Over the counter medicine for morning sickness

There’s a reason morning sickness is the most well-known symptom of pregnancy—it’s really common. “Fifty to ninety percent of pregnant people experience some degree of nausea, with or without vomiting,” says Dr. Nathan Fox, ob-gyn, creator of the Healthful Woman podcast and Babylist Health Advisory Board member. So there’s a decent chance you’ll feel some level of nausea while pregnant, especially during the first trimester.

But what about when your stomach is upset all the time? Or what if your nausea is so bad that you can barely get out of bed? If you’re experiencing a level of morning sickness that has you feeling like you’re on a ship at high seas all day (and all night) long, you might consider talking to your healthcare provider about a pharmaceutical intervention.

Nausea Beyond the First Trimester

While most pregnancies typically include nausea during weeks five through 16 or so, some pregnant people might experience nausea and/or vomiting past that point. “Symptoms may continue until the third trimester in 15 to 20 percent of women,” Dr. Fox says, “and until delivery in five percent.” Yikes. Thankfully, doctors have a few go-to solutions for both extreme and long-term nausea (as well as for run-of-the-mill, kinda-queasy nausea).

Doctor-Recommended, Pregnancy-Safe Nausea Relief

Dietary Changes for Morning Sickness

Most morning sickness (which is a total misnomer, as you’ve probably experienced—it can occur at any time of day) can be alleviated by dietary changes like avoiding greasy, hot foods, sticking to food that’s cold, bland or easy to digest and eating smaller, more frequent meals.

But sometimes, dietary changes aren’t enough. If you’re still feeling ill even after having nothing but ginger ale, bananas and dry toast (some of the most commonly recommended food remedies for nausea), it might be time to talk to your healthcare provider about medication.

Vitamin B6 + Antihistamines for Morning Sickness

“Fortunately, about half of pregnant people improve significantly with a combination of Vitamin B6 and Unisom (doxylamine),” Dr. Fox says, “which are both safe to take in pregnancy.” You may recognize Unisom as an over-the-counter sleep aid, but it’s also an antihistamine to treat hay fever and allergy symptoms, and it’s a common nausea treatment.

Another antihistamine often used to treat pregnancy-related nausea is Benadryl (diphenhydramine), says Dr. Nateya Carrington.

Keep in mind that antihistamines commonly have the side effect of drowsiness, so your doctor will likely tell you to take it at night. And keep in mind that before taking any medication, talk to your healthcare provider to make sure it’s the right treatment option for you.

Don’t want to take two pills at once? Good news: Dr. Fox says, “There are [FDA-approved] prescription medications like Bonjesta and Diclegis that combine Vitamin B6 and doxylamine into one pill to be taken once or several times a day.”

Vitamin B6 + Natural Ingredients for Morning Sickness

You can also find Vitamin B6 (without doxylamine) in combination with other natural, non-pharmaceutical nausea remedies like ginger, mint or lemon, usually in the form of chews or lozenges. Some natural flavors—ginger especially—can work wonders on nausea all on their own!

Prescription Medications for Morning Sickness

In a small percentage of pregnancies, nausea can get so bad (sometimes classified as hyperemesis gravidarum) and be so persistent that the usual remedies don’t provide much relief. If you’ve tried everything above—from dietary changes to over-the-counter medications—but are still overwhelmed by nausea and/or vomiting, Dr. Carrington advises you should ask your provider about trying prescription medications.

“Nausea during pregnancy is one of the most common and uncomfortable symptoms that impacts about 70% of pregnant women,” says Janelle Luk, MD, medical director and co-founder of Generation Next Fertility in New York City. 

What causes nausea during pregnancy?

“Nausea is linked to the pregnancy hormone (human chorionic gonadotropin [or HCG] hormone), which is released when the fertilized egg attaches to the uterine lining,” Dr. Luk says. It’s also linked to elevated estrogen and progesterone levels during pregnancy.

What week of pregnancy does nausea start?

Nausea is usually most severe during early pregnancy within the first trimester (which includes the first 13 weeks of pregnancy), and may even be associated with vomiting. Luckily, these sickness symptoms should start to disappear in the second trimester after HCG hormone levels have peaked and no longer interfere with your daily life. Unfortunately for some women, pregnancy nausea can last the duration of the pregnancy. You’ve probably heard the term “morning sickness,” but that’s a misnomer. It should really be called “all day sickness,” because the truth is that it can strike at any time of the day or night. And it feels awful.

The good news is, the typical nausea and vomiting related to hormone changes experienced during pregnancy is unlikely to harm the fetus. If you can’t keep any food or fluids down due to severe nausea and vomiting—a condition known as hyperemesis gravidum—you should seek medical attention. If left untreated, it has the potential to be harmful to the developing fetus. More on this in a bit. Aside from this very rare scenario, pregnancy nausea and vomiting is harmless. To the fetus. 

For the pregnant woman, it’s a relentless queasiness that makes you want to hide in bed all day (as long as there’s a bathroom nearby). Here are 9 remedies you can try.

9 lifestyle changes for nausea during pregnancy 

Outside of pregnancy, feelings of nausea might have you running to the pharmacy for an over-the-counter (OTC) solution; however, drug choice requires more thought when you’re pregnant. 

Often, pregnant people are able to manage their nausea on their own, according to Rebecca Berens, MD, lactation consultant and board-certified family medicine physician at Vida Family Medicine in Houston. Here’s a list of natural remedies to try if you experience nausea while pregnant:

1. Eat small meals or bland foods. “Home remedies with small, frequent, bland snacks, such as saltine crackers or dry toast [may be enough],” says Dr. Berens. “Hard candies such as peppermints, sour candies, and commercial products such as ‘Preggie Pops’ can also be effective.” Avoid skipping meals and having an empty stomach, which can make nausea worse.
2. Try ginger products. Products containing ginger are known to be helpful, such as ginger candies and ginger teas,” Dr. Berens says. For nausea relief, it may help to try products like ginger ale). 
3. Limit acidic or spicy foods. During pregnancy, the hormone progesterone causes the esophageal sphincter to relax, increasing the odds of heartburn, and acidic foods like citrus fruit or spicy foods like hot peppers can make heartburn worse.
4. Avoid stuffy rooms or strong odors. Family nurse practitioner and owner of Staunton Primary Care in Cincinnati, Ciara Staunton says that avoiding nausea triggers like heat, humidity, stuffy rooms and odors (perfume, chemicals, food, and smoke) is important. 
5. Get enough rest and sleep in the correct position. Quickly changing positions and not getting enough rest/sleep may also aggravate symptoms of morning sickness, says Staunton. Don’t forget to get some exercise. It can help with nausea.
6. Wait to lie down after eating. Lying down soon after eating and lying on the left side are additional potentially aggravating factors,” Staunton says. She explains that this could slow down digestion and keep food in your stomach for longer.
7. Wear anti-nausea wristbands. Using acupressure bands like Sea-Bands can decrease the severity and frequency of nausea and vomiting. You can also try homeopathic remedies like acupressure, but be sure to seek a practitioner who has experience treating pregnant patients. 
8. Change the timing of your prenatal vitamins. If your prenatal is making you feel sick, consider taking the vitamin at a different time. For example, if you normally take them in the morning, switch the timing up to the afternoon or evening. Also, don’t take your prenatal on an empty stomach.
9. Try alternative treatments. Although not scientifically proven, some people have reported relief from alternative therapies such as acupuncture, hypnosis, aromatherapy and others.

What can I take for nausea during pregnancy?

OTC treatments

Our experts say if those interventions fail to ease your nausea, it’s time to talk to your provider. There are OTC and prescription medications that may help. The following treatment options are safe for pregnancy nausea:

• Vitamin B6: Your best bet for nausea, Staunton says, is vitamin B6 supplements: “Vitamin B6, 50–100 mg orally once daily, is nontoxic and may help some patients.” If your prenatal vitamin already contains vitamin B6, which is also known as pyridoxine, consult your healthcare provider before taking additional supplements. Too much vitamin B6 can cause nerve damage and numbness.
• Emetrol: The over-the-counter syrup is considered safe to take during pregnancy. Take 1-2 tablespoons in the morning when you wake up, or if you are vomiting, take 1-2 tablespoons every 15 minutes until the vomiting stops. Do not exceed five doses in an hour.
• Unisom: Dr. Berens says that Unisom (doxylamine 25mg) is another drug that is safe and sometimes effective in treating nausea and vomiting during pregnancy. 
• Diclegis: The FDA has approved a prescription medication for use during pregnancy that is a combination of Vitamin B6 and doxylamine called Diclegis. This is the only FDA approved medication for treating nausea and vomiting during pregnancy.

“The same effect is possible, and much cheaper, by buying [Vitamin B6 and doxylamine] over the counter,” says Dr. Berens. “Many physicians recommend trying Vitamin B6 alone first, then adding doxylamine, which is also a sleep aid, if Vitamin B6 alone is not effective. The sedating side effects of doxylamine may not be desired by a woman in her first trimester who is already exhausted!” One way to potentially avoid the unwanted sedating effects of doxylamine—but also to reap the anti-nausea benefits!—is taking it first at bedtime and waiting to see if it reduces daytime nausea. 

Researchers are not totally sure why the Unisom/Vitamin B6 combination works to treat morning sickness. It might be because the drug combination blocks the neurotransmitters that send nausea signals in your brain. Or it could be that it simply disrupts your bodily processes that lead to vomiting. 

You may be tempted to try CBD or cannabis to help with nausea during pregnancy, since these products are popping up everywhere and known to help with stomach issues. However, the FDA strongly recommends against using CBD or THC during pregnancy or while breastfeeding.

Prescription medications for nausea during pregnancy

Some women experience extreme nausea and vomiting during pregnancy that can’t be controlled with dietary changes or OTC medications; this is known as hyperemesis gravidarum. If this is the case for you, talk to your provider to first make sure no other medical conditions are involved and to explore other prescription medications that might help. 

Although rare, occurring only in approximately 0.3-3% of pregnancies, hyperemesis gravidarum can cause such extreme nausea that it’s difficult to keep anything down, including fluids, resulting in weight loss and extreme dehydration. It can also make it hard to get enough nutrients for a growing baby. Per Dr. Berens, “Dehydration associated with hyperemesis gravidarum … can be serious and requires urgent treatment.” Seek medical treatment if you are experiencing severe nausea or vomiting. 

There are many prescription medication options available to treat severe cases of extreme nausea and vomiting, but unfortunately clinical trials often exclude pregnant women, which makes it difficult to fully understand if potential harm exists when used during pregnancy. Working with your healthcare provider, it is important to weigh the potential risks of leaving your nausea and vomiting untreated with the benefits of trialing these medications on a case-by-case basis. 

If you are experiencing nausea with your pregnancy or wondering what’s the strongest medicine that you can take safely during your pregnancy, consult with your healthcare provider. Possible prescription medications for severe morning sickness and pregnancy nausea include the following:

• Phenergan (promethazine)
• Zofran (ondansetron)
• Antivert (meclizine)
• Inapsine (droperidol)
• Tigan (trimethobenzamide) 
• Thorazine (chlorpromazine) 
• Dramamine (dimenhydrinate)
• Benadryl (diphenhydramine)

It’s important to speak with your primary care provider or your OB-GYN, before taking any of the above medication.

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