Is it safe to take Unisom during pregnancy?

Nausea affects approximately 70% of pregnant women, while insomnia has been reported by 66% to 94% of pregnant women. Unisom offers several over-the-counter products that may be recommended to pregnant women to treat nausea and insomnia. Taking some forms of Unisom while pregnant is generally considered safe as long as you read the label for active ingredients, consult your healthcare provider for recommendations, and stick to the right dosage. 

“The safe dosage of Unisom varies depending on the specific formulation and the active ingredient,” says Ila Dayananda, MD, Chief Medical Officer and Founding Medical Director at Oula Health in New York. You should follow the dosage provided on the product’s packaging or take it as directed by your healthcare provider. 

Is Unisom safe during pregnancy?

“Unisom is an over-the-counter sleep aid, and its active ingredient is usually diphenhydramine, melatonin, or doxylamine,” explains Dr. Dayananda. “All three are generally considered safe for occasional use during pregnancy, particularly for managing sleep disturbances.

Unisom with doxylamine or melatonin is considered safe during all trimesters. 

The use of Unisom containing diphenhydramine should be avoided in the first trimester, but it’s important to weigh the benefits versus the risks of any medication during pregnancy. 

For instance, untreated severe morning sickness can be more harmful than any potential side effects of a medication. Hyperemesis gravidarum is a severe form of pregnancy sickness that can lead to dehydration and severe weight loss. It’s estimated that up to 3% of pregnant women will experience this debilitating condition which can often lead to hospitalization. 

Therefore, if you are really struggling with insomnia or nausea to the point where it’s affecting daily activities and you’ve not seen any improvement with natural remedies, then your healthcare provider may feel that Unisom is beneficial. 

Research has shown that when doxylamine is the active ingredient in Unisom, it is generally considered safe and is well-tolerated by pregnant women as long as the correct dosage is administered. With that being said, Dr. Dayananda encourages women to always consult with their healthcare provider before using any medication during pregnancy.

Unisom side effects may only last for a short period of time, especially if it’s only taken occasionally. If taken longer, these side effects could become uncomfortable and even interfere with daily activities. If this is the case, you should discuss this with your healthcare provider. They may consider a lower dosage or even switching to an alternative medication. 

Severe side effects of this medication are considered rare, but they can still affect you. Dr. Dayananda stresses that you seek medical attention right away if you experience any of the adverse effects after taking Unisom:

• Severe dizziness
• Difficulty breathing
• A rash
• Itching or swelling

These symptoms could suggest an allergic reaction to the drug and will require immediate medical attention. 

How effective is Unisom for pregnancy nausea?

If natural remedies like ginger and peppermint don’t relieve your pregnancy nausea, then you’ll likely need something stronger and more effective. 

Unisom with diphenhydramine or doxylamine is often combined with vitamin B6 (pyridoxine) to treat morning sickness, says Kim Langdon, MD, an OB-GYN and advisor at Blue ABA Therapy. This is a remedy that has been used for many years to treat moderate to severe morning sickness. 

It’s not clear why this combination is so effective at combating nausea. However, we understand that antihistamines work by blocking the effects of histamine in the body, which can reduce episodes of nausea and vomiting. Whereas vitamin B6 may alleviate nausea in some pregnant women who have lower levels of vitamin B6 in their blood.

A 2023 systematic review that evaluated the current evidence of vitamin B6 for pregnancy nausea and vomiting found that vitamin B6 supplementation alone, as well as with an active ingredient, did indeed have beneficial effects for women.

Another study evaluated the effectiveness of combining doxylamine succinate (Unisom) and pyridoxine hydrochloride (vitamin B6) as a treatment for nausea and vomiting in pregnancy. Over the course of the 15 days, it was reported that the pregnant women who received this medication saw some improvement in symptoms compared to those who received a placebo. It was also reported that women taking this medication required fewer alternative treatments to manage nausea and/or vomiting.

Regarding the safety of taking Unisom and vitamin B6, it’s generally considered an effective and safe treatment for pregnant women. The American College of Obstetricians and Gynecologists (ACOG) has reported that both of these treatments, whether taken alone or together, are safe to take during pregnancy and present no harm to the fetus. 

It may be advised that vitamin B6 is tried first as it presents fewer side effects than Unisom. However, if there is no improvement in nausea and/or vomiting, then it could be combined with Unisom to see if there is any improvement in symptoms. Many pregnant women will see an improvement in nausea, but if it doesn’t work for you, there are other anti-sickness medications that may be more effective, especially in severe cases.

How effective is Unisom for pregnancy insomnia?

While sleep problems can occur during any stage of pregnancy, they are more common as you enter the third trimester. There are a few possible explanations for this, including leg pain and back pain, which can make it difficult to get in a comfortable position to fall asleep. Around this time, some women may experience more anxiety as they start to think about the birth and baby preparations. 

Unisom containing doxylamine or diphenhydramine works by blocking histamine effects on the body, which can make you feel drowsy and more relaxed. There is also a formulation of Unisom that contains melatonin. There are limited studies showing the effectiveness of Unisom for insomnia, but it may prove to be effective for you.

If Unisom doesn’t work for you and you are still having trouble falling asleep and staying asleep, speak to your healthcare provider. They may be able to suggest something that is more effective.

How to take Unisom while pregnant

“The safe dosage of Unisom varies depending on the specific formulation and the active ingredient,” Dr. Dayananda says. You should follow the dosage provided on the product’s packaging or take it as directed by your healthcare provider. 

The Unisom dosage for pregnancy can range from 10 to 25 mg, depending on the severity of symptoms. 

“Generally, I advise using the lowest effective dose for the shortest duration, especially during pregnancy,” explains Dr. Dayananda. 

While all forms of Unisom are considered to be safe during pregnancy, there are very few studies about the possible effects on the fetus. It is best not to use diphenhydramine during the first trimester. Therefore, it should always be used cautiously. 

Unisom is safe for short-term use during pregnancy, but your healthcare provider will need to assess whether you should continue to take it throughout the rest of the pregnancy based on your individual circumstances. If you see a slight improvement in symptoms over time, they may suggest weaning you off the medication to see how you react. Gradually reducing your dosage is better than stopping the medication altogether since you’re less likely to experience withdrawal symptoms. If you are at a higher dosage, your healthcare provider may suggest taking half over the next few days before stopping it completely. 

However, if your symptoms quickly return, then your healthcare provider will need to consider prescribing Unisom on a long-term basis or offering an alternative drug. 

Pregnancy-safe Unisom alternatives for nausea

While Unisom is a good option for insomnia during pregnancy, Dr. Dayananda says it’s not usually the first choice for pregnancy-related nausea. There are other pregnancy-safe medications that may be more effective.

Vitamin B6

It’s suggested that women with severe morning sickness may have lower levels of vitamin B6. Therefore, taking a supplement could reduce nausea and vomiting. The recommended dosage is 10 to 25 mg, taken up to three times a day.

Phenergan 

Phenergan (promethazine) is a prescription antihistamine that is used to treat nausea and vomiting in pregnancy. There is no evidence that it harms the fetus during the first and second trimester. However, it should be used with caution toward the end of the pregnancy due to the increased risk of slowed breathing in newborns.

Generic Zofran

Ondansetron (previously known as Zofran) is one of the most commonly prescribed medications for pregnancy nausea. It can be taken orally, by injection, or by IV. There is no evidence to suggest that ondansetron is harmful to the fetus, but some doctors may advise against the use of it during the first trimester. They may recommend vitamin B6 or Phenergan first. If these are not successful at treating your nausea, then ondansetron may be prescribed. 

Pregnancy-safe Unisom alternatives for insomnia 

If Unisom doesn’t work as intended or you would simply prefer an alternative medication, then these pregnancy-safe options for insomnia could provide you with some relief:

Other natural remedies

If you are trying to avoid medication due to side effects or you simply want to try reducing your symptoms, there are a few things you can try:

• Cognitive behavioral treatment is considered first-line treatment that’s safe and effective during pregnancy
• Getting fresh air every day (great for both nausea and insomnia)
• Daily walks (to help with body aches and pains)
• Using an exercise ball
• Self-massage 
• Meditation or yoga before bed
• Avoiding screens just before bed
• Taking a prenatal (including vitamin D)
• Avoiding daytime napping
• Avoiding caffeine

Benadryl 

If you’re having sleep problems, then Benadryl (diphenhydramine, which is also the active ingredient in some forms of Unisom) could be the first line of treatment. Benadryl is an antihistamine that can make you drowsy, which may allow you to sleep better throughout the night. Diphenhydramine should be avoided in the first trimester. Benadryl is considered to be safe for occasional use during pregnancy, but it may not be recommended for long-term use or in the late stages of pregnancy. Therefore, you must discuss this with your healthcare provider first.

Melatonin 

There is limited evidence as to whether melatonin is safe to use during pregnancy or not, but Dr. Langdon believes it to be a safe option for pregnant women. If you are considering taking melatonin, speak to a healthcare professional first. They can advise whether it’s a safe option for you.