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Nausea medications for pregnancy: What is the strongest?

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Prescription optionsOTC optionsNatural remediesSummary
Prescription-only combination medications are the strongest medications for reducing symptoms of morning sickness. Yet a variety of natural remedies can also help.
Medically reviewed by Jennie Olopaade, PharmD, RPH
Written by D. M. Pollock
Updated on

Morning sickness is the feeling of intense nausea or physical vomiting that happens during pregnancy. Despite its name, it can happen at any time during the day or night.

While morning sickness is usually nothing to worry about, it can be unpleasant and cause serious disruption to your ability to function throughout your daily life.

For most people, nausea and vomiting from pregnancy will go away after 14 weeks. If your symptoms are severe, you may have a condition known as hyperemesis gravidarum. This is the most severe type of morning sickness.

If your symptoms affect your daily life, you may be able to try a variety of remedies and prescription medications to relieve your symptoms.  

Prescription options

A pregnant person washing their hands in a bathroom after taking nausea medication for pregnancy.
Photography by Klaus Vedfelt/Getty Images

Morning sickness is common and affects up to around 70% of pregnant people. While nausea and vomiting during pregnancy are not harmful to you or your baby, regular vomiting can prevent you from getting essential minerals and nutrients from your food.

If you experience severe vomiting or symptoms of nausea are affecting your daily life, a doctor may recommend a strong prescription medication.

While over-the-counter (OTC) options are available, prescription drugs are generally stronger. But they might also have a higher risk of side effects.

Some examples include:

Combination medications

A combination medication containing doxylamine and pyridoxine is considered by experts to be a first-line treatment for pregnancy-related nausea and vomiting. It is the only type of medication approved by the Food and Drug Administration (FDA) for this use.

These medications contain both pyridoxine (a similar substance to vitamin B6) and doxylamine (an antihistamine). This combination of ingredients may be the strongest medication available to manage morning sickness symptoms.

According to a 2016 research review, taking these combination medications before you notice morning sickness can be more effective than taking them once you experience nausea.

Doctors may prescribe one of two combination medications. These medications are available by prescription only. They contain the same ingredients but at different strengths:

  • Diclegis: This medication contains 10 milligrams (mg) doxylamine and 10 mg pyridoxine
  • Bonjesta: This medication is an extended-release medication, meaning it takes longer to work than Diclegis but is more suitable for longer-term treatment. It is also a higher strength, containing 20 mg doxylamine and 20 mg pyridoxine.

Anti-sickness medications

Metoclopramide is a type of medication that belongs to a group of dopamine receptor agonist medications. It is available as a generic medication and under brand names, such as Reglan.

It is an anti-sickness medication, also known as an antiemetic. Doctors may prescribe it for people experiencing severe nausea and vomiting during pregnancy.

But it does not have approval from the FDA for use in morning sickness treatment. In fact, its primary use is for heartburn.

This means if you receive a prescription from a doctor for this drug, it will be off-label. Off-label means prescribing a drug for a purpose other than what it has FDA approval for.

A research review from 2021 found that metoclopramide was effective in the first trimester of pregnancy without an increased risk of harming the unborn baby.

Another anti-sickness drug used off-label in pregnancy is ondansetron (Zofran).

Need a refill for ondansetron (Zofran)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes with no video or appointment needed. Learn more here.

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OTC options

While OTC medications for managing nausea and vomiting are not the strongest, they can be very effective. The ingredients in these OTC medications are also ingredients in prescription-only medications for nausea and vomiting during pregnancy.

These OTC medications include:

Vitamin B6 supplements

While researchers are uncertain why vitamin B6 can help to reduce the symptoms of morning sickness, it has been in use for decades.

Vitamin B6 may often be the first treatment a doctor recommends if you are experiencing morning sickness.

Typically, you take vitamin B6 as and when you need it. Each tablet contains typically 10–25 mg. You can take vitamin B6 three to four times per day. These doses are low enough that they are not associated with side effects or risks to your health.

Antihistamines

Although effective, vitamin B6 does not work for everyone. If this is the case, a doctor may recommend trying an antihistamine medication if you are still experiencing vomiting.

Around 15% of pregnant people report taking OTC antihistamines during pregnancy.

Examples of OTC antihistamines used in pregnancy nausea include:

While antihistamines are generally considered safe for use short-term during pregnancy, you may still consider speaking with a healthcare professional before taking them. They can help you weigh the benefits and risks considering your individual situation and medical history.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

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Natural remedies

If you do not wish to take medication to help relieve your morning sickness symptoms, you can try a wide variety of effective natural alternatives.

These alternatives include a range of herbal and therapeutic remedies, such as:

  • Ginger: Ginger may help relieve milder feelings of nausea during pregnancy.
  • Dietary changes: Try removing spices, high fat foods, and odorous foods from your diet to prevent nausea. Boosting the amount of protein and low fat foods may help.
  • Acupressure: Acupressure is a type of traditional Chinese massage that focuses on 14 points around your body. According to a study from 2024, acupressure was effective in reducing feelings of nausea and vomiting in pregnancy compared with a placebo.

Summary

If you experience morning sickness during pregnancy, it can have a big effect on your daily life. By speaking with a doctor, they can recommend medications or lifestyle interventions such as dietary changes to help relieve your symptoms.

Prescription options are typically the strongest treatments for nausea and vomiting in pregnancy, but they may not be the first choice. A healthcare professional may recommend you try less strong OTC options first to see if they have any benefit.

If your symptoms do not improve and you are struggling to keep any food down, it is important to seek medical attention to avoid complications with your baby.   

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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