Bonjesta vs. Zofran for Morning Sickness and Nausea: Important Differences and Potential Risks.

Key takeaways

Bonjesta (doxylamine/pyridoxine) and Zofran (ondansetron) are both medications used to treat nausea and vomiting, but they are used in different situations. Bonjesta is specifically FDA-approved for morning sickness during pregnancy, while Zofran is approved for preventing nausea and vomiting after surgery or cancer treatments. Bonjesta combines an antihistamine (doxylamine) and a dietary supplement (pyridoxine, or vitamin B6), whereas Zofran is an antiemetic that works by blocking serotonin in the brain. Bonjesta is taken as a tablet, typically once or twice a day, and does not have a generic version available. Zofran, on the other hand, is available in multiple forms, including tablets, orally disintegrating tablets, and injections, and it does have a generic version. Common side effects of Bonjesta include sleepiness, while Zofran can cause headaches and fatigue. Additionally, Zofran has potential interactions with medications that affect serotonin levels, which can lead to a serious condition called serotonin syndrome.

Bonjesta

(doxylamine / pyridoxine)

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Ondansetron

(Zofran)

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Summary for Bonjesta

Prescription only

Bonjesta (doxylamine / pyridoxine) treats morning sickness, or nausea and vomiting that happens during pregnancy. It's typically taken when changing your diet or staying away from nausea triggers isn't enough help. This medication contains an antihistamine called doxylamine and a dietary supplement called pyridoxine (also known as vitamin B6). The dosage is 1 tablet taken by mouth at bedtime, but it can be adjusted to 1 tablet in the morning and 1 tablet at bedtime if needed. This medication commonly causes sleepiness as a side effect.

Indications for Bonjesta

Morning sickness (nausea and vomiting during pregnancy) when non-medication options haven't provided enough relief

Pros and Cons for Bonjesta

Pros

One of the few medications that's FDA approved for morning sickness during pregnancy
Combines two medications into one tablet for convenience
Dose ranges from 1 to 2 tablets per day, depending on your needs

Cons

Can cause sleepiness
Not for severe nausea and vomiting during pregnancy (hyperemesis gravidarum)
Not known whether it works well or is safe for people under 18 years old

Common Side Effects for Bonjesta

Sleepiness (14%)

Warnings for Bonjesta

Sleepiness
Worsening of certain other medical conditions

Summary for Zofran

Prescription only

Ondansetron (Zofran) is an antiemetic (or anti-nausea) medication. It's used to prevent nausea and vomiting after surgery or cancer treatments. It works by stopping a chemical called serotonin from binding to receptors in the brain that cause the feeling of nausea and vomiting. Ondansetron (Zofran) is taken by mouth, typically every 8 to 12 hours. It comes in different formulations, including orally disintegrating tablet (ODT) and oral solution. It can also be given as injection by a healthcare professional (HCP) in a hospital setting. Side effects of this medication include headache, tiredness, and constipation or diarrhea.

Indications for Zofran

Prevention of nausea and vomiting due to cancer medications (chemotherapy) or radiation therapy
Prevention of nausea and vomiting after surgery

Pros and Cons for Zofran

Pros

Can use for both adults and children
Available as a lower-cost generic
Available as a liquid, dissolvable tablet, and injection for people who have problems swallowing pills or are too nauseous to keep medication down
Possible option during pregnancy and breastfeeding

Cons

Needs to be taken multiple times daily
Might cause headache
Can interact with certain medications, like antidepressants and migraine medications
Not the best option for people who are at risk for stomach or gut blockages (bowel problems)

Common Side Effects for Zofran

Headache (up to 24%)
Fatigue (up to 13%)
Constipation (up to 9%)
Diarrhea (up to 6%)

Warnings for Zofran

Severe allergic reactions
Life-threatening abnormal heart rhythm (QT prolongation)
Serotonin syndrome
Risk of heart attack
Masking of gut blockage and stomach bloating
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only