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Vomited Medications

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Vomited Medications, Re-dosing Medications After Vomiting

  • See Also
  1. Medication Induced Vomiting
  2. Medication Causes of Disordered Sense of Taste
  3. Difficulty Swallowing Pill
  • Management
  1. Medication taken within 15 minutes of Vomiting (or intact drug seen in Emesis)
    1. May re-dose medication
  2. Medication taken within 15-60 minutes of Vomiting
    1. May re-dose medication IF risk of missed dose outweighs risk of extra dose
    2. Re-dose in most cases of antimicrobials (e.g. Hepatitis C, HIV, Chlamydia)
    3. Consult with oncology regarding Chemotherapy medications
    4. Consult with transplant team regarding Immunosuppressants
    5. Combination Oral Contraceptives do not typically need re-dosing
    6. Avoid re-dosing of medications at higher risk of toxicity
      1. Avoid re-dosing Anticoagulants, Antihypertensives, Methotrexate, Phenytoin
      2. Avoid re-dosing diabetes and ADHD Medications
      3. Avoid re-dosing Acetaminophen or Opioids
    7. Avoid re-dosing medications in which a missed dose will have little impact
      1. Long Half-Life medications (e.g. Amiodarone, Fluoxetine)
      2. Medications intended for longterm prevention (e.g. Statins, Bisphosphonates, Dementia agents)
    8. Avoid re-dosing medications with rapid absorption
      1. Chewable, liquid or dissolving medications (e.g. sublingual or buccal medivcations)
  3. Medication taken within 3 hours of Vomiting
    1. Re-dose Progestin-Only PillContraception or Emergency Contraception
    2. However, longterm combination Oral Contraceptives do not typically require redosing
  • Prevention
  1. Consider pretreating Nauseating medications with an Antiemetic (e.g. Ondansetron)
  2. Some medications may be tolerated if taken with food
  3. Consider alternative routes of administration (e.g. intranasal Triptans)
  4. Consider alternative formulations (e.g. tablet instead of liquid)
  • References
  1. (2020) Presc Lett 27(2): 7-8
  2. (2024) Presc Lett 31(11): 62-3