Managing Nausea and Vomiting on GLP-1s Guide

Nausea affects 15-30% of patients who take GLP-1s, and in rare cases it can lead to vomiting. The good news is this usually resolves over several weeks as your body adapts to the medication. It can, however, return with every dose increase so it’s important to reach out to the Medical Team via the Support Center in the app if your nausea persists so the titration schedule can be modified.

Importantly, if the nausea and vomiting are interfering with your daily life or if you’re unable to tolerate liquids, send the Medical Team a message through the Support Center to discuss the temporary use of a prescription anti-nausea medication. Keep in mind, these medications come with their own side effects such as constipation and drowsiness. They also have interactions with many medications such as SSRIs. Often, the below recommendations can help ease symptoms of nausea without having to resort to a prescription.

Nausea/vomiting can also be triggered by rapid changes in blood glucose while on GLP-1 medication. With this in mind, avoiding sugary/sweet foods can help prevent symptoms. Additionally, eating protein and fiber at the beginning of your meals can help blunt the glucose spike.

Try antihistamines - Over-the-counter antihistamine medication such as Diphenhydramine (Benadryl) and Meclizine (Antivert, Bonine) can help with mild nausea. However, be cautious as these medications can cause drowsiness and can lead to constipation. Follow the instructions on the packaging and do not drive until you know how these medications will affect you.
Take fennel seeds - Chew 1 tsp of fennel seeds or try sipping some fennel tea (we like the brand Traditional Medicinals for this). To make your own, simply steep fennel seeds or powder in boiled water. This approach works especially well after meals, but it can be used anytime.
Incorporate ginger - Ginger tea, lozenges, or fresh or powdered ginger added to meals can be particularly helpful. To make your own ginger tea, steep fresh ginger slices in boiling water for 15 minutes. For ready-to-use tea, we especially like Yogi and Traditional Medicinals. Sip slowly and, for best results, start taking the ginger before your nausea usually starts.
Use some lemon - Add a squeeze of fresh lemon juice to a bottle of water along with a pinch of sea salt. The water should be room temperature or warmer (never cold!). Drink this throughout the day.
Do acupressure - An acupressure technique commonly used for nausea is to apply pressure on your inner wrist about 2.5 inches from where your hand and wrist meet, between two large tendons. Holding pressure here for several minutes may help. Use a circular motion with firm but gentle pressure. Several other acupressure points can be helpful for nausea as well. You can also try a Sea-Band Anti-Nausea Acupressure Wristband.
Work on diaphragmatic or deep breathing - Long, slow exhales stimulate the parasympathetic nervous system to calm the nerves and put the body in “rest and digest” mode, which can alleviate nausea. To do this, breathe in through the nose, hold your breath for three seconds, and slowly exhale through the mouth. Try this for a couple minutes.

If these methods don’t provide relief, please reach out to the Medical Team via the Support Center in the app to discuss changing the dose of your medication and to see if a prescription anti-nausea medication is appropriate. Also, keep in mind that if you are having any issues with constipation, that can be a significant contributing factor to nausea as well. Let our Medical Team know (and also refer to our constipation guide).

Even without intervention, your nausea should start to improve after three-to-four weeks, so if it doesn’t, please reach out to the Medical Team. Also, always, if your symptoms get significantly worse, or if you’re worried about being dehydrated, please stop the medication; seek in-person medical care from your primary care doctor, urgent care, or the ER; and reach out to the Calibrate Medical Team.