What is the first-line treatment for hyperemesis gravidarum?

The first-line treatment for hyperemesis gravidarum is a combination of pyridoxine (vitamin B6) and doxylamine. This approach is based on the fact that these medications have shown efficacy in alleviating nausea and vomiting during pregnancy, particularly in hyperemesis gravidarum, which is a severe form of morning sickness characterized by persistent vomiting, dehydration, and weight loss.

Pyridoxine is a safe and well-tolerated vitamin that has been found to reduce nausea in pregnant individuals. Doxylamine, an antihistamine, can also help mitigate symptoms of nausea and vomiting. The combination of these two drugs is often effective, and it is recommended because of its safety profile for both the mother and the fetus.

In comparison, other treatments may be utilized for hyperemesis gravidarum, but they are not considered first-line. Dexamethasone, while potentially effective for severe cases, is used more cautiously due to concerns about potential risks in pregnancy. Zofran (ondansetron) is often used for nausea and vomiting in various contexts, but it is typically not considered first-line for hyperemesis gravidarum, and there are concerns regarding its use in pregnancy. Metoc