Key takeaways:
Nausea and vomiting are side effects of some medications. This includes chemotherapy medications, opioids, and some antibiotics.
If you throw up soon after taking your medication, you may need to retake it. But it depends on which medication it is, so talk to your healthcare provider or pharmacist first.
If you think a medication is causing you to throw up, talk with your healthcare provider. They can help you decide what to do next.
If you’ve ever felt like throwing up (vomiting) after taking your medication, you’re not alone. Many medications list nausea and vomiting as potential side effects. Vomiting is your body’s way of getting rid of something that’s irritating it.
Here, we’ll cover 10 medications that can cause you to vomit, and what to do if you throw up soon after taking a medication.
1. Antibiotics
Antibiotics treat various types of bacterial infections. These include urinary tract infections and ear infections. Antibiotics work by killing the bad bacteria in the body. But they also kill good bacteria. This can cause nausea and vomiting.
Examples of antibiotics that may cause vomiting include:
Cephalosporins, like cephalexin (Keflex)
Lincosamide antibiotics, like clindamycin (Cleocin)
Fluoroquinolones, like levofloxacin
Macrolide antibiotics, like erythromycin (Ery-Tab)
Talk to your healthcare provider about whether you can take your antibiotic with food. This may help ease nausea. But if your antibiotic causes extreme nausea or vomiting, ask about switching to another antibiotic.
Relieving upset stomach from medications: Explore 10 pharmacist-backed tips to help ease nausea caused by medications.
Treating nausea: Many prescription and over-the-counter medications can help put a stop to nausea.
Taking Zofran for nausea: Three people share their experiences taking ondansetron (Zofran), a common prescription nausea treatment.
2. Antidepressants
Antidepressants are a broad group of medications that treat depression, anxiety, and other mental health conditions. Some antidepressants — like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) — may cause nausea and vomiting. It’s more common in older adults. Luckily, nausea and vomiting with antidepressants usually improves after a few weeks.
SSRIs and SNRIs raise the levels of a chemical called serotonin in your body. This activates certain areas in the gastrointestinal (GI) tract and brain, which can lead to nausea and vomiting. Fluvoxamine (Luvox) and sertraline (Zoloft) may be the most likely of the SSRIs to cause nausea. Escitalopram (Lexapro) may be the least likely SSRI to cause nausea. And venlafaxine (Effexor XR) is an SNRI that may be more likely to cause nausea.
Bupropion (Wellbutrin SR, Wellbutrin XR), another antidepressant, can cause nausea and vomiting too. This happens because bupropion raises levels of a chemical in the brain called dopamine.
If your antidepressant makes you feel sick, ask your healthcare provider if you can take it with food. You can also try ginger-containing drinks or foods to relieve nausea. And talk to your provider about dividing your dose throughout the day instead of taking it all at once.
- OndansetronGeneric Zofran
- PrometheganPromethazine
- PhenadozPromethazine
3. NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat pain, fever, and inflammation. They include common over-the-counter (OTC) medications like ibuprofen (Advil, Motrin) and aspirin. Aspirin is also used to help protect your heart.
NSAIDs block a protein (enzyme) in the body called cyclooxygenase-1 (COX-1). COX-1 helps protect your stomach lining — blocking it can cause GI side effects.
Taking NSAIDs with a meal may help minimize nausea. But the best way to avoid nausea from NSAIDs is to take the lowest possible dose for the shortest amount of time. If you need NSAIDs long-term (like for rheumatoid arthritis), your healthcare provider may prescribe another medication to protect your stomach. These include histamine-2 antagonists (H2 blockers) and proton pump inhibitors (PPIs).
4. Chemotherapy
Chemotherapy medications kill cancer cells in the body. Chemotherapy-induced nausea and vomiting (CINV) is a common side effect of chemotherapy.
Certain chemotherapy medications trigger areas of the body that regulate nausea. This includes areas of the brain and GI tract.
Chemotherapy medications that are most likely to cause CINV include cisplatin, carmustine (Bicnu), and dacarbazine. These medications cause CINV in over 90% of people that use them.
Luckily, CINV is treatable. The American Society of Clinical Oncology has recommendations for how to manage CINV. It includes medications like olanzapine (Zyprexa), aprepitant (Emend), and ondansetron (Zofran). Steroids like dexamethasone can also be used.
5. Opioids
Opioids are medications that treat pain. Nausea is a common side effect of opioids. And vomiting occurs in up to 25% of people that take opioids. Examples of opioids include oxycodone (Roxicodone, Oxycontin), hydrocodone/acetaminophen, and morphine (MS Contin). Opioids may cause vomiting by triggering areas of the brain that cause you to throw up.
Nausea and vomiting from opioids typically resolves on its own after a few days. But if it doesn’t go away, talk to your healthcare provider about your options. They may suggest lowering your dose or switching to another opioid that’s less likely to cause vomiting. They may also suggest adding a medication to help with nausea. These include OTC medications like meclizine (Dramamine Less Drowsy), scopolamine (Transderm Scop), and diphenhydramine (Benadryl).
6. Irons supplements
Your body needs minerals like iron to work properly. But iron supplements can make you nauseated, especially if you take too much. Typically, the symptoms improve once you stop the supplement.
Iron is best absorbed when taken on an empty stomach. But you may take it with food to prevent nausea if needed. Don’t take it with calcium-containing foods like milk, cheese, or yogurt. Calcium prevents iron from being absorbed.
If you experience nausea or vomiting from iron supplements, talk to your healthcare provider. They may recommend another type of iron supplement or suggest splitting up your dose throughout the day.
7. Metformin
Metformin is a commonly prescribed medication to treat Type 2 diabetes. More than 25% of people taking metformin experience nausea and vomiting. But researchers aren’t sure why nausea and vomiting are so common with metformin.
Nausea and vomiting from metformin may be avoided by starting at a low dose and taking it with meals. Usually, nausea improves over time. But if your symptoms persist, talk to your healthcare provider. They may be able to switch you to the extended-release (ER) version, which is known to cause less nausea.
8. Exenatide
Exenatide (Bydureon BCise, Byetta) is an injectable medication that is used to treat Type 2 diabetes. Approximately 30% of people taking exenatide will experience nausea and vomiting.
Researchers aren’t sure why. It may be partly because it slows down how quickly food passes through your stomach after eating, which can lead to nausea
Like metformin, starting exenatide at a lower dose can lower the risk of nausea. Eating smaller portion sizes more frequently can help.
Typically, nausea and vomiting from exenatide resolves within a few months. If your symptoms continue or worsen, talk with your healthcare provider. They may be able to lower your dose or switch you to another diabetes medication.
9. Dopamine agonists
Dopamine agonists are used to treat restless leg syndrome and Parkinson’s disease. These include bromocriptine (Parlodel), ropinirole, and pramipexole (Mirapex ER).
Dopamine agonists work by raising dopamine levels in the brain. The extra dopamine can lead to side effects like nausea and vomiting. To avoid nausea and vomiting, your healthcare provider may start you at a low dose and slowly increase your dose over several weeks.
10. HIV medications
Antiretrovirals are a broad group of medications that treat HIV. Nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs) are three groups of HIV medications that may cause nausea and vomiting.
If you develop nausea and vomiting while taking an HIV medication, you can try taking your medication with food and eating smaller but more frequent meals. You can also talk to your healthcare provider about changing the time that you take your medications or switching to alternative formulations.
If I throw up my medication, should I retake it?
It depends.
In general, it's recommended to retake a medication if vomiting occurs within 15 to 30 minutes after taking the original dose.
But there are exceptions. Some medications may not need to be taken again after throwing up. These include sublingual tablets, buccal tablets, and orally disintegrating tablets. These types of tablets dissolve in your mouth. So vomiting doesn’t have much effect on their absorption.
If you’re unsure whether you should retake your medication after throwing up, talk to your healthcare provider or pharmacist.
The bottom line
Vomiting is a side effect of some medications like certain antibiotics, antidepressants, and chemotherapy. To minimize your chances of vomiting after taking medications, you might be able to take your medication with food, lower the dose of your medication, or switch medications altogether. But don’t make any changes to your medications without talking to your healthcare provider.
If you throw up after taking your medication, talk with your provider. They can let you know what to do next.
Why trust our experts?
References
American Cancer Society. (2020). Understanding nausea and vomiting.
Anastasi, J., et al. (2011). Nausea and vomiting in human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS). Gastroenterology Nursing.
AstraZeneca Pharmaceuticals, Inc. (2022). Bydureon [package insert].
Carvalho, A. F., et al. (2016). The safety, tolerability, and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature. Psychotherapy and Psychosomatics.
Choi, J., et al. (2022). Dopamine agonists. StatPearls.
Denton Pharma, Inc. (2022). Bupropion hydrochloride tablet, extended release [package insert].
Ellero, C., et al. (2010). Prophylactic use of anti-emetic medications reduced nausea and vomiting associated with exenatide treatment: A retrospective analysis of an open-label, parallel-group, single-dose study in healthy subjects. Diabetic Medicine.
Endocrine Society. (2022). Adrenal hormones.
Gelenburg, A., et al. (2010). Practice guideline for the treatment of patients with major depressive disorder. American Psychiatric Association.
Hesketh, P., et al. (2017). Antiemetics: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology.
Kelly, K., et al. (2008). Toward achieving optimal response: Understanding and managing antidepressant side effects. Dialogues in Clinical Neuroscience.
Kendrick, J., et al. (2012). Vomiting of oral medications by pediatric patients: Survey of medication redosing practices. The Canadian Journal of Hospital Pharmacy.
Leukemia and Lymphoma Society. (2020). Side effect management: Managing nausea and vomiting.
Maceira, E., et al. (2012). Medication related nausea and vomiting in palliative medicine. Annals of Palliative Medicine.
Mallick-Searle, T., et al. (2017). The pathophysiology, incidence, impact, and treatment of opioid-induced nausea and vomiting. Journal of the American Association of Nurse Practitioners.
McCreight, L., et al. (2016). Metformin and the gastrointestinal tract. Diabetologia.
McNatty, D. (2008). Side effect solutions: Helping patients avoid drug induced nausea. Pharmacy Times.
National Cancer Institute. (2020). Nausea and vomiting related to cancer treatment (PDQ) – patient version.
National Cancer Institute. (2022). Nausea and vomiting related to cancer treatment (PDQ) - health professional version.
National Health Service. (2021). Diclofenac.
National Human Genome Research Institute. (2022). Microbiome.
NHS Inform. (2022). Vomiting in adults.
Penn Medicine. (2021). Nausea and vomiting.
Rao, K. V., et al. (2012). Chemotherapy-induced nausea and vomiting: Optimizing prevention and management. American Health & Drug Benefits.
Reid, T. (2013). Practical use of glucagon-like peptide-1 receptor agonist therapy in primary care. Clinical Diabetes.
Rogers, E., et al. (2013). Four strategies for managing opioid-induced side effects in older adults. Clinical Geriatrics.
Russell, R. (2001). Non-steroidal anti-inflammatory drugs and gastrointestinal damage - problems and solutions. Postgraduate Medical Journal.
Shengyu, G., et al. (2020). Comparative risk of selective serotonin reuptake inhibitors (SSRIs)-induced nausea among Chinese senile depression patients. Medicine.
Siavash, M., et al. (2017). Severity of gastrointestinal side effects of metformin tablet compared to metformin capsule in type 2 diabetes mellitus patients. Journal of Research in Pharmacy Practice.
Singh, P., et al. (2016). Nausea: A review of pathophysiology and therapeutics. Therapeutics in Gastroenterology.
Swegle, J., et al. (2006). Management of common opioid-induced adverse effects. American Family Physician.
U. S. Food and Drug Administration. (2022). Mixing medications and dietary supplements can endanger your health.
Wang, Z, et al. (2022). Risks of digestive system side-effects of selective serotonin reuptake inhibitors in patients with depression: A network meta-analysis. Therapeutics and Clinical Risk Management.
Wharton, S., et al. (2021). Managing the gastrointestinal side effects of GLP-1 receptor agonists in obesity: Recommendations for clinical practice. Postgraduate Medicine.
