• Clinical science
  • Clinician



Antiemetics are a heterogeneous group of drugs used to treat various causes of nausea and vomiting. Different antiemetics act on different receptors, and they may have a peripheral effect, a central effect, or both. Whereas serotonin antagonists, for example, bind 5-HT3 receptors and effectively combat cytotoxic drug nausea, certain anticholinergic drugs target M1 receptors and specifically treat motion sickness (kinetosis). Hospitals and clinics commonly use the dopamine D2 antagonist metoclopramide. However, because of its strong central effect and possible extrapyramidal side effects, metoclopramide must be used with caution.


Antiemetic class Drug Mechanism of action Clinical use Side effects
Dopamine receptor antagonists
  • Prokinetic effect used to treat diabetic and postsurgery gastroparesis (delayed gastric emptying)
  • Hyperemesis gravidarum
  • Persistent GERD
  • D2 antagonist
  • Central antiemetic effect at the area postrema
  • Prokinetic effect

Serotonin receptor antagonists

(5-HT3 antagonists)

  • 5-HT3 antagonist
  • Strong central antiemetic effect at the area postrema
  • Peripheral antiemetic effect via inhibition of the vagus nerve
Anticholinergic agents
  • Motion sickness, vestibular-induced nausea, and vomiting


Neurokinin receptor antagonists

  • NK1 antagonist
  • Inhibition of NK1 receptors in the solitary nucleus central antiemetic effect via
  • Additional inhibition of substance P-induced vomiting due to antagonism


Benzodiazepines [3][4]

  • GABA agonist
  • Central antiemetic effect likely due to depression of the chemotrigger zone [4]

Atypical antipsychotics [3][4][5][6]

Cannabinoids [3][7][8]

  • CINV treatment
  • Anorexia causing weight loss in patients with advanced HIV






We list the most important contraindications. The selection is not exhaustive.

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last updated 03/27/2020
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