Women who are in the early stages of pregnancy may use Diclegis to help reduce nausea and vomiting when diet changes and nonmedicine methods have not worked. This prescription medicine contains both an antihistamine and vitamin B6. Diclegis is taken on a daily basis (sometimes several times a day) and continued until nausea and vomiting improves, which is usually after the first trimester.
Diclegis® (doxylamine and pyridoxine) is a prescription combination medication that contains an antihistamine (doxylamine) and vitamin B6 (pyridoxine). It is approved to treat nausea and vomiting in pregnant women who continue to have these symptoms despite changes in diet and other nonmedicine treatments.
Up to 90 percent of pregnant women will experience nausea during their pregnancy, with or without vomiting. This is commonly referred to as "morning sickness." However, the term morning sickness is a bit misleading, as many women who have nausea and vomiting during pregnancy actually feel sick throughout the day.
For most women, the symptoms first appear at about week 5 of pregnancy, peak at week 9, and improve by week 15. However, some women will continue to experience nausea and vomiting into their third trimester.
The exact reason pregnancy causes nausea and vomiting is unknown, but could be due to increased hormone levels, slowed movement of food through the gastrointestinal (GI) tract, psychological reasons such as stress, or a combination of these factors. What is known is that certain women appear to have a higher risk for nausea and vomiting during pregnancy, including women who:
- Are prone to nausea and vomiting from birth control pills, motion sickness, or migraine headaches
- Have experienced nausea and vomiting during previous pregnancies
- Have heartburn or acid reflux
- Did not take multivitamins before week 6 of pregnancy.
The initial treatment of mild nausea and vomiting is generally conservative in nature. Conservative treatment includes changes in diet and lifestyle aimed at reducing symptoms, especially enough so a woman can eat and keep food and liquids down. Examples of diet and lifestyle modifications that may help alleviate nausea and vomiting due to pregnancy include:
- Eating several small meals throughout the day (as opposed to three large meals)
- Eating bland, low-fat foods
- Avoiding smells that trigger nausea
- Drinking carbonated or sour fluids, such as ginger ale or lemonade
- Not lying down immediately after eating.
Diclegis is a medication option for use in women whose symptoms do not adequately respond to nonmedicine strategies. Women start by taking the medication once a day before bedtime, and can increase this dosage to up to four tablets (one in the morning, one in the mid-afternoon, and two at night) if necessary.
It should be noted that Diclegis has not been studied for severe nausea and vomiting of pregnancy, known medically as hyperemesis gravidarum. Women with hyperemesis gravidarum will often vomit every day, and usually become dehydrated from the frequent vomiting.
Diclegis is meant to be taken on a daily basis to prevent nausea and vomiting, not as needed. Because your symptoms may subside as your pregnancy progresses, your healthcare provider will periodically reassess your need for Diclegis. For most women, nausea and vomiting improves after the first trimester of pregnancy.