The pharmacologic management of nausea and vomiting of pregnancy

J Fam Pract. 2014 Feb;63(2 Suppl):S31-7.


Nausea and vomiting are common in early pregnancy. Forty percent or more of pregnant women may continue to suffer beyond the first trimester and 10% beyond the second trimester. A focus of the assessment is to confirm that the nausea and vomiting is due to the pregnancy and not some other cause. Nonpharmacologic options, particularly dietary modification, are a mainstay of treatment. For those who continue to experience symptoms, pharmacologic management can be employed. The combination of doxylamine succinate/pyridoxine hydrochloride was reintroduced in the United States following FDA approval in early 2013. The product was given a pregnancy safety rating of A and is recommended as first-line pharmacologic treatment for NVP. Other options include antihistamines, metoclopramide, ondansetron, phenothiazines, and after the first trimester, corticosteroids.

Publication types

  • Review

MeSH terms

  • Antiemetics / therapeutic use*
  • Dicyclomine
  • Doxylamine / therapeutic use*
  • Drug Combinations
  • Female
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Nausea / drug therapy*
  • Nausea / etiology
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / etiology
  • Pyridoxine / therapeutic use*
  • Vomiting / drug therapy*
  • Vomiting / etiology


  • Antiemetics
  • Drug Combinations
  • Histamine H1 Antagonists
  • dicyclomine, doxylamine, pyridoxine drug combination
  • Dicyclomine
  • Doxylamine
  • Pyridoxine