Which of the following drugs is indicated for the treatment of nausea and vomiting in pregnancy?
a. Zofran
b. Diclegis
c. Antivert
d. Benadryl
e. Motrin
Answer: (b) Diclegis.
Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP.
The recommended dosing is as follow:
For oral dosage form (delayed-release tablets):
Adults-2 tablets taken at bedtime (Day 1). If symptoms are controlled the following day, continue taking 2 tablets at bedtime. If symptoms persist in the afternoon of Day 2, take 2 tablets at bedtime and start taking 3 tablets on Day 3 (1 tablet in the morning and 2 tablets at bedtime). If symptoms are controlled on Day 4, continue taking 3 tablets daily. Otherwise, take 1 tablet in the morning, 1 tablet in the mid-afternoon, and 2 tablets at bedtime (total of 4 tablets).
For oral dosage form (extended-release tablets):
Adults-1 tablet taken at bedtime (Day 1). If symptoms are controlled the following day, continue taking 1 tablet at bedtime. If symptoms persists on Day 2, take 1 tablet in the morning and 1 tablet at bedtime. However, the dose is usually not more than 2 tablets per day.
The drowsiness is more frequently reported side effect of the drug.
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