A side effect of ability is nausea/vomiting, likely for the reasons you noted, so what are your options? The obvious, which I absolutely am not going to recommend, would be discontinuing it. Again, I don't suggest this, and not going to discuss timing of that. Second option would be taking a large stat dose Of reglan. I don't recall the affinities at the D2 receptor off the top of my head. (This would only be a starting place to determine if this is possible and relative dosages that would be needed).
the third option would be to explore other antiemetics, namely zofran. I know the commonly accepted view is that zofran doesnt have any effect on SN. The ctz is complex, and I can tell you zofran is, by a wide margin, the drug used to prevent nausea due to chemotherapy or anesthesia in the US. I haven't commented on this before, as reglan works great, and it is accepted as fact here. I'll just relay that tens of thousands of doses (or much more) of zofran are used in a hospital setting to prevent NV.
you might also look at small doses of propranolol and benzos to decrease anxiety and some SN physical symptoms. I'm hypothesizing, some of the vomitting, especially when it occurs very quickly, is due to anxiety
one other thing to put your mind at ease is that due to constant partial agonism by ability, your D2 receptor will be slightly downregulated, and you MAY be less likely to vomit from SN than had you not taken the ability. Also, keep in mind that vomitting does not mean the attempt has failed. People have succeeded with taking no additional SN or by taking a smaller dose if NV occur.
