Should doxylamine-pyridoxine be used for nausea and vomiting of pregnancy?

Navindra Persaud, Jessica Chin, Mark Walker

Journal: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2014;36(4):343-348

PMID: 24798673

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Abstract

Doxylamine-pyridoxine is the first-line agent for the treatment of nausea and vomiting of pregnancy (NVP) according to Canadian guidelines, and this combination is commonly prescribed to pregnant women. There is limited evidence that doxylamine-pyridoxine is more effective than pyridoxine alone. There is stronger support for the safety of pyridoxine monotherapy than for the combination of doxylamine-pyridoxine during pregnancy, and some conflicting evidence links doxylamine-pyridoxine use to pyloric stenosis and childhood malignancies. The role of doxylamine-pyridoxine as the first-line pharmacological treatment for NVP in Canada should be reconsidered.

Address: Department of Family and Community Medicine, St. Michael's Hospital, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto ON; Department of Family and Community Medicine, University of Toronto, Toronto ON.; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto ON.; Ottawa Hospital Research Institute, Ottawa ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa ON.

DOI: 10.1016/S1701-2163(15)30611-3

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MeSH Terms: Abnormalities, Drug-Induced, Antiemetics, Dicyclomine, Doxylamine, Drug Combinations, Female, Humans, Morning Sickness, Neoplasms, Practice Guidelines as Topic, Pregnancy, Pyloric Stenosis, Pyridoxine, Randomized Controlled Trials as Topic