Severe 24/7 Nausea at 8 Weeks: Bonjesta Isn’t Enough. How Did You Add Zofran?

I’d really appreciate advice on nausea medication during pregnancy. My OB-GYN has dismissed the possibility of hyperemesis gravidarum (HG), so I’ve been getting my prescriptions from my family doctor instead.

I’m eight weeks pregnant with my first baby. For the past three weeks, I’ve barely been able to function. I only vomit a few times, but the nausea is relentless, 24/7. I struggle to stand upright, shower, leave the house, eat, or drink. I can only manage a very limited range of foods and fluids.

I know my symptoms may sound mild compared with those of people who vomit constantly, lose weight, or need IV fluids. But I’ve gone from working and functioning normally to being bedridden and completely dependent on my partner. My mental health has taken a serious hit too, which is why I keep trying to find something that helps.

I take Bonjesta (doxylamine succinate and pyridoxine hydrochloride, or vitamin B6) at 9 p.m. Because I take it on an empty stomach, I avoid food for two hours before and one hour after the dose. Those are the hardest hours of my day. The nausea becomes unbearable, and that’s usually when I vomit. I don’t feel any relief after taking Bonjesta. Once the hour has passed, I eat something and can finally fall asleep, so it feels like the food helps more than the medication at night.

I wake up nauseated at around 7 a.m. and take another Bonjesta. That dose does seem to help, but it also knocks me out until noon. From noon onward, I eat something about every hour, and that’s how I get through most of the day.

I also have Pramin (metoclopramide) for particularly bad episodes, but it doesn’t seem to help much either. My family doctor has now prescribed Zofran (ondansetron), which I haven’t picked up yet.

For those who have been through this, what would be the next step? Did you add ondansetron to Bonjesta, or switch to ondansetron? If ondansetron caused constipation, how manageable was it?

Thank you so much. I feel like I haven’t had understanding or meaningful guidance from my OB-GYN, and hearing what helped other women would mean a lot. I’m a junior doctor myself, and I’m honestly shocked by how easily severe pregnancy nausea can be dismissed, especially by the specialists who are supposed to treat it.