Sticking to your medication schedule is an essential step in controlling your epilepsy. But in some cases, your ability to keep your meds down may be out of your control, such as when you throw up.

“I vomited this morning and I’m concerned my meds went with it,” one MyEpilepsyTeam member wrote. Another said, “When you vomit shortly after taking your medication, how do you handle the situation medication-wise if you can physically see the meds in your vomit?”

Read on to discover what to do if you vomit after taking your epilepsy medication and whether there are ways to prevent this situation from happening.

Don’t Immediately Take an Extra Dose

Your first instinct after vomiting may be to immediately reach for an additional dose of your antiepileptic drugs (AEDs), but that could be a bad idea. Taking too much of your AEDs (also called anti-seizure medications) can lead to potentially dangerous side effects, which may include:

• Sleepiness
• Double vision
• Poor concentration
• Unsteadiness
• Tremors
• Vomiting
• Changes in heart rate
• Slowed breathing

“I have doubled up on my meds twice,” one MyEpilepsyTeam member wrote. “One time I ended up in the hospital, another time I was unable to walk, with double vision, drowsiness, etc. Oh, what a mess it is!”

Update Your Neurologist

If you vomit after taking your medication, contact your neurologist right away to get advice on what to do. While it’s clear that you don’t necessarily want to take a double dose, you also don’t want to miss a dose of your epilepsy treatment because that could cause you to have a seizure.

Your neurologist will take the following factors into account when evaluating whether you should retake your medications right away or wait until the next dose.

Which AED Did You Take?

Your neurologist will consider which anti-seizure medicines you take when deciding whether you should retake the drug.

For instance, your neurologist will consider the medication’s half-life. This is the time it takes your body to eliminate half of the medication from your system. Because many AEDs need to stay at the same level in your body, your doctor will use information about the medication’s half-life to determine whether you can forgo another dose of medication after vomiting.

What Is Your Dosing Schedule and Formulation?

Each person with epilepsy will take their AED on a different schedule and may even take a different formulation of the drug. For instance, one person may take an immediate-release formulation medication four times a day, while another may take a sustained-release formulation once a day that’s expected to slowly release into their bloodstream and reach sustained levels until the next day.

How Long After Taking the AED Did You Vomit?

Your doctor will be particularly interested in learning how much time passed between taking the antiepileptic drug and when you vomited. If you were able to see your medication in your vomit, let your physician know because it may guide their decision on whether you should retake it. If not, provide them with an estimate of the time that passed between taking your medication and the vomiting episode.

If you threw up within a few minutes of taking the medication, your health care provider may advise you to take another dose. But if an hour or more has passed, the neurologist may ask you to wait until your next scheduled dose before taking the medication again. However, this is just a general guide and every case is different, so always get specific advice from your neurology team.

Evaluate Vomiting Causes

You may vomit up your AEDs on occasion due to stomach upset, motion sickness, or other common reasons. But if vomiting becomes more frequent, it’s a good idea to investigate what may be causing it. This will not only help you improve your quality of life but can also help reduce the chances of throwing up your medication.

Unfortunately, nausea is a common side effect of many AEDs. One study found that nearly 34 percent of participants experienced nausea from taking their antiepileptic medications. Nausea may progress to vomiting, particularly when your body is just getting used to a new medication.

Some MyEpilepsyTeam members have found ways to reduce this side effect. “My doctor prescribed me an antiemetic to control nausea/vomiting before it started,” one member wrote. Another said, “I take a medication to control nausea too. It’s helped a lot.”

If you experience nausea or vomiting from your AED, ask your doctor how to manage this side effect.

In other cases, viral infections may cause vomiting. Even though these are typically short-lived, they may be seizure triggers in some people, so it’s important to call your doctor right away if you have a virus. They may prescribe medication to help curb vomiting episodes. This can help you potentially avoid seizure activity and help you to keep your medication down.

Know How To Overcome Nausea

Nausea and vomiting are part of everyone’s life occasionally, but for someone with epilepsy, these situations can be dangerous. That’s why it’s smart to have a strategy in place ahead of time that will help you manage nausea before it progresses to vomiting.

Get medical advice from your neurologist about nausea control methods that won’t interfere with your epilepsy treatment regimen. At-home solutions may include:

• Adjust your diet. Don’t eat heavy, fried foods and add clear liquids and bland options.
• Consume food and drinks more slowly.
• Avoid vigorous activities and exercises right after eating or drinking.
• Have small, frequent meals rather than eating big meals.
• Avoid mixing cold and hot beverages and foods together.

By working with your neurology team to find a solution, you’ll be less likely to face episodes of vomiting so you can ensure that your AEDs work for you.

Find Your Team

Are you or a loved one living with severe epilepsy? When you join MyEpilepsyTeam, you gain a community of more than 120,000 people who are living with epilepsy or who care for a loved one with the condition.

Have you vomited your seizure medication, or are you the caregiver of someone with epilepsy who has? Did you retake the missed dose or wait? Share your experiences or questions in a comment below, or start a conversation on your Activities page today.