Do you experience nausea and vomiting as symptoms of your migraine? If you throw up after taking medication, you aren’t alone. Many migraine warriors complain of vomiting five minutes after taking medication. These symptoms cause great discomfort and interfere with oralmigraine treatments. Truth is, scientists don’t fully understand why nausea and vomiting occur with migraine, but brain imaging studies show the nausea centers in the brain are “switched on” as part of a migraine attack. What causes the switch to be activated remains a mystery.
What Happens When You Vomit After Taking Medication?
You may have had this happen: You swallow your medicine and promptly vomit it up before the medication has had a chance to be absorbed. Even if you don’t vomit, you may not absorb an effective dose of medication if you’re nauseated. If you have a hard time keeping your medicine down, talk to your doctor about other ways of taking it. Have this conversation before your next migraine attack so you can be prepared to stop it before it gets out of hand.
How Do You Stop Throwing Up Medication?
Acute treatments given along with prophylactic medications such as triptans, gepants, or lasmiditan help prevent migraine and control nausea and vomiting. Taking these medications as early as possible during an attack may help reduce the chance of your nausea becoming severe.
Healthcare providers may also recommend antiemetic therapies to prevent vomiting and nausea. If you find it difficult to keep your medication down or are troubled with severe nausea with or without vomiting, talk with your healthcare provider. They may prescribe a drug in the phenothiazine class of medications. The medication can be given at home in pill form or by rectal suppository. They may also be given in urgent care or in a doctor’s office setting by intramuscular injection, intravenous line (IV), or rectal suppository.
A related medication, metoclopramide, can be taken by pill at home or be given by IV in an urgent care setting. Ondansetron and granisetron are strong anti-nausea medications that can be taken in regular or orally dissolving tablets.
How Long After Taking Pills Can I Throw Up Without Losing the Effectiveness of Migraine Medications?
Try as you might to keep it down, the oral medication you swallowed has made its way out once again. Now, the question first on your mind is likely “Was it down long enough to be absorbed — or was it wasted?”
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On average, the oral medication is absorbed into your system within 30 to 60 minutes — but it varies from person to person. What is long enough for one may not be for another. That’s why healthcare providers recommend taking medication via a route other than oral if significant nausea and vomiting occur. If your stomach is upset, your oral medication is probably not going to be absorbed properly even if you aren’t vomiting.
Will My Medication Still Work After I Throw Up?
This question is tricky to answer. If you throw up immediately or within 20 minutes after taking the medication, the answer is probably no. If you manage to hold it down for at least 30 minutes, it may still be helpful. At the very least, you may feel some relief from the very act of purging the contents of your stomach. Talk to your healthcare provider for instructions on taking a second dose via a different route.
Can Over-the-Counter Medications Treat Nausea and Vomiting During a Migraine Attack?
Prescription medications for nausea and vomiting are generally more effective than over-the-counter medications like meclizine. Try eating saltine crackers or bland foods, or sip lightly on sports drinks to replace lost water and electrolytes. Patients sometimes find drinking ginger tea or ginger ale calms the stomach. Avoid caffeine, spicy foods, and strong smells as odors can make nausea worse. If you’re to the point of vomiting, prescription pills are generally required to gain control over nausea and vomiting.
What Prescription Medications Are Used to Treat Nausea and Vomiting in People With Migraine?
- Gepants
- Lasmiditan
- Lorazepam: used for sleep and anxiety but has anti-nausea properties
- Ondansetron and granisetron: serotonin receptor medications
- Phenothiazines: Phenergan, Compazine, and Reglan target dopamine receptors
- Triptans
Cannabinoids
Cannabinoids are often used for treatment of nausea associated with chemotherapy. Not enough research has been done on their effectiveness on migraine-related nausea. Anecdotally, migraine patients say cannabinoids are helpful with nausea. One review of self-reported effects of inhaled cannabis showed reduction of migraine or headache pain by nearly 50 percent but with effectiveness diminishing over time.
One of the concerns of cannabinoids is the effects may be similar to the effects of opioids. It may provide short-term benefits at the risk of long-term worsening of the problem. Though rare, cannabinoid hyperemesis syndrome (CHS) can result from long-term cannabis use. CHS, which causes episodes of severe nausea and vomiting, can occur with frequent use of marijuana and resolves when marijuana is stopped.
What Are the Best Non-Oral Medications for Treating Nausea and Vomiting During a Migraine Attack?
Migraine-specific therapies should include treatment for headache, but also for other migraine-related symptoms, including nausea and vomiting. Taking migraine medication when nauseated can be a hard pill to swallow. Luckily, there are other medications that don’t require swallowing a pill:
- Dissolvable gepants (Nurtec)
- Injectable preparations: triptan (available as sumatriptan)
- Nasal preparations: sumatriptan liquid or powder forms
- Nasal sprays: zolmitriptan is inhaled directly into your nostrils
- Orally dissolvable tablets (ODT): ondansetron and granisetron pills melt under your tongue rather than by swallowing
- Suppositories: phenothiazine is administered rectally to treat symptoms of nausea and vomiting
Prescription medications target specific chemicals and hormones that can help to reduce nausea related to migraine. Prescription medications are generally more effective than non-prescription medications at targeting the mechanisms of nausea that are at play during a migraine attack.
Many of these prescription medications can be given by injection in urgent care settings. Severe nausea and vomiting can land you in the emergency room, which may be the only place to access treatments that will be absorbed and effective. IV fluids can also be given to prevent or treat dehydration and restore electrolyte imbalance.
What Are the Common Side Effects of Prescription Drugs Used to Treat Nausea and Vomiting?
As with all medications, anti-nausea and vomiting drugs like phenothiazines have side effects.
- Akathisia: Feeling of restlessness, inability to sit still, sensation of skin crawling and muscle quivering. This is a common side effect, especially when phenothiazine is given by injection.
- Drowsiness: Feeling of being sleepy, lethargic, excessive sleepiness.
- Dystonia: Involuntary muscle contractions and spasms that cause repetitive, twisting movements — often in the head and neck. This major severe side effect is of concern to healthcare providers and can be very uncomfortable and distressing to the patient.
These side effects are reversible and there are effective treatment options if they occur.
Ondansetron and granisetron are better tolerated and have fewer side effects associated with them. As always, talk to your doctor about which medication may best treat your nausea after taking medication.
Do People With Motion Sickness Have More or Less Migraine Nausea and Vomiting?
No studies have proven a link between motion sickness and migraine. There’s a higher occurrence of motion sickness, particularly in childhood, in those with migraine. It’s possible motion sickness is associated with more severe nausea and vomiting during migraine attacks.
On Your Way to Better Health
If you have migraine, treating your chronic and episodic pain is vital to living a happy, healthy life. Living with migraine is challenging enough, but adding nausea and vomiting takes it to a whole new level. If you find nausea and vomiting are out of control when a migraine attack strikes, or you struggle to keep your medications down, contact your neurologist or healthcare provider for assistance. You can’t make migraine disappear, but you can take steps to manage migraine by taking preventive medications, avoiding known migraine triggers, and dealing with nausea and vomiting as soon as they start.
