Pregnant woman struggling with morning sickness

Treating Morning Sickness: Are There Alternatives To Zofran?

Pregnant woman struggling with morning sickness“Morning” sickness, the nausea and vomiting that affects upwards of 90% of pregnant women during the first trimester, doesn’t just stop by lunchtime. In fact, for most women, the symptoms last all day.

And while many sources report that morning sickness ends around 12 weeks of pregnancy, it’s actually far more variable than that. Symptoms of nausea and vomiting can last up to 20 weeks.

Normal Nausea & Vomiting: Lifestyle Tips For Expectant Mothers

If you’re nausea is not severe, medical treatment may or may not be necessary. For many women, changes in lifestyle are enough to keep morning sickness manageable. For others, medical intervention is necessary. This is something that you need to discuss and decide with your doctor.

Below you’ll find 7 suggestions to try. We recommend talking with your doctor about working through the list one at a time until you hit on something that is effective in your own case:

  1. Hydrate more frequently, sipping water or an electrolyte-rich sports drink throughout the day. If you can’t stomach liquids, try freezing Gatorade and sucking on the ice cubes.
  2. Eat smaller, more frequent meals rather than three big ones. If almost every taste and smell nauseates you, stick to foods you can tolerate. After your symptoms subside, ease back into a more balanced diet.
  3. Eat foods at colder temperatures than you’re used to. This reduces their odor, which can be a big trigger for some women.
  4. Change the time of day when you take your prenatal vitamins.
  5. Acupressure, applying pressure to acupuncture points, helps some women reduce nausea. Babycenter suggests pericardium point six. Sea Band is a product that pushes this pressure point for you.
  6. Ginger products, including ginger ale and snaps, as well as lemon and peppermint may help.
  7. Studies have found that taking Vitamin B6 can reduce pregnancy-related nausea, and Vitamin B12 may lessen vomiting. Speak with your doctor first before taking any new supplements or medications.

And while it may be miserable, recent research has shown that women who experience morning sickness are less likely to miscarry and less likely to deliver babies prematurely. They’re also less likely to deliver babies with congenital defects and developmental delays.

Morning sickness is thought to be caused by rapidly rising levels of a hormone called human chorionic gonadotropin, which is produced by the placenta. Babies need this stuff to grow healthily, and it seems that higher levels equal more nausea.

Severe Morning Sickness: Symptoms, Risks & Treatment Options

In rare cases, morning sickness can even extend throughout an entire pregnancy. Women who suffer from nausea that never subsides and is accompanied by severe vomiting may have a condition called hyperemesis gravidarum (HG).

According to the Hyperemesis Education & Research Foundation (HER), HG that is severe and / or untreated is associated with:

  • weight loss over 5% of body weight before pregnancy
  • nutritional deficiencies
  • electrolyte and other metabolic imbalances
  • dehydration
  • an increase in ketones, molecules produced by the liver in periods of inadequate food intake
  • fatigue and other difficulties that impact daily activities

Hyperemesis gravidarum need not last all 40 weeks; HER reports that many cases end by 21 weeks. Even with adequate medical intervention, the weight loss and other physiological deficiencies associated with HG can increase the risk of adverse outcomes for mothers as well as their babies.

How Is Hyperemesis Gravidarum Treated?

Women who suffer from extremely severe HG may need to be hospitalized. Most women struggling with hyperemesis gravidarum are treated through a combination of prescription drugs, nutritional therapy, intravenous hydration and bed rest.

Which Drugs Are Used To Alleviate Morning Sickness?

Anti-emetic (anti-vomiting) drugs are the most common method of treating serious morning sickness symptoms. The category of anti-emetics covers a wide range of medications, many of which have entirely different mechanisms of action.

Antihistamines

Antihistamines, which researchers believe block your inner ear from sensing motion, are a fairly common treatment method. Over the counter medications like Benadryl and Dramamine are antihistamines, although women being treated for HG are more likely to receive prescription forms.

Corticosteroids

Corticosteroids are chemicals that mimic naturally-produced hormones. They are often used to treat cancer patients suffering from severe nausea due to chemo or radiotherapy, and commonly prescribed to pregnant women with severe morning sickness as well.

Serotonin Antagonists

Serotonin antagonists block a neurotransmitter that researchers believe triggers your brain’s “vomiting center.” Like corticosteroids, many of these drugs are approved for use in patients undergoing cancer treatments. Doctors may also prescribe them in severe cases of morning sickness.

Serotonin antagonists include:

  • Kytril (granisetron)
  • Anzemet (dolasetron)
  • Zofran (ondansetron)

Ondansetron, sold under the brand name Zofran but also available in generic versions, has become one of the more commonly prescribed anti-nausea drugs for pregnant women.

But in recent years, many women have become concerned about the potential risks of Zofran exposure during early pregnancy. Several large epidemiological studies have found an increased incidence of congenital defects, like cleft palate and congenital heart defects, in babies born to mothers prescribed ondansetron during early pregnancy.

The science investigating the nature of this link, between ondansetron and birth defects, is still evolving, but expectant mothers have begun to look for other options.

Drug Safety During Pregnancy

It’s critical to note that none of the drugs we have mentioned so far are FDA approved for use during pregnancy. Among other things, this means that none of these drugs were subjected to rigorous clinical trials involving pregnant women.

At least one, cortisone, has been linked to an increased incidence of birth defects in animal studies. Again, no adequate studies have investigated cortisone’s effects as a treatment for morning sickness in human pregnancies. Doctors have to weigh the risks a drug may present against its benefits, and the risks of leaving a serious case of hyperemesis gravidarum untreated.

Are There Any Drugs FDA Approved To Treat Morning Sickness?

On April 8, 2013, the FDA approved Diclegis, America’s first drug approved specifically for the treatment of morning sickness since Bendectin was pulled from the market in 1983.

Diclegis is taken daily in tablet form. The drug’s active ingredients combine an antihistamine, doxylamine succinate, with a form of Vitamin B6, pyridoxine hydrochloride.

In clinical trials, the safety and efficacy of Diclegis were studied in 261 pregnant women suffering from morning sickness. Half were given Diclegis, and half a placebo; all were between 7 and 14 weeks of pregnancy. The drug’s most common side effect, experienced by 14.3% of women taking it, was somnolence, or drowsiness.

Diclegis’ effects have not been studied in women suffering from hyperemesis gravidarum. With that being said, physicians have begun prescribing it to women with HG, often in combination with other drugs or as an early intervention measure.