I got through 24 cycles of Folfirinox and 22 cycles of 5-FU/Leucovorin every 15 days over 24 months without interruption using the following proactive methods:

Always kept a small amount of bland food in my stomach such as crackers, low salt pretzels, saltines and bland foods when eating during chemo sessions.

Ate small meals-more like grazing throughout the day.

Used some form of ginger as it is an anti-emetic. Chewing thinly sliced fresh ginger was very effective in quickly knocking down queasiness. Hard ginger candy, sipping room temperature Ginger Ale or drinking warm ginger tea.

Drinking cold water, particularly on an empty stomach would trigger queasiness. I slowly sipped room temp water and always ate a small amount of bland food.

Aroma therapy with essential oils: lavender, citrus (orange) and peppermint were ones I had tried.

There are several pathways that can lead to nausea. There is no single drug developed yet acts on all of the pathways simultaneously. Anticipatory nausea becomes an issue when having experienced queasiness, nausea and vomiting with prior cycles. It will require being proactive in taking a combination of anti-emetics prior to chemo administration. The following is a list of anti-emetic medications:

Drug |Activity |Side Effects
Aloxi, Anzemet, Kytril, Zofran, Ginger (the spice) |
Activity: Serotonin 5-HT3 receptor agonist |
Side effects: Constipation, Dry mouth, Fatigue

Compazine, Motilium, Zyprexa |
Dopamine agonist Targets D2 receptor |
Side effects: Constipation, Dry mouth, Fatigue, Muscle spasms, Tinnitus, restlessness

Emend, Varubi
NK1 receptor agonist
Decrease in urination, Dry mouth, Heartburn

Cannabis, Marinol (Dronabinol), Cesamet (Nabilone) |
Cannabinoid |
Perception, Dizziness

Also, for longer-acting relief, Sustol (aka granisetron, a 5-HT3 receptor antagonist) is a 5-day extended release antiemetic injection to relieve nausea.

https://www.sustol.com/hcp https://www.sustol.com/patient

A couple of links addressing nausea:
https://www.ncoda.org/wp-content/uploads/2021/03/
nauseavomiting_supplemental.pdf

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