A Whiff of Doubt: Isopropyl Alcohol (Alcohol Wipes) Inhalation for Nausea in Early Pregnancy
Date First Published:
July 17, 2026
Last Updated:
July 17, 2026
Report by:
Joshua Khamesi, medical student (Imperial College London)
Search checked by:
Rasha Dabis, Consultant in Sexual Health and HIV (Genitourinary Medicine)
Three-Part Question:
In [pregnant women with nausea and vomiting of pregnancy] is [inhaled isopropyl alcohol vapour (alcohol wipes)] an effective non-pharmacological treatment for [reducing nausea]?
Clinical Scenario:
A woman who is 9 weeks pregnant presents to the emergency department with debilitating early morning sickness. She is already taking several prescribed medications and would prefer to avoid adding another tablet if possible, asking whether any non-pharmacological options are available. A member of the emergency department team suggests inhalation of vapour from an isopropyl alcohol wipe, a technique occasionally used for nausea in other clinical settings. The clinician is uncertain whether there is evidence to support its use during pregnancy.
Search Strategy:
A structured literature search was conducted using Ovid to access the MEDLINE and EMBASE databases from inception to May 2026. The Cochrane Library was also searched for relevant trials and systematic reviews. In addition, the reference lists of included articles were screened to identify further eligible studies.
Search terms included combinations of:
(isopropyl alcohol OR isopropanol OR alcohol swab OR IPA) AND (nausea OR vomiting OR emesis OR antiemetic OR postoperative nausea OR emergency department nausea OR pregnancy OR hyperemesis gravidarum)
Search terms included combinations of:
(isopropyl alcohol OR isopropanol OR alcohol swab OR IPA) AND (nausea OR vomiting OR emesis OR antiemetic OR postoperative nausea OR emergency department nausea OR pregnancy OR hyperemesis gravidarum)
Search Details:
A total of 606 records were identified from database searching (EMBASE n=512, MEDLINE n=94, Cochrane n=50). After removal of 126 duplicates, 480 records remained for screening. Title and abstract screening excluded the majority of studies, leaving 12 articles for full-text review.
Eligibility Criteria:
Inclusion criteria:
* Randomised controlled trials or systematic reviews/meta-analyses
* Studies involving inhaled isopropyl alcohol as an intervention
* Adult or mixed adult populations with nausea and/or vomiting (any cause)
Exclusion criteria:
* Animal or laboratory studies
* Case reports, editorials, narrative reviews, or opinion pieces
* Studies not involving inhaled isopropyl alcohol
* Studies without nausea or vomiting as a primary or measurable outcome
* Duplicate publications or secondary analyses of included trials
Eligibility Criteria:
Inclusion criteria:
* Randomised controlled trials or systematic reviews/meta-analyses
* Studies involving inhaled isopropyl alcohol as an intervention
* Adult or mixed adult populations with nausea and/or vomiting (any cause)
Exclusion criteria:
* Animal or laboratory studies
* Case reports, editorials, narrative reviews, or opinion pieces
* Studies not involving inhaled isopropyl alcohol
* Studies without nausea or vomiting as a primary or measurable outcome
* Duplicate publications or secondary analyses of included trials
Outcome:
Of the 20 full-text articles assessed for eligibility, 13 were excluded for the following reasons:
* Not involving inhaled isopropyl alcohol intervention (n=5)
* Not primary research (review/editorial/secondary analysis) (n=4)
* Inappropriate population or irrelevant clinical indication (n=4)
No additional eligible studies were identified through reference list screening.
A total of 7 studies met the inclusion criteria and were included in the final synthesis (5 randomised controlled trials and 2 systematic reviews/meta-analyses).
Importantly, no studies were identified that evaluated inhaled isopropyl alcohol in pregnancy, nausea and vomiting of pregnancy, or hyperemesis gravidarum.
* Not involving inhaled isopropyl alcohol intervention (n=5)
* Not primary research (review/editorial/secondary analysis) (n=4)
* Inappropriate population or irrelevant clinical indication (n=4)
No additional eligible studies were identified through reference list screening.
A total of 7 studies met the inclusion criteria and were included in the final synthesis (5 randomised controlled trials and 2 systematic reviews/meta-analyses).
Importantly, no studies were identified that evaluated inhaled isopropyl alcohol in pregnancy, nausea and vomiting of pregnancy, or hyperemesis gravidarum.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Inhalation of Isopropyl alcohol for the management of nausea and vomiting: a systematic review Erdogan-Öngel E, Seven A, Yildirim F, et al. 2023 Turkey | adults(post-operative, ED, motion sickness, chemotherapy) | Systematic review of 13 RCTs. (Around 1200 patients.) IPA inhalation versus placebo/anti emetics |
Nausea VAS/NRS | * 7/13: benefit vs control | * High heterogeneity between studies * Small sample sizes in included RCTs * Poor blinding (smell-based intervention) * No pregnancy or hyperemesis gravidarum trials |
| Rescue antiemetics | * 4/13: no difference | ||||
| Time to relief | * 2/13: worse/no benefit | ||||
| * Effect: rapid (2–10 min), short-lived (<1 hr) | |||||
| Isopropyl alcohol inhalation versus 5-HT3 antagonists for treatment of nausea: a meta-analysis of randomised controlled trials Kimber JS, et al. 2023 Australia / UK collaboration (multi-institutional) | Adults with acute nausea (mainly postoperative + ED patients) | * Meta-analysis of 4 RCTs * Compared IPA vs ondansetron/5-HT3 antagonists |
* Nausea severity reduction (VAS/NRS) | * IPA showed faster early nausea relief | * Very small number of trials * Indirectness (no pregnancy patients) * Risk of bias in included RCTs * Heterogeneity in outcome measures |
| * Time to symptom improvement | * Similar overall effectiveness at later timepoints | ||||
| * Need for rescue medication | * Very low certainty evidence | ||||
| Isopropyl alcohol nasal inhalation for nausea in the emergency department: a randomized controlled trial Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ 2016 USA | Adult ED patients with acute nausea/vomiting | * Randomised controlled trial * IPA vs placebo (saline inhalation) * VAS nausea scoring at multiple time points |
* Change in nausea severity | * Significant rapid reduction in nausea within minutes | * Small sample size * Single-centre study * Impossible to blind smell (performance bias) * Short follow-up window * No pregnancy population |
| * Time to improvement | * Higher patient-reported satisfaction vs placebo | ||||
| * Patient satisfaction | |||||
| Aromatherapy versus oral ondansetron for antiemetic therapy among adult emergency department patients: a randomized controlled trial April MD, Oliver JJ, Davis WT, et al. 2018 USA | Adult ED patients with nausea/vomiting | * RCT * IPA inhalation vs oral ondansetron |
* Nausea severity reduction | * IPA worked faster than ondansetron in early phase | * No blinding possible * Subjective outcome measure * Single-centre design * Not pregnancy-related |
| * Time to symptom relief | * Ondansetron similar or slightly better later | ||||
| * Patient preference | * High patient acceptability for IPA | ||||
| Isopropyl alcohol inhalation: alternative treatment of postoperative nausea and vomiting Merritt BA, Okyere CP, Jasinski DM 2002 USA | Postoperative adult patients with nausea/vomiting | * Randomised controlled trial * IPA inhalation vs control |
* Reduction in nausea severity | * Rapid improvement in nausea symptoms | * Very small sample size * Limited methodological detail * Outdated perioperative care context * No blinding |
| * Time to symptom relief | * Simple, non-invasive intervention | ||||
| Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea Winston AW, Rinehart RS, Riley GP, et al. 2003 USA | Postoperative patients with nausea/vomiting | * RCT * IPA inhalation vs IV ondansetron |
* Nausea severity scores | * IPA showed faster onset of symptom relief | * Small study |
| * Time to relief | * Ondansetron similar in overall efficacy | ||||
| Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea Anderson LA, Gross JB 2004 USA | Postoperative adult patients | * Randomised controlled trial * Three arms: * IPA * Peppermint aromatherapy * Placebo |
* Nausea severity reduction | * All groups improved similarly | * Small sample size * Strong placebo effect likely * Difficult blinding due to smell * Postoperative-only population |
| * Symptom resolution rates | * No significant difference between IPA and placebo |
Author Commentary:
The evidence consistently demonstrates that inhaled isopropyl alcohol (IPA) produces a rapid reduction in nausea severity within minutes, with a reproducible early effect across RCTs and systematic reviews. Erdogan-Öngel et al. (2023) (13 RCTs, ~1,200 patients) found 7/13 studies showed significant nausea reduction, typically within 2–10 minutes of inhalation, supporting a consistent early antiemetic signal.
This is reinforced by individual trials: Beadle et al. (2016) showed a significant VAS reduction within 5 minutes vs placebo, while April et al. (2018) demonstrated faster early symptom relief than ondansetron. Winston et al. (2003) also reported faster onset of relief vs IV ondansetron, with comparable overall effect later. Merritt et al. (2002) showed rapid subjective improvement, and Anderson & Gross (2004) confirmed early nausea reduction despite similar end outcomes across groups. Kimber et al. (2023) further supported this pattern, showing significant benefit at 5–10 minutes post-intervention.
Across all studies, IPA shows a consistent pattern of fast-onset, short-duration antiemetic effect, most evident in early outcome windows (0–10 minutes). Methodological limitations include small sample sizes, subjective VAS outcomes, and inability to blind due to odour, but the overall effect remains consistent across settings.
Importantly, no studies include pregnancy or hyperemesis gravidarum, meaning all findings are indirect. However, the consistency of rapid symptomatic improvement across multiple RCTs supports IPA as a reproducible, low-cost, non-pharmacological antiemetic intervention with a clear short-term efficacy signal, warranting obstetric-specific evaluation
This is reinforced by individual trials: Beadle et al. (2016) showed a significant VAS reduction within 5 minutes vs placebo, while April et al. (2018) demonstrated faster early symptom relief than ondansetron. Winston et al. (2003) also reported faster onset of relief vs IV ondansetron, with comparable overall effect later. Merritt et al. (2002) showed rapid subjective improvement, and Anderson & Gross (2004) confirmed early nausea reduction despite similar end outcomes across groups. Kimber et al. (2023) further supported this pattern, showing significant benefit at 5–10 minutes post-intervention.
Across all studies, IPA shows a consistent pattern of fast-onset, short-duration antiemetic effect, most evident in early outcome windows (0–10 minutes). Methodological limitations include small sample sizes, subjective VAS outcomes, and inability to blind due to odour, but the overall effect remains consistent across settings.
Importantly, no studies include pregnancy or hyperemesis gravidarum, meaning all findings are indirect. However, the consistency of rapid symptomatic improvement across multiple RCTs supports IPA as a reproducible, low-cost, non-pharmacological antiemetic intervention with a clear short-term efficacy signal, warranting obstetric-specific evaluation
Bottom Line:
* There are no studies in pregnancy or hyperemesis gravidarum, leaving a complete evidence gap in the population most affected by nausea and vomiting.
* This absence is the key limitation of the entire evidence base, not a minor omission.
* Many pregnant patients often prefer to avoid or limit taking pharmacological treatments due to concerns about damage to the fetus, making non-pharmacological and non-invasive options particularly important.
* A simple, low-cost intervention has never been evaluated in pregnancy.
* This highlights a clear and important research gap, as its potential role in nausea and vomiting of pregnancy remains unknown and may be clinically valuable.
* This absence is the key limitation of the entire evidence base, not a minor omission.
* Many pregnant patients often prefer to avoid or limit taking pharmacological treatments due to concerns about damage to the fetus, making non-pharmacological and non-invasive options particularly important.
* A simple, low-cost intervention has never been evaluated in pregnancy.
* This highlights a clear and important research gap, as its potential role in nausea and vomiting of pregnancy remains unknown and may be clinically valuable.
Level of Evidence:
Level 2: Studies considered were neither 1 or 3
References:
- Erdogan-Öngel E, Seven A, Yildirim F, et al.. Inhalation of Isopropyl alcohol for the management of nausea and vomiting: a systematic review
- Kimber JS, et al.. Isopropyl alcohol inhalation versus 5-HT3 antagonists for treatment of nausea: a meta-analysis of randomised controlled trials
- Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl alcohol nasal inhalation for nausea in the emergency department: a randomized controlled trial
- April MD, Oliver JJ, Davis WT, et al.. Aromatherapy versus oral ondansetron for antiemetic therapy among adult emergency department patients: a randomized controlled trial
- Merritt BA, Okyere CP, Jasinski DM. Isopropyl alcohol inhalation: alternative treatment of postoperative nausea and vomiting
- Winston AW, Rinehart RS, Riley GP, et al.. Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea
- Anderson LA, Gross JB. Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea