Anti-emetic drugs are commonly used to treat nausea and vomiting, particularly in patients undergoing chemotherapy, radiation therapy, and surgery.

While these drugs are generally safe and effective, recent studies have suggested that they may increase the risk of stroke in certain patients. In this article, we will explore the relationship between anti-emetic drugs and stroke, and discuss what patients and healthcare providers need to know about this potential risk.

The Link Between Anti-Emetic Drugs and Stroke

Several studies have suggested a link between anti-emetic drugs and an increased risk of stroke.

For example, a study published in the Journal of Clinical Oncology in 2012 found that patients taking the drug aprepitant for chemotherapy-induced nausea and vomiting had a higher risk of stroke than those who did not take the drug. Similarly, a study published in the journal Cancer in 2013 found that the drug ondansetron was associated with an increased risk of ischemic stroke in patients with cancer.

The exact mechanism by which anti-emetic drugs may increase stroke risk is not entirely clear. Some researchers believe that these drugs may affect blood pressure and blood flow in the brain, which could increase the risk of stroke.

Others suggest that the drugs may interact with other medications or medical conditions to increase stroke risk.

Risk Factors for Stroke in Patients Taking Anti-Emetic Drugs

While anti-emetic drugs may increase the risk of stroke in some patients, not all individuals taking these medications are at equal risk. Certain factors may increase the risk of stroke in patients taking anti-emetic drugs, including:.

Age: Older adults may be at higher risk of stroke when taking anti-emetic drugs
History of stroke or heart disease
High blood pressure
Diabetes
Smoking
Obesity

Patients with these risk factors may need to be monitored more closely while taking anti-emetic drugs, and may need to avoid certain types of anti-emetics altogether.

Types of Anti-Emetic Drugs

There are several different types of anti-emetic drugs, each of which works in a slightly different way. Some of the most commonly used anti-emetic drugs include:.

5-HT3 receptor antagonists: These drugs, such as ondansetron and granisetron, block serotonin receptors in the gut and brain, reducing nausea and vomiting
Corticosteroids: Steroids such as dexamethasone can help reduce inflammation and nausea
NK-1 receptor antagonists: These drugs, such as aprepitant and fosaprepitant, block NK-1 receptors in the brain, reducing nausea and vomiting
Benzodiazepines: These drugs, such as lorazepam and diazepam, can help reduce anxiety and nausea
Cannabinoids: These drugs, such as dronabinol and nabilone, are synthetic versions of THC (the active ingredient in marijuana) and can help reduce nausea and vomiting

It is important to note that while all of these drugs can be effective at reducing nausea and vomiting, they may not all carry the same risk of stroke.

Patients should talk to their healthcare provider about the risks and benefits of each medication before starting treatment.

Reducing the Risk of Stroke in Patients Taking Anti-Emetic Drugs

For patients taking anti-emetic drugs, there are several steps that can be taken to reduce the risk of stroke. These may include:.

Choosing the right medication: Patients with a history of stroke or other risk factors may need to avoid certain types of anti-emetic drugs
Monitoring blood pressure: Keeping blood pressure under control can help reduce the risk of stroke in patients taking anti-emetic drugs
Monitoring for signs of stroke: Patients taking anti-emetic drugs should be aware of the signs and symptoms of stroke (such as sudden weakness or numbness on one side of the body), and should seek medical attention immediately if these symptoms occur
Discontinuing anti-emetic drugs if necessary: In some cases, the risks of taking anti-emetic drugs may outweigh the benefits, and the medication may need to be discontinued

Conclusion

Anti-emetic drugs are an important tool for managing nausea and vomiting in patients undergoing chemotherapy, radiation therapy, and surgery.

While these drugs are generally safe, recent studies have suggested that they may increase the risk of stroke in certain patients. Healthcare providers and patients should be aware of this potential risk, and take steps to reduce the risk of stroke when using anti-emetic drugs.