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

Key takeaways

Diclegis (doxylamine/pyridoxine) and Zofran (ondansetron) are both medications used to treat nausea and vomiting, but they belong to different medication classes and have different uses. Diclegis is a combination of an antihistamine and a dietary supplement, specifically designed to treat morning sickness during pregnancy. It is taken orally, with a starting dose of 2 tablets at bedtime, and can be adjusted up to 4 tablets per day. Common side effects include sleepiness and dizziness. Zofran, on the other hand, is an antiemetic that blocks serotonin to prevent nausea and vomiting caused by surgery or cancer treatments. It is available in various forms, including tablets, orally disintegrating tablets, and injections. Zofran is typically taken every 8 to 12 hours, and its side effects can include headache, fatigue, and constipation. While Zofran can be used off-label for nausea during pregnancy, it is not FDA-approved for this purpose, and there are concerns about its safety for the baby. Both medications are available in generic form. However, Zofran has more potential drug interactions, especially with medications that affect serotonin levels or heart rhythm.

Diclegis

(doxylamine / pyridoxine)

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Ondansetron

(Zofran)

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Summary for Diclegis

Prescription only

Diclegis (doxylamine / pyridoxine) helps treat morning sickness, or nausea and vomiting that people experience during pregnancy. It's typically taken when changing your diet or avoiding nausea triggers isn't enough. This medication contains an antihistamine called doxylamine and a dietary supplement called pyridoxine (also known as vitamin B6). The dosage starts at 2 tablets taken by mouth at bedtime, but it can be adjusted if you need more relief. A common side effect is sleepiness. This medication has a brand-name and generic version.

Indications for Diclegis

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

Pros and Cons for Diclegis

Pros

One of the few medications that's FDA approved for morning sickness during pregnancy
Combines two medications into one tablet for convenience
Dose can be adjusted based on response

Cons

Dose ranges from 2 to 4 tablets per day, depending on your needs
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 Diclegis

Sleepiness (14%)

Warnings for Diclegis

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