Vomiting from Drugs: Causes, Common Medications, and What to Do

When you take a new medication and start feeling sick to your stomach, it’s not always just a bad day—it could be vomiting from drugs, a direct reaction to a pharmaceutical compound that irritates the digestive system or triggers the brain’s vomiting center. Also known as drug-induced nausea and vomiting, this reaction isn’t rare. In fact, it’s one of the most common reasons people stop taking their meds—even when those meds are life-saving.

Some drugs are just more likely to cause this than others. Antibiotics like azithromycin, a macrolide antibiotic used for respiratory and skin infections, can trigger nausea and vomiting, especially in older adults. Chemotherapy drugs, painkillers like opioids, and even common pills like iron supplements or NSAIDs are frequent culprits. Even some heart meds and antidepressants can upset your stomach. The problem isn’t always the drug itself—it’s how your body reacts to it. Your gut has its own nervous system, and many drugs interfere with it directly. Others activate the chemoreceptor trigger zone in your brain, which doesn’t care if the drug is helping your condition—it just says, "Get this out."

What makes it worse is that people often ignore early signs. A little nausea after taking a pill? They think it’ll pass. But if vomiting keeps happening, it’s not just uncomfortable—it can lead to dehydration, poor nutrient absorption, and even treatment failure. That’s why knowing which drugs are most likely to cause this matters. For example, macrolide antibiotics, a class of drugs including clarithromycin and azithromycin, are linked to QT prolongation and gastrointestinal distress, especially when taken on an empty stomach. And if you’re on multiple meds, interactions can make vomiting more likely. A drug that slows digestion might let another sit in your stomach longer, increasing irritation.

There’s no one-size-fits-all fix, but there are practical steps. Taking meds with food often helps. Switching to a delayed-release version can reduce stomach upset. Sometimes, your doctor can add an antiemetic like ondansetron or metoclopramide. But don’t just power through it—talk to your provider. Vomiting from drugs isn’t something you have to live with. Many people stop their treatment because they assume it’s normal. It’s not. There are options, and your health depends on you speaking up.

Below, you’ll find real-world insights from patients and doctors on how specific drugs trigger nausea, which ones are safest for sensitive stomachs, and what actually works to stop the vomiting before it derails your treatment.