MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Antiemetics and Antinauseants

Drug Safety Update

 August 2012: Ondansetron (Zofran) important new intravenous dose restrictions for high doses used in the management of chemotherapy induced nausea and vomiting

 August 2013: Ondansetron for intravenous use posology in patients aged 65 years and older - new advice on dilution and administration when being used for the management of chemotherapy induced nausea and vomiting

 August 2013: Metoclopramide - risk of neurological side effects

 May 2014: Domperidone - risk of cardiac side effects

 December 2019: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents

 January 2020: Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy

July 2023: Hyoscine hydrobromide patches (Scopoderm 1.5mg Patch or Scopoderm TTS Patch): risk of anticholinergic side effects, including hyperthermia

First-line for PONV

Pack Price
10 tablet £9.36
30 tablet £6.60
Pack Price
10 tablet £5.72
Pack Price
10 tablet £34.96
Pack Price
10 tablet £71.94
Pack Price
50 ml £18.81
Pack Price
5 ampoule £39.60
Pack Price
5 ampoule

Useful for the treatment of vertigo

Pack Price
28 tablet (2 x 14 tablets) £1.32
84 tablet (6 x 14 tablets) £4.59

Buccastem can be purchased OTC for nausea & vomiting in previously diagnosed migraine

Pack Price
8 tablet £4.01
Pack Price
10 ampoule £5.23

Effective in treating nausea and vomiting resulting from many underlying causes. Use second line for PONV.

Pack Price
100 tablet (10 x 10 tablets) £7.26
Pack Price
5 ampoule £10.70

Licensed for motion sickness also used off licence for hypersalivation

Releases 1mg hyoscine over 72hours

Pack Price
2 patch £12.87

Approved for use in nausea & vomiting in pregnancy (NVP) only.

Please note that  it is licensed for this indication and it is listed as one of the available first line options within the RCOG NVP 2024 guidance to be considered. However, it should be noted that the evidence for its use at is weak and it is a higher cost option than existing alternatives. Choice of antiemetic should be based on patient-clinician discussion and there may be a preference to use an existing option that is more cost-effective and for which there is more experience in use. See Trust guidance on Q-pulse.

Pack Price
20 tablet (2 x 10 tablets) £28.50
Pack Price
100 tablet (10 x 10 tablets) £4.40
30 tablet (3 x 10 tablets) £1.76
Pack Price
200 ml £49.32

Used in palliative care

Pack Price
84 tablet (3 x 28 tablets) £20.26
Pack Price
10 ampoule £20.13

Used for nausea & vomiting associated with cancer chemotherapy or palliative care.

Dexamethasone injection is usually prescribed in terms of dexamethasone base - see IV guide for more details.

Pack Price
100 tablet £7.59
50 tablet £6.60
Pack Price
10 ampoule £9.68
Pack Price
10 vial £19.99