II. Management
- Medication taken within 15 minutes of Vomiting (or intact drug seen in Emesis)
- May re-dose medication
- Medication taken within 15-60 minutes of Vomiting
- May re-dose medication IF risk of missed dose outweighs risk of extra dose
- Re-dose in most cases of antimicrobials (e.g. Hepatitis C, HIV, Chlamydia)
- Consult with oncology regarding Chemotherapy medications
- Consult with transplant team regarding Immunosuppressants
- Combination Oral Contraceptives do not typically need re-dosing
- Avoid re-dosing of medications at higher risk of toxicity
- Avoid re-dosing Anticoagulants, Antihypertensives, Methotrexate, Phenytoin
- Avoid re-dosing diabetes and ADHD Medications
- Avoid re-dosing Acetaminophen or Opioids
- Avoid re-dosing medications in which a missed dose will have little impact
- Long Half-Life medications (e.g. Amiodarone, Fluoxetine)
- Medications intended for longterm prevention (e.g. Statins, Bisphosphonates, Dementia agents)
- Avoid re-dosing medications with rapid absorption
- Chewable, liquid or dissolving medications (e.g. sublingual or buccal medivcations)
- Medication taken within 3 hours of Vomiting
- Re-dose Progestin-Only PillContraception or Emergency Contraception
- However, longterm combination Oral Contraceptives do not typically require redosing
III. Prevention
- Consider pretreating Nauseating medications with an Antiemetic (e.g. Ondansetron)
- Some medications may be tolerated if taken with food
- Consider alternative routes of administration (e.g. intranasal Triptans)
- Consider alternative formulations (e.g. tablet instead of liquid)
IV. References
- (2020) Presc Lett 27(2): 7-8
- (2024) Presc Lett 31(11): 62-3