Here’s a list of antiemetic medications that can be used for nausea and vomiting in pregnancy (NVP), typically in order of preference and safety:
First-line
1. Pyridoxine (Vitamin B6)
2. Doxylamine + Pyridoxine (e.g., Diclegis, Bonjesta) – FDA-approved combo for NVP
Second-line
3. Promethazine – Antihistamine with sedative effects
4. Dimenhydrinate – Antihistamine, often used for motion sickness
5. Diphenhydramine – Antihistamine, also helps with sleep
6. Meclizine – Another antihistamine safe in pregnancy
Third-line
7. Metoclopramide – Prokinetic agent; can cause extrapyramidal side effects
8. Ondansetron (Zofran) – Commonly used, some controversy over first trimester use but still widely prescribed
Others (used cautiously or in severe cases)
9. Prochlorperazine – Dopamine antagonist
10. Chlorpromazine – Older phenothiazine; more side effects
11. Trimethobenzamide – Less commonly used
Always tailor treatment to severity (mild, moderate, severe/Hyperemesis Gravidarum), and consider hydration/nutrition support if severe.
