Melphalan Vomiting Management: Simple Ways to Keep Nausea at Bay

Melphalan is a powerful chemo drug, and a common side effect is feeling sick or actually vomiting. That won’t help you heal, so you need a plan that works right away. Below are straight‑forward steps you can add to your routine without any medical jargon.

First, know why melphalan makes you nauseous. It attacks fast‑growing cells, including those in your stomach lining and the brain’s vomiting center. The result is a rapid trigger that can start minutes after an infusion and last for a day or two. Knowing the timing helps you line up the right tools.

Antiemetic Options You Can Use

Ask your oncologist about a combination of anti‑vomit meds. The most common trio includes a serotonin blocker (like ondansetron), a dopamine blocker (such as metoclopramide), and a steroid (dexamethasone) for extra protection. Take the first dose about 30 minutes before melphalan, then follow the schedule they give you. If oral pills upset you, many clinics can give you an IV or a patch that works for 24‑48 hours.

Don’t forget to ask about newer agents like olanzapine or NK‑1 antagonists if standard drugs don’t cut it. They’re safe for most people and can dramatically lower the need for rescue meds.

Everyday Tricks to Reduce Nausea

Small habit changes make a big difference. Eat a light, bland snack (crackers, toast, or a banana) 1‑2 hours before your chemo session. Avoid greasy, spicy, or very sweet foods the day of treatment—they’re more likely to trigger the gag reflex.

Stay hydrated, but sip slowly. Warm ginger tea, flat ginger ale, or a few bites of fresh ginger can calm the stomach. If you can’t keep liquids down, try small sips of electrolyte solution every 10‑15 minutes instead of big gulps.

Position matters, too. Sit up or recline slightly upright for at least an hour after infusion. Lying flat can let stomach acid rise, worsening nausea.

When you feel a wave coming on, try the “pressure point” trick: press firm gentle pressure on the inner wrist, about three finger‑widths down from the base of the palm. Many people find it helps distract the brain’s nausea center.

Don’t rely on coffee or nicotine—they can actually heighten nausea for many patients. If you smoke, consider a nicotine patch or a low‑dose lozenge instead of a cigarette during chemo days.

Track your symptoms in a simple notebook or app. Write down the timing of each melphalan dose, the antiemetics you took, what you ate, and how you felt. Spotting patterns lets you and your doctor fine‑tune the plan.

When to call the doctor? If you can’t keep any fluids down for more than 12 hours, if you vomit more than three times in a row, or if you notice blood or severe abdominal pain. Those signs mean you need immediate medical attention.

Finally, give yourself permission to rest. Stress amplifies nausea, so schedule short breaks, listen to calming music, or practice deep breathing for a few minutes every hour. A relaxed mind often means a calmer stomach.

Putting these strategies together—proper antiemetics, timed meals, hydration tricks, and symptom tracking—creates a solid safety net against melphalan‑induced vomiting. Talk to your care team about any step you’re unsure about, and adjust as you learn what works best for your body.