Nausea and Vomiting Medications in Pregnancy

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What else should I know about Nausea and Vomiting Medications in Pregnancy?

What is nausea and vomiting in pregnancy?

Nausea and vomiting in pregnancy (NVP) is a common part of pregnancy for many women. It is commonly known as “morning sickness” but the symptoms can occur at any time of the day. These symptoms can be unpleasant and affect your daily activities. It usually occurs within the first 12 weeks of pregnancy (first trimester). However, for some women, it may last longer or even throughout pregnancy.

What medications can help nausea and vomiting?

In most cases, NVP does not need treatment with medication. See a doctor if your symptoms are severe or affecting your daily life.

There are many medications that have shown to be safe to use during pregnancy to treat NVP. The table below lists some of the common medications that may be used. You should take your medications as instructed by your doctor or pharmacist.

Medication	How should I take/use this medication?	What are some possible side-effects, and how to manage?
Pyridoxine (Vitamin B₆)	May be taken with or without food.	Generally well tolerated.
Diclectin® (Contains doxylamine and pyridoxine)	Take half to one hour before food, on an empty stomach. Swallow tablets whole, do not chew, crush or split.	Drowsiness Avoid driving or operating machineries. Other side effects include dry mouth, constipation, urinary retention (difficulty to urinate) and blurred vision.
Promethazine Teoclate	May be taken with or without food.	Drowsiness Avoid driving or operating machineries. Other side effects include dry mouth, constipation, urinary retention (difficulty to urinate) and blurred vision.
Metoclopramide	Take half to one hour before food, on an empty stomach.	Drowsiness Avoid driving or operating machineries. Stop and seek medical advice immediately if you experience uncontrollable movements (usually head and neck) such as shaking, twisting movement or muscle contraction (stiffness, rigidity).
Ondansetron	May be taken with or without food.	Generally well tolerated but may experience constipation, fatigue and/or headache. This medication is usually reserved for more severe NVP, from the second trimester onwards.

What should I do if I forget to take/use this medication?

Medications for nausea and vomiting are to be taken only when necessary. If you have no symptoms, you do not need to take the medication.

What else can I do?

Do's

Don'ts

Drink enough fluid throughout the day to ensure you are well-hydrated (sip in small amounts so that it is better tolerated).
Suck on ice cubes or a spoonful of crushed ice if you have difficulty keeping fluids down.
Eat dry biscuits or toast in the morning when you get up.
Get up slowly and do not lie down right after eating as this delays gastric emptying.
Eat smaller but more frequent meals [i.e. every 2 hours] to avoid an overly full stomach and to ensure your stomach is never empty, as this can cause nausea.
Eat cold or cooled food instead of hot food as cold food tends to have less smell that may trigger nausea or vomiting.
Have a range of food on hand with different tastes and textures [i.e. sweet, salty, crunchy] as your taste may change throughout the day.
If you are producing too much saliva, spit it out instead of swallowing it. The bitter taste of saliva may cause nausea and vomiting.
You may take Simethicone or antacid for gas, bloating or heartburn symptoms. Sometimes, your doctor may prescribe medications such as Famotidine or Omeprazole for more severe heartburn symptoms.
Try consuming ginger-containing foods or drinks.
Get plenty of rest (tiredness can make nausea worse).

Do not skip meals or go on for a long time without eating.
Avoid excessive carbonated or caffeinated drinks, as it may cause heartburn or nausea.
Avoid warm places, as this may increase the feeling of sickness.
Avoid strong odours including cigarette smoke, perfumes and chemicals.
Avoid cooking or eating spicy food, oily food, foods with a strong smell, as these can cause heartburn or nausea.

What precautions should I take?

Inform your healthcare professional if:

You are allergic to the medications prescribed or any of the other ingredients of the medication
You are taking any other medications, including supplements, traditional medications and herbal remedies.
Nausea and vomiting becomes severe and you experience signs of dehydration or weight loss. Signs of dehydration include feeling â€˜dry’ or very thirsty, becoming drowsy or unwell, or your urine changing from light yellow to dark yellow or brown colour.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store these medications?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away these medications safely?

Pack the medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last Updated on May 2022