Can You Take Anti-Nausea Medication for Pregnancy Morning Sickness?

Up to 90% of pregnant people will experience some level of nausea or morning sickness during pregnancy. Thankfully, feeling nauseous or frequent vomiting during pregnancy is often manageable with diet and lifestyle changes, and sometimes the addition of over-the-counter medications. 

If your morning sickness is particularly bad, you may even consider if prescription antiemetics can offer some relief. Our pregnancy experts explain what brands of nausea medicine are safe for pregnancy and offer suggestions for other lifestyle changes and supplements that can help. 

Related: How to Ease the Most Common Pregnancy Symptoms

When Does Morning Sickness Happen During Pregnancy? 

The term “morning sickness” is most commonly associated with pregnancy nausea, but these symptoms can actually occur at any time of the day or night. 

According to the American College of Obstetricians and Gynecologists (ACOG), the reason that many pregnant people experience nausea is unknown, although it is thought to be caused by the hormone changes that occur in pregnancy. 

Nausea typically begins around 9 weeks of pregnancy and resolves by 14 weeks of pregnancy. This time frame can vary drastically, with some people never feeling nauseous, while 20-30% of pregnant women experience nausea beyond 20 weeks of pregnancy, or even through their entire pregnancy.

Over-The-Counter Medications for Morning Sickness 

Thankfully, there are over-the-counter medications available at most pharmacies When you are considering starting an over-the-counter medication, it’s a good idea to check in with your healthcare provider to make sure that it aligns with the medical advice that they provide. The most common and safe over-the-counter options include:

Unisom (doxylamine succinate)

Also available as an over-the-counter sleep aid, Unisom or doxylamine succinate provides relief from nausea. You can take Unisom tablets alone or in combination with vitamin B6. 

The recommended dosage is 12.5 mg orally twice per day (half of the over-the-counter pill). Most people prefer to take Unisom at night or right before bed because drowsiness is a common side effect. 

Antihistamines

OTC antihistamines are also a safe option to help with pregnancy nausea. Studies performed on the safety of antihistamine use in pregnancy have shown no increase in birth defects or other negative pregnancy outcomes. According to Up To Date, both medications can be taken 25 to 50 mg orally, every 4-5 hours as needed.

Some common brand name options include Gravol (dimenhydrinate) and Benadryl (diphenhydramine). The most common side effects of taking an antihistamine are drowsiness, sedation, dry mouth, lightheadedness, and constipation. 

Other Natural Remedies to Manage Nausea in Early Pregnancy

Beyond seeking over-the-counter treatment options, diet and lifestyle changes, supplements and other alternative interventions can help relieve morning sickness symptoms. 

Foods to Eat and Avoid for Morning Sickness 

The first step to managing nausea is to look at your diet during pregnancy and see how you can alter it to minimize food triggers and eat easier-to-digest bland foods. 

For some people, simply drinking ginger ale, eating crackers, dry toast, or other simple starches helps with their upset stomach. Other foods that have been shown to help with nausea include bananas, rice, and applesauce. 

There are also many common foods that can worsen nausea and vomiting during pregnancy that you may want to avoid. Spicy, fried, fatty, greasy, and acidic foods can trigger a bout of nausea more easily.

Many people often find foods with strong odors upsetting during pregnancy. Keeping a food journal can help determine what might cause nausea for you, helping you to avoid your personal trigger foods. 

 It is also important to eat frequently throughout the day as an empty stomach may make the pain worse. Adding protein to every meal and eating frequent protein snacks can also help lessen your symptoms. While some people experience aversions to eating meat in early pregnancy, good non-meat sources of protein include yogurt, nuts and seeds, and protein powders/shakes. 

Staying well hydrated, drinking electrolyte beverages, mint tea, and lemon water, drinking frequent small amounts, drinking from a straw, and consuming carbonated drinks can also be helpful.

Tip: Eating a protein snack (like a handful of almonds) when you wake up in the middle of the night can help reduce early morning sickness.

Alternative Interventions for Morning Sickness 

Some alternative interventions have been shown to help reduce nausea and vomiting in early pregnancy, and they have minimal to no negative side effects.

Acupuncture and Acupressure 

Although there is no confirmed research on if acupuncture and acupressure truly help with morning sickness, many people find these practices offer them some relief. They are valid options to try due to ease of access and low potential for negative side effects. 

One way to achieve acupressure at home is the use of wristbands which are marketed for sea sickness. These are widely available at most pharmacies, and apply constant pressure to a pressure point in the wrists. Some pregnant people find these tremendously helpful, while others find minimal benefit.

Aromatherapy 

Some pregnant people enjoy using essential oils for aromatherapy to offset feelings of nausea. The essential oil with the most proven benefit for nausea is lemon essential oil. It has proven benefits and is easy to achieve at home with an essential oil diffuser, or the bottle can be carried with you throughout the day and you can smell the oil when you feel nauseous.

Herbs

Some herbs have been shown to help reduce nausea, with the most impressive results seen with ginger. Ginger can be consumed in a capsule, candy, gummy, in some brands of ginger ale, and in tea made from fresh ginger. Other herbs that may be helpful to try are peppermint and chamomile.

Vitamins and Supplements for Morning Sickness

Vitamin B6 (pyridoxine) is the main supplement used for nausea that occurs in the first trimester of pregnancy. It can reduce symptoms of nausea, is very safe, and has minimal side effects. 

With very large doses outside of the normal taken in pregnancy, one rare side effect of B6 overdose is numbness in the hands and feet. The recommended dose of Vitamin B6 for a pregnant adult is 10-25 mg every 6-8 hours, with a maximum of 100 mg in a day.

Taking prenatal vitamins before and during pregnancy has been shown to reduce nausea, however sometimes the act of swallowing a large tablet can trigger nausea. Some people find that taking prenatal vitamins at night is more tolerable. Avoid supplements that contain iron until the nausea resolves, as iron can trigger nausea and vomiting.

If you have to pause taking your prenatal vitamin due to nausea, consider switching to a children’s chewable multivitamin along with a folic acid supplement (400 to 800 mcg daily). Tying a gummy prenatal vitamin is another possible option.  

When to Get Medical Help for Morning Sickness 

Nausea doesn’t hurt your baby, but it can cause dehydration, affect your mood and your ability to go to work or social events, and it can be exhausting. If none of the remedies listed here are helping, it’s important to talk to your healthcare provider about your symptoms. 

If you aren’t able to keep down food for more than 24 hours, you’re losing weight, you feel that nausea and/or vomiting is affecting your quality of life or causing you to skip work or school, these also warrant a call to your healthcare provider. 

According to ACOG, if you are unable to keep fluid down, you are only urinating a small amount and it is dark in color or you’re not urinating at all, you feel dizzy or you faint, or if you feel like your heart is racing, these may be signs of dehydration. 

If nausea and vomiting are severe, you may be diagnosed with hyperemesis gravidarum. Hyperemesis (or “HG”) is a medical diagnosis that occurs when vomiting leads to dehydration and weight loss and may require medications, intravenous fluids, and occasionally hospitalization. Thankfully, HG affects less than 3% of pregnancies.

There are some other medical conditions that can occur in pregnancy that can cause nausea and vomiting, including thyroid or gallbladder issues, food-borne illnesses, or ulcers, which is why it’s important to discuss symptoms and treatment options with your doctor.

Common Prescription Nausea Medications and Side Effects

When diet and lifestyle changes, supplements, and over-the-counter medications aren’t working, your healthcare provider may prescribe an antiemetic (or “anti-nausea”) medication.

Bonjesta 

Currently, Bonjesta is the only prescription medication marketed and FDA-approved specifically to treat nausea and vomiting in pregnancy. Bonjesta is also known by the brand names Diclegis and Diclectin). 

While your healthcare provider may prescribe the brand-name medication, it is often not covered by insurance and can be mimicked by taking vitamin B6 (pyridoxine) and Unisom (doxylamine) together. 

If Bonjesta doesn’t adequately manage symptoms, your healthcare provider may start to work down a list of other common prescription medications, along with continued diet and lifestyle changes, until you find a medication that works well for you. 

Reglan (Metoclopramide) 

Reglan is taken as a 5-10 mg oral pill every 6-8 hours as needed. The most common side effects include diarrhea, drowsiness, feeling weak, and constipation. This medication is not used long-term due to the potential to develop a rare but serious side effect known as tardive dyskinesia, which is an irreversible movement disorder.

Phenergan (Promethazine)

Promethazine can be taken as an oral pill, or a rectal suppository (which is preferred for people who cannot stop vomiting to keep the pill down). The dosage is 12.5 to 25 mg every four hours. The most common side effects include drowsiness, dizziness, and restlessness.

Zofran (Ondansetron)

While Zofran can be very effective to treat nausea and vomiting, its use in pregnancy is controversial, and therefore it is typically reserved for when other medications have failed to work.

Zofran is often not prescribed before 10 weeks of pregnancy. There is some evidence that Zofran use in early pregnancy is associated with a small increase risk of birth defects. The most common side effects include headache, fatigue, constipation, and drowsiness.

If all oral medications fail, or you are diagnosed with hyperemesis gravidarum, you will likely be prescribed intravenous medications which are administered in a clinic or at the hospital, along with IV fluids to avoid dehydration. 

The good news is that for the majority of pregnancies, nausea and vomiting resolve at the end of the first trimester, and most pregnant people go on to enjoy their pregnancies without having to worry about managing these uncomfortable symptoms.

Need more support?

Nausea and vomiting can be exhausting, on top of growing a baby which can already be a stressful time, even with all the joy that comes along with it. If you’re looking for more support and resources, thankfully there is a lot of help out there!

• If you are struggling with hyperemesis gravidarum, the HER Foundation is a great resource: https://www.hyperemesis.org/
• If you want to research the safety, risks, and side effects of medication use during pregnancy and breastfeeding, Mother to Baby has a huge list of Fact Sheets available: https://mothertobaby.org/