Maternal safety of the delayed-release doxylamine and pyridoxine combination for nausea and vomiting of pregnancy; a randomized placebo controlled trial

BMC Pregnancy Childbirth. 2015 Mar 18:15:59. doi: 10.1186/s12884-015-0488-1.

Abstract

Background: Nausea and vomiting of pregnancy (NVP) is the most common medical condition in pregnancy, affecting up to 80% of expecting mothers. In April 2013 the FDA approved the delayed release combination of doxylamine succinate and -pyridoxine hydrochloride (Diclegis®) for NVP, following a phase 3 randomized trial in pregnant women. The fetal safety of this medication has been proven by numerous studies. However, because it is the only FDA-approved medication for NVP that is likely to be used by a large number of pregnant women, its maternal safety is an important public health question. The Objective is to evaluate the maternal safety of doxylamine succinate -pyridoxine hydrochloride delayed-release preparation (Diclegis® as compared to placebo.

Methods: We randomized women suffering from NVP to receive Diclegis® (n = 131) or placebo (n = 125) for 14 days at doses ranging from 2-4 tablets a day, based on a pre-specified titration protocol response to symptoms. Adverse events were collected through patient diaries, clinical examination and laboratory testing.

Results: Doxylamine succinate 10 mg and pyridoxine hydrochloride 10 mg use was not associated with an increased rate of any adverse event over placebo, including CNS depression, gastrointestinal or cardiovascular involvement.

Conclusions: Doxylamine succinate-pyridoxine hydrochloride delayed release combination is safe and well tolerated by pregnant women when used in the recommended dose of up to 4 tablets daily in treating nausea and vomiting of pregnancy.

Trial registration: Clinical Trial Registration No: NCT00614445 .

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiemetics / administration & dosage
  • Antiemetics / adverse effects
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Dicyclomine* / administration & dosage
  • Dicyclomine* / adverse effects
  • Double-Blind Method
  • Doxylamine* / administration & dosage
  • Doxylamine* / adverse effects
  • Drug Combinations
  • Drug Monitoring / methods
  • Female
  • Histamine H1 Antagonists / administration & dosage
  • Histamine H1 Antagonists / adverse effects
  • Humans
  • Nausea* / drug therapy
  • Nausea* / etiology
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pyridoxine* / administration & dosage
  • Pyridoxine* / adverse effects
  • Treatment Outcome
  • Vitamin B Complex
  • Vomiting* / drug therapy
  • Vomiting* / etiology

Substances

  • Antiemetics
  • Delayed-Action Preparations
  • Drug Combinations
  • Histamine H1 Antagonists
  • dicyclomine, doxylamine, pyridoxine drug combination
  • Vitamin B Complex
  • Dicyclomine
  • Doxylamine
  • Pyridoxine

Associated data

  • ClinicalTrials.gov/NCT00614445