Morning sickness affects many pregnant women. Though most cases of morning sickness can be managed with dietary changes and will resolve themselves by the end of the first trimester, more severe cases may need treatment with medications.
Pyridoxine and Doxylamine
Doxylamine, an antihistamine, and pyridoxine, also called Vitamin B6, have been given in combination to relieve mild to moderate cases of morning sickness. Doxylamine may work to suppress a vomiting center in the brain. Pyridoxine may work by replenishing depleted Vitamin B6 levels in the pregnant woman. Doxylamine has been used in common over-the-counter sleep aids and may cause drowsiness and dry mouth. Both doxylamine succinate and pyridoxine are available without a prescription.
Metoclopramide
Metoclopramide is the only medication approved by the Food and Drug Administration to treat nausea related to morning sickness. It is a medication that reduces gastric emptying time by speeding up the movement of food out of the stomach and into the intestines, which reduces nausea and vomiting. It has been shown to be safe during pregnancy and is now classified as a Category A medication for use during pregnancy. Metoclopramide may be given up to four times daily and is available by prescription in injectable and tablet form.
Phenothiazines
Prescription phenothiazine anti-emetics such as promethazine or prochlorperazine have been used as off-label medications for cases of severe nausea and vomiting associated with pregnancy, particularly if vomiting is causing dehydration or weight loss. Many physicians will not prescribe phenothiazines unless the morning sickness has progressed to a condition known as hyperemesis gravidarum, or HG, that is threatening the health of the mother or baby. Phenothiazine type anti-emetics have side effects such as sedation, dizziness, dry mouth and constipation. Both promethazine and prochlorperazine are available in injectable, rectal and oral formulations.
Ondansetron
Ondansetron is an anti-emetic available by prescription in injectable and tablet formulations that has traditionally been used to treat severe nausea and vomiting associated with chemotherapy or surgical procedures requiring general anesthesia. It has also been used as an off-label use to treat severe nausea and vomiting associated with pregnancy to prevent health risks of HG. It works by suppressing serotonin activity which may help to reduce nausea and vomiting. It may cause side effects such as diarrhea, constipation, headache, dizziness and visual disturbance.
