CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Parkinson's disease - Management
How do I manage nausea and vomiting in people with Parkinson's disease?
For nausea or vomiting after starting or increasing the dose of a dopaminergic drug
- Initially, if nausea is mild:
- Reassure that nausea often settles over time as tolerance occurs.
- Advise the person to take their medication with food.
- If nausea persists or is more severe:
- Prescribe domperidone, reducing or stopping it when the nausea or vomiting settles.
- Do not use metoclopramide or prochlorperazine.
- Consider seeking the advice of a specialist, who may recommend one or more of the following:
- An increase in the proportion of decarboxylase inhibitor to levodopa (only feasible for co-careldopa).
- A slower titration of the anti-parkinsonian drug.
- A switch to an alternative.
For nausea or vomiting unrelated to medication
- If an anti-emetic is required, use domperidone, reducing or stopping it when the nausea settles. Avoid metoclopramide or prochlorperazine.
In depth
© NHS Institute for Innovation and Improvement