Medications for HG

* New Update* Zofran (Ondansetron)

  • Helps nausea & vomiting.
  • It is taken 4 to 8 mg every 6 hours.
  • Can be given via SQ pump, oral tablet, liquid, dissolve film, or IV. Suppository available outside US.
  • Can be compounded into a suppository or other form.
  • Dosing throughout pregnancy may prevent relapse or stabilize symptoms.
  • Zofran tablets are available as a generic.
  • Widely available around the world.
  • Proactively treat with a daily regimen of stool softeners and laxatives as needed.
  • Some report generic oral dis-solvable tablets do not dissolve to well.

Compazine, Stemetil (Prochlorperazine)

  • Helps with nausea and vomiting.
  • 5–10 mg orally, IM, or IV every 6–8 hours.
  • It can burns in the IV pretty bad, I.M. injection burns too.
  • 25 mg every 6–8 hours rectal risk of EPS increased with metoclopramide. 

Reglan

  •  Helps with nausea, vomiting, loss of appetite, heartburn and early satiety (feeling of fullness). 
  • 10–20 mg IV/orally every 6 hours
  • May be given orally, SQ pump, IV (SLOWLY).
  • In pill form 5-10 MG 1-4 X a day.
  • In IV piggy backed for 15 minutes on IV fluids.

Promethazine

12.5–25 mg IVP/orally, IM/PR every 4-6 hours.  *IV dose contains sulfite  

NEW Research Warning from HELP HER: IV or injected doses can cause tissue damage. More info available on fda.gov. GIVE IV dose SLOWLY to avoid contractions.  

Side-effects of anxiety, sedation, and restlessness common and may limit use.

Kytril, Sancuso, Granisetron

1 mg every 12 hours (IV or orally)  Allows twice a day dosing.  Also available in transdermal patch form

Thorazine (Chlorpromazine)

Oral/IM 12.5–25mg every 4–6 hours.  Rectal 50–100 mg every 6–8 hours. May increase risk of fetal malformations.  May cause muscle spasms in neck/face and/or difficulty with speech. Research articles on PubMed.

Haldol (Haloperidol)

1–2 mg orally/IM every 8 hours Extrapyramidal symptoms (EPS) more common. May cause constipation. Research articles on PubMed.

Medication For The Battery Acid Heartburn

Zantac (Ranitidine) 50 mg IV every 8 hours or 150 mg orally daily or twice a day.

Pepcid (Famotidine) 20 mg IVP/orally every 12 hours.

Prevacid (Lansoprazole) 30-60 mg/day.

Antihistamines & Corticosteroids

Bonine, Antivert, Marezine

Follow directions on the label.

Dramamine (Dimenhydrinate)

50-100 mg every 4-6 hours used for motion sickness.

Unisom

25 mg orally at bedtime, 1/2 tablet every 6 hours as needed.

Component of Diclegis/Diclectin.

UNISOM is often taken with vitamin B6 they now have it as a pill combined as a pill and gos by the names Diclectin, Diclegis.

Doxylamine plus Pyridoxine

Average dose is 1 tablet in morning, one in afternoon and two at night. May be given in higher doses up to 12 tablets daily - see research links on right. Differs from Unisom/B6 combo because it isa delayed release formula.

Benadryl (Diphenhydramine or Gravol)

25 mg IVP/orally every 4–6 hours. Benadryl and Phenergan combined in an IV helps many HG mothers relax and sleep for a short time to have a reprieve, or Zofran and Benadryl both at the sametime.  

Disclaimer:

If you have never had Benadryl make sure it is pushed slowly over a course of 3-5 mintues until you know how you will react ,

Corticosteroids/Cortisone

Not recommended until after 8-10 weeks, however, the benefit may outway the risk, please talk with your doctor if you are very sick. Can cause birth defects if used earlier but has helped many HG mothers with extreme HG symptoms  - Used for refractory Hyperemesis Gravidarum, usually in conjunction with Ondansetron/Zofran - Possible side-effects: blood sugar instability, weight loss, nausea and vomiting, increased risk of preeclampsia - Possible fetal complications: reduced birth weight, clefts (if early use), adrenal insufficiency (if exposed to large doses) - Inconclusive concerns over impact on fetal brain development and oral/lip clefts with prolonged dosing at high levels, and use during the first trimester.

Remeron

Comes in pill form for HG has not been determine also works intravenous. Helps nausea and vomiting in some case studies.

Diclegis/Diclectin

For treatment of nausea in pregnancy the return to the USA of doxylamine-pyridoxine delayed release combination Diclegis® was made for morning sickness and morning sickness and HG are NOT one and the same and many medical doctors are still learning this. For some women this works and some it doesn't. They took the B6 and Unisom and made it into one pill called Diclegis. Some HG mothers that have light HG said it helped and mothers with severe HG nothing helps.

Tigan (Trimethobenzamide)

25 mg orally every 6-8 hours 200 mg IM every 6-8 hours.

Vistaril, Atarax (Hydroxyzine)

25 mg orally every 6 hours syrup available. Helpful for insomnia.

Benadryl and Zofran

Sometime the two medications together can help a HG mother fall asleep for a some time to stop the vomiting and severe nausea.    

25-50 mg of IV Benadryl

​4 ml of Zofran

Gabapentin (Neurontin)

In trials for use in HG. Considered as last resort in patients who have exhausted other medication categories. There are some facebook groups with mothers trying this, message if you need a link. Very helpful for some mothers.   ​