stayUsually managed at home or in a clinic; a short stay sometimes helps settle severe sickness

Time off workNot applicable in the usual sense; the aim is to help you feel and function better

When you'll see resultsMany people feel better within a day or two; the right medicine sometimes takes a little adjusting

On the NHS?Widely available free on the NHS and in hospices; private care is mainly for speed or choice

A general guide. Your specialist will give you advice for your situation.

Best fit

Less nausea and vomiting, so you feel more comfortable

Pause if

Persistent vomiting with severe tummy pain and no wind or bowel movement may be a blockage needing urgent assessment, not just anti-sickness tablets.

Main recovery point

An assessment to find the likely cause, an anti-sickness medicine matched to it, and treatment of any cause such as constipation.

Good aftercare

A medicine matched to the likely cause, given regularly, with the cause treated too

First appointment

An assessment to find the likely cause, an anti-sickness medicine matched to it, and treatment of any cause such...

First day or two

Many people start to feel less sick as the medicine takes effect, especially when taken regularly rather than only...

First week

The plan is reviewed; if the first medicine is not enough, it is changed or a second is added, and the route...

Ongoing

Regular reviews keep the sickness controlled as causes change, for example with new medicines or treatments.

Medical line illustration of malignant bowel obstruction care for Nausea and vomiting management. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is nausea and vomiting management?

Feeling sick (nausea) and being sick (vomiting) are common in serious illness. They can be caused by the illness itself, by treatments such as chemotherapy, by medicines including strong painkillers, by constipation, by problems in the tummy or bowel, or by chemical changes in the body. Often there is more than one cause.

Managing it well starts with finding the likely cause, because different causes respond to different anti-sickness medicines (antiemetics). Common ones include metoclopramide, haloperidol, cyclizine and levomepromazine; sometimes a combination is needed. They can be given as tablets, as wafers that melt in the mouth, as injections, as suppositories, as skin patches, or through a small pump under the skin if you cannot keep tablets down.

Practical measures help too: eating small amounts often, cool or bland foods, sipping fluids between meals rather than with them, fresh air, and resting upright after eating.

The aim is to bring the sickness under control so you feel more comfortable and can eat and drink more easily. It cannot always remove every bit of nausea, and treating any underlying cause — such as constipation — is part of the plan.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Finding the cause first

Your team looks for likely causes — medicines, constipation, the illness, chemical changes, or tummy or bowel problems — because the best anti-sickness medicine depends on the cause.

Anti-sickness medicines (antiemetics)

Different medicines suit different causes — for example metoclopramide for a slow stomach, cyclizine for movement-related or raised-pressure sickness, and haloperidol for chemical causes. Sometimes a combination is used.

Different ways to take them

If you cannot swallow or keep tablets down, the same medicines can be given as melt-in-the-mouth wafers, injections, suppositories, skin patches, or through a small pump under the skin.

Treating the underlying cause

Easing constipation, adjusting a medicine that is causing sickness, or treating a tummy or bowel problem can reduce the sickness at its source.

Practical and supportive measures

Small frequent meals, cool or bland foods, avoiding strong smells, fresh air, mouth care and relaxation can all help alongside medicines.

Matching the medicine to the cause

Likely cause	Often-used medicine
Slow or full stomach	Metoclopramide
Chemical / medicine-related	Haloperidol
Movement or raised pressure in the head	Cyclizine
Hard to settle / several causes	Levomepromazine or a combination

This is a simple guide only. Your team chooses and adjusts the medicine for your situation.

Preparing for your treatment

Keep a simple note of when you feel sick or are sick, and what seems to trigger or ease it.
List all your medicines, including painkillers and anything new, as some can cause sickness.
Mention when you last opened your bowels, as constipation is a common, treatable cause.
Note whether you can swallow and keep tablets down, so the right route can be chosen.
Tell your team about any tummy pain, bloating or change in bowel habit.
Have your questions ready, including what to do if you cannot keep the anti-sickness medicine down.

What happens

Your doctor or nurse asks about the pattern of your sickness, your medicines, your bowels and any tummy symptoms, and may examine you, to work out the likely cause or causes.

They then choose an anti-sickness medicine matched to that cause, often given regularly rather than only when you feel sick. If you cannot swallow or keep tablets down, they will use another route — a melt-in-the-mouth wafer, an injection, a suppository, a patch, or a small pump under the skin.

They also treat any underlying cause, such as constipation, and suggest practical measures. The plan is reviewed and, if the first medicine does not work well enough, changed or combined with another. You will be told who to contact if the sickness is not controlled.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Persistent vomiting with severe tummy pain and no wind or bowel movement may be a blockage needing urgent assessment, not just anti-sickness tablets.
Anti-sickness tablets are the wrong route if you cannot swallow or keep them down — another route is needed.
Metoclopramide is generally avoided where there is a complete bowel blockage or certain movement disorders.
If sickness is from a treatable cause, such as constipation or a high calcium level, treating that is more important than the anti-sickness medicine alone.

Delay or rearrange if…

Signs of a possible bowel blockage or severe dehydration need urgent assessment first.
You cannot keep tablets down, so a non-oral route should be started rather than persisting with tablets.
A reversible cause, such as a new medicine or constipation, has not yet been addressed.
Key information about your medicines or bowels is missing and would change the choice of medicine.

Alternatives to discuss

Treating the underlying cause, such as constipation or a medicine side effect
A different anti-sickness medicine, or a combination, if the first is not enough
A non-oral route — wafer, injection, suppository, patch or under-the-skin pump
Steroids in selected situations, for example raised pressure in the head
Practical measures alone for very mild, occasional nausea

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Less nausea and vomiting, so you feel more comfortable
Better able to eat, drink and keep medicines down
Treatment matched to the likely cause rather than one-size-fits-all
Several ways to take medicines if swallowing is difficult
Underlying causes, such as constipation, treated at the same time
Improved energy, mood and quality of life when sickness eases

Risks & complications

More common

Side effects of anti-sickness medicines, such as drowsiness or a dry mouth
Needing to try more than one medicine, or a combination, before sickness is controlled
Some medicines can affect the bowel — speeding it up or, occasionally, slowing it

Less common

Restlessness or muscle stiffness with certain medicines (such as metoclopramide or haloperidol), which settles when the medicine is changed
Sickness that is hard to control and needs specialist input or a different route
Low blood pressure or dizziness with some medicines

Rare but serious

An unusual movement reaction to certain anti-sickness medicines
A serious reaction to a medicine needing prompt review

Most anti-sickness medicines are well tolerated, with drowsiness or dry mouth the usual issues. A few can cause restlessness or stiffness, which settles when the medicine is changed, so report any new movement problems. Because sickness often has more than one cause, it can take a couple of changes to get it right. Tell your team if you cannot keep the medicine down — the route can be switched to a wafer, injection, patch or under-the-skin pump.

Published figures to discuss

How well sickness responds depends heavily on the cause, or causes, and on the individual. Many people improve quickly once the medicine is matched to the cause, but sickness with several causes can take more adjustment. Side effects of anti-sickness medicines are usually mild, though a few medicines can cause restlessness or stiffness. We have not given fixed percentages because robust, comparable figures depend on the situation; your team can explain what is likely for you.

Figure	Reported range	How to interpret it	Source / confidence
Cause of nausea missed	Common	Constipation, bowel obstruction, raised calcium, medicines, gastritis, liver disease and brain metastases need different treatment.	Guide sourcesClinical context
Dehydration or kidney injury	Higher with persistent vomiting or poor intake	Reduced urine, dizziness, confusion or inability to keep medicines down needs prompt review.	Treating nausea and vomiting in palliative care: a review (PMC)pmc.ncbi.nlm.nih.govSource-linked context
Antiemetic side effects	Drug-dependent	Sedation, movement side effects, constipation and QT prolongation depend on the antiemetic used.	Guide sourcesClinical context
Oral medicines not absorbed	Common in vomiting/obstruction	Sublingual, transdermal, rectal or subcutaneous routes may be needed.	Treating nausea and vomiting in palliative care: a review (PMC)pmc.ncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery in the usual sense. What matters is how quickly the sickness eases and stays controlled — which is reviewed and adjusted over time.

First appointment

An assessment to find the likely cause, an anti-sickness medicine matched to it, and treatment of any cause such as constipation.

First day or two

Many people start to feel less sick as the medicine takes effect, especially when taken regularly rather than only when sick.

First week

The plan is reviewed; if the first medicine is not enough, it is changed or a second is added, and the route adjusted if swallowing is hard.

Ongoing

Regular reviews keep the sickness controlled as causes change, for example with new medicines or treatments.

What's normal — and not a worry

Needing a few changes before sickness is well controlled
Mild drowsiness or dry mouth from some anti-sickness medicines
Appetite taking a while to return even as sickness improves
Better days and worse days, especially during treatment such as chemotherapy

Aftercare

Take anti-sickness medicines regularly as prescribed, not only when you already feel sick.
Eat small amounts often, choosing cool or bland foods, and avoid strong cooking smells.
Sip fluids slowly between meals rather than with them, to avoid feeling too full.
Rest upright after eating rather than lying flat straight away.
Keep your bowels moving and take any laxative prescribed, as constipation worsens sickness.
Tell your team if you cannot keep the medicine down, so the route can be changed.
Report new restlessness, stiffness or unusual movements promptly.

Before your treatment

Note of when sickness happens and what triggers or eases it
Full medicines list, including painkillers and anything new
Anti-sickness medicine and clear instructions on when to take it
Plan for an alternative route (wafer, injection, patch or pump) if needed
Laxative in place if constipation is a factor
Day and night contact number saved
Small, bland foods and cool drinks to hand

⚠ Get urgent help if…

Vomiting that will not stop, or being unable to keep any fluids or medicines down
Signs of dehydration — very little urine, dizziness, a dry mouth or confusion
Vomiting blood, or material that looks like coffee grounds
Severe tummy pain, a swollen tummy, or no bowel movement or wind with vomiting (possible blockage)
A high temperature or feeling suddenly very unwell
New restlessness, muscle stiffness or unusual movements after an anti-sickness medicine
Vomiting alongside a severe headache or new drowsiness

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Good management brings the sickness under control so you feel more comfortable and can eat, drink and keep medicines down more easily. Many people feel better within a day or two, though it can take a couple of medicine changes to get it right when there is more than one cause.

It cannot always remove every bit of nausea, and the cause can change over time, so the plan is reviewed. The measure of success is feeling well enough to do more of what matters to you — and your comfort guides the plan.

How long it lasts

Sickness can come and go as its causes change — for example with new treatments, new medicines or constipation — so the plan is reviewed and adjusted to match. Some people need anti-sickness medicine only for a while, others on and off, and some continuously. Regular review keeps it working as things change.

Related tests, treatments or support

Nausea and vomiting management often runs alongside other care: laxatives for constipation, pain control (since some painkillers cause sickness), mouth care, and the wider support of a specialist symptom-control team. If you cannot swallow, the same anti-sickness medicines can be combined with others in a single under-the-skin pump.

Follow-up & long-term care

You will have regular reviews, more often while medicines are changing, in person or by phone. Your team checks how well the sickness is controlled, looks again at the cause if it is not, and adjusts the medicine or route. They coordinate with your GP, district nurses and any hospital or palliative care team, and you can contact them between appointments.

Taking anti-sickness medicines regularly as prescribed
Keeping the bowels moving with laxatives if needed
Re-checking the cause if sickness returns or changes
Adjusting the route (tablet, wafer, injection, patch or pump) as swallowing changes
Regular reviews to keep the plan matched to your symptoms

Repeat, follow-on and what comes next

It is common to change the anti-sickness medicine, or add a second, before sickness is well controlled.
If sickness returns, the cause is re-checked rather than simply continuing the same medicine.
The route is changed (for example to a pump) if you cannot keep tablets down.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A medicine matched to the likely cause, given regularly, with the cause treated too
A clear plan and alternative route if you cannot keep tablets down
Regular reviews that re-check the cause and adjust treatment
Advice to report movement reactions, dehydration or signs of blockage promptly
A named contact and day-and-night route for help if sickness is not controlled

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

How complex the cause is and how much specialist input is needed
The number and length of appointments and reviews
The medicines used, including if more than one is needed
The route used — tablets, wafers, injections, patches or an under-the-skin pump
Any tests needed to find the cause
Out-of-hours support and how quickly the team can respond
Coordination with your GP and other teams

Make sure your written quote includes

The specialist's fee and what each appointment includes
Whether anti-sickness medicines are included or charged separately
Cost of an alternative route, such as a syringe pump, if tablets cannot be kept down
Cost of any tests needed to find the cause
How follow-up and medicine changes are arranged
What happens, and what it costs, if sickness is not controlled or worsens
How the private team coordinates with your NHS GP and other teams

On the NHS? Anti-sickness treatment is widely available free on the NHS through GPs, hospital teams, district nurses and hospices; private care is used mainly for speed or choice rather than because NHS care is lacking.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What do you think is causing my sickness, and which medicine suits that cause?
Should I take the anti-sickness medicine regularly or only when I feel sick?
What should I do if I cannot keep the medicine down?
Could any of my other medicines, or constipation, be making it worse?
What side effects should I watch for, and when should I contact you?
What practical changes to food and drink might help me?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Why do I need to find the cause before treating the sickness?

Because different causes respond to different anti-sickness medicines. Matching the medicine to the likely cause — such as a slow stomach, a medicine side effect, or constipation — gives the best chance of relief.

What if I cannot keep the anti-sickness tablet down?

The same medicines can be given as a melt-in-the-mouth wafer, an injection, a suppository, a skin patch, or through a small pump under the skin, so you still get relief without needing to swallow.

Can my pain medicines be making me sick?

Yes, strong painkillers can cause sickness, especially at first, and it usually settles. Tell your team rather than stopping your pain relief — they can add an anti-sickness medicine or adjust things.

Could constipation be making me feel sick?

Yes, constipation is a common and very treatable cause of nausea. Your team will ask about your bowels and treat constipation as part of the plan.

Will the medicine make me drowsy?

Some anti-sickness medicines can cause mild drowsiness or a dry mouth. If this is troublesome, tell your team, as a different medicine may suit you better.

Is this treatment available on the NHS?

Yes, widely and free, through your GP, hospital team, district nurses and hospices. Private care is mainly for speed or choice rather than because NHS care is lacking.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Marie Curie — Feeling sick and vomiting: causes and treatments Marie Curie — Managing symptoms (terminal illness) NHS — Vomiting in adults Marie Curie (professionals) — Nausea and vomiting Treating nausea and vomiting in palliative care: a review (PMC)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.