Morning sickness strikes most moms-to-be in some way. Maybe you feel slightly nauseated when you first wake up, or perhaps certain smells make you sick. Or, if you've got a severe case, you might not be able to keep anything down morning, noon or night.

For most women, nausea and vomiting subside by the second trimester, while others have these symptoms for the duration of their pregnancies.

Many expectant moms think they have to weather morning sickness symptoms for the first trimester and maybe longer. But there are over-the-counter remedies that may help ease morning sickness. If OTC products don't help, your doctor might recommend an FDA-approved medication such as Diclegis or a combination therapy of its two main ingredients, vitamin B and doxylamine (sold over the counter as Unisom SleepTabs).[1]

Diclegis is a prescription drug that may ease pregnancy-related nausea and vomiting. But before you run to your doctor for a prescription, use this guide to figure out the questions you need to ask and the important points you should discuss with your obstetrician. Then you can work together to determine whether Diclegis is right for you.

What is Diclegis?

Available only by prescription, Diclegis is a medication that is used to control nausea and vomiting of pregnancy (NVP). 

For years, doctors have recommended that women manage morning sickness with a combination therapy of vitamin B6 and doxylamine, but they had to be taken separately. Diclegis combines these two ingredients in a formulation specifically designed and approved for use during pregnancy.

Let your doctor know whether your symptoms are getting in the way of your daily life. You may be asked to take a questionnaire called the Pregnancy-Unique Quantification of Emesis (PUQE) that can reveal the severity of your symptoms.

If you’re suffering from continual vomiting, you may have hyperemesis gravidarum, a more serious condition that can lead to weight loss and dehydration. In that case, it isn't known if Diclegis will be safe or effective. Your doctor may recommend hospitalization so you can be treated intravenously with liquids and medication.

Is Diclegis safe during pregnancy?

Diclegis was approved by the Food and Drug Administration (FDA) two decades ago following extensive testing. A similar version has been available in Canada for more than 30 years.

The most common side effect reported is drowsiness, while other women report dizziness, blurred vision, stomach upset, diarrhea, constipation, headache and trouble sleeping. Be sure to report any symptoms to your doctor

Should I take Diclegis first before trying other ways to treat morning sickness?

Your doctor will likely recommend that you try dietary and lifestyle changes to ease your symptoms before considering medication, as well as over-the-counter products such as ginger chews, candies or tea. If you’ve tried all that and your nausea isn't getting better, you may consider medications.

A major downside of Diclegis is that it can be relatively expensive. The drug costs about $100 per month and isn’t usually covered by insurance. This makes Diclegis out of the question for many women, especially in the first trimester where costs can climb as high as $300.

That said, the two ingredients in Diclegis, doxylamine (Unisom SleepTabs) and B6, can be bought for about $10 per month. Ask your practitioner if you might benefit from taking those two medications separately to ease your symptoms. Both can be purchased over the counter.

As a matter of fact, the American College of Obstetricians and Gynecologists (ACOG) says that vitamin B6 may be tried first for morning sickness, and doxylamine can be added if your symptoms don't improve.[2]

Will Diclegis cure my morning sickness?

Diclegis can be effective at reducing symptoms as long as you stay on the medication, but your morning sickness may return if you stop taking it.

If taking Diclegis or a combination of vitamin B6 and doxylamine doesn’t improve your symptoms, your doctor may recommend “antiemetic” drugs, such as metoclopramide (Reglan) to prevent vomiting. In general, antiemetics are well-tolerated, but can have potential side effects, such as constipation or diarrhea, headache, fatigue and other symptoms such as blurred vision and dry mouth.

Talk to your doctor about how much Diclegis to take and when to take it, including when to stop using the medication. Do not take more than four tablets (one in the morning, one in the mid-afternoon and two at bedtime) in one day. Take the medication on an empty stomach with a glass of water.

Thankfully, morning sickness symptoms for most women usually improve around week 14. So in time, you’ll hopefully be feeling much better and can focus on planning for your baby.