Doxylamine and Pyridoxine (oral)

Overview

When women become pregnant, the hormonal changes which occur can result in a number of symptoms. Morning sickness is particularly common and can cause patients to experience nausea and vomiting for an extended period of time. Despite its name, patients can experience these symptoms at any time and may feel unwell for weeks, or even months.

In many cases, lifestyle changes can help to reduce nausea and vomiting when patients are pregnant. Often, women find that temporarily changing their diet can help them to feel better. However, in some cases, nausea and vomiting is so debilitating that patients require medical intervention.

If other medications have been tried and the patient is still experiencing bouts of nausea and vomiting, Doxylamine and Pyridoxine may be prescribed. As a combination medicine, both ingredients help to reduce nausea associated with pregnancy and may combat symptoms.

Doxylamine is an antihistamine and works by blocking particular substances in the patient's body. Although antihistamines are normally prescribed to reduce allergic reactions, they can also be effective in reducing nausea. By blocking H1 receptors in the brain, it is believed that antihistamines prevent the brain from creating the sensation of nausea, despite the action of chemicals in other parts of the body.

Pyridoxine, also known as vitamin B6, plays an important role in reducing nausea too. It is thought that many pregnant patients are deficient in vitamins, particularly B6. By increasing the level of vitamin B6 in their system, nausea can be significantly reduced. As the vitamin has an effect on neurotransmitters, such as dopamine and serotonin, it can help to alleviate nausea caused by changes to these chemicals.

When used in conjunction, Doxylamine and Pyridoxine can be extremely effective in treating the symptoms of morning sickness. Without medical intervention, many women struggle to function effectively throughout their pregnancy and may struggle to work and/or care for other members of their family. In more extreme cases, women may lose weight, become dehydrated or be unable to absorb key nutrients because of constant nausea and vomiting. By taking Doxylamine and Pyridoxine, however, these symptoms can be reduced and patients can resume their usual activities.

Conditions Treated

  • Pregnancy-induced nausea and vomiting

Type Of Medicine

  • Antihistamine
  • Vitamin

Side Effects

Although Doxylamine and Pyridoxine has been deemed safe for pregnant women, patients should be aware of the side effects which can occur when taking this medication. Whilst it's not uncommon to feel more tired or drowsy when taking Doxylamine and Pyridoxine, patients should seek medical help if they experience any of the following side effects:

  • Discomfort in chest
  • Labored or difficult breathing
  • Decrease in frequency of urination
  • Painful or difficult urination
  • Decrease in urine volume
  • Swelling of the face, eyelids, hands, lips or feet
  • Pounding, irregular, racing or fast pulse or heartbeat

Patients should also seek medical advice if they notice any other adverse effects when taking Doxylamine and Pyridoxine. If patients do experience other, unlisted, side effects, they can also report them to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

When patients are prescribed Doxylamine and Pyridoxine, their physician will determine what dose of medication is appropriate. As Doxylamine and Pyridoxine is available in both delayed-release form and extended-release form, the dose may vary depending on the type of medication which is prescribed.

If patients are prescribed extended-release Doxylamine and Pyridoxine tablets, the standard dose is one tablet to be taken at bedtime. If this is enough to control the patient's symptoms, they should maintain this dose and take one tablet every night. However, if their symptoms persist, patients may be advised to take one tablet in the morning and one in the evening. The maximum dose of extended-release tablets is normally two per day.

However, if patients are given delayed-release tablets, they should take two at night and continue with this regimen if symptoms are relieved. However, if symptoms persist, patients may be instructed to take one tablet in the morning and two at night. If symptoms are still on-going, the patient's dose may be increased to one tablet in the morning, one in the mid-afternoon and two at night. Normally, the maximum dose of delayed-release tablets is four per day.

Although these are standard dosing instructions for treatment with Doxylamine and Pyridoxine, patients should follow the advice given by their physician. If patients are not obtaining relief from their prescribed dose, they should contact their doctor for advice, rather than increasing the dose themselves.

In most cases, patients are advised to take Doxylamine and Pyridoxine on an empty stomach and should swallow the tablet whole. Generally, the tablet should be swallowed with water and patients should not attempt to crush, chew or break the tablet. If patients are struggling to take their medication, their physician may be able to provide an alternative.

If patients miss a dose of Doxylamine and Pyridoxine, they should take the tablet as soon as they remember to do so. However, if their next dose of medicine is almost due, patients should skip the missed dose and carry on taking their tablets normally. Patients shouldn't attempt to take a double dose of Doxylamine and Pyridoxine, even if they have missed a dose.

Potential drug interactions:

When patients are pregnant, there are a number of medications which should not be taken as they may pose a risk to their unborn baby. Furthermore, interactions between medications may need to be avoided. Due to this, Doxylamine and Pyridoxine may not be prescribed if patients are taking other medicines. If patients are taking any of the following medicines, for example, their physician will not usually prescribe Doxylamine and Pyridoxine:

  • Furazolidone
  • Tranylcypromine
  • Iproniazid
  • Toloxatone
  • Isocarboxazid
  • Sodium Oxybate
  • Linezolid
  • Selegiline
  • Methylene Blue
  • Rasagiline
  • Moclobemide
  • Safinamide
  • Nialamide
  • Procarbazine
  • Phenelzine

The following medications are also not usually recommended for use in conjunction with Doxylamine and Pyridoxine. However, doctors may prescribe both medicines if they feel it will be beneficial for the patient. By altering the patient's dose or advising them to take their medication as specific times, physicians may be able to reduce the risk of interactions occurring. These medicines include:

  • Acepromazine
  • Zotepine
  • Alfentanil
  • Baclofen
  • Alprazolam
  • Buprenorphine
  • Altretamine
  • Bromazepam
  • Amisulpride
  • Bromopride
  • Amobarbital
  • Benperidol
  • Anileridine
  • Bupropion
  • Aripiprazole
  • Butorphanol
  • Asenapine
  • Buspirone
  • Droperidol
  • Butabarbital
  • Clobazam
  • Carbinoxamine
  • Diphenhydramine
  • Carisoprodol
  • Diazepam
  • Carphenazine
  • Dichloralphenazone
  • Chloral Hydrate
  • Enflurane
  • Chlordiazepoxide
  • Dexmedetomidine
  • Chlorpromazine
  • Dihydrocodeine
  • Chlorzoxazone
  • Difenoxin
  • Clonazepam
  • Diphenoxylate
  • Clorazepate
  • Donepezil
  • Clozapine
  • Estazolam
  • Codeine
  • Diacetylmorphine
  • Cyclobenzaprine
  • Eszopiclone
  • Hydroxyzine
  • Ethchlorvynol
  • Halothane
  • Fluspirilene
  • Ethopropazine
  • Hexobarbital
  • Ethylmorphine
  • Haloperidol
  • Isoflurane
  • Fentanyl
  • Ketamine
  • Flibanserin
  • Ketazolam
  • Fluphenazine
  • Hydromorphone
  • Flurazepam
  • Ketobemidone
  • Fospropofol
  • Hydrocodone
  • Halazepam
  • Methotrimeprazine
  • Levorphanol
  • Meprobamate
  • Lorazepam
  • Methdilazine
  • Loxapine
  • Methocarbamol
  • Orphenadrine
  • Meclizine
  • Opium
  • Melperone
  • Olanzapine
  • Meperidine
  • Oxazepam
  • Mephobarbital
  • Nalbuphine
  • Meptazinol
  • Nicomorphine
  • Mesoridazine
  • Nitrazepam
  • Metaxalone
  • Pimozide
  • Methadone
  • Paregoric
  • Methohexital
  • Phenobarbital
  • Midazolam
  • Piperacetazine
  • Molindone
  • Perphenazine
  • Moricizine
  • Periciazine
  • Morphine
  • Piritramide
  • Morphine Sulfate Liposome
  • Pipotiazine
  • Nitrous Oxide
  • Primidone
  • Opium Alkaloids
  • Perazine
  • Oxycodone
  • Perampanel
  • Oxymorphone
  • Papaveretum
  • Trifluperidol
  • Quetiapine
  • Pentazocine
  • Quazepam
  • Ramelteon
  • Pentobarbital
  • Remifentanil
  • Prazepam
  • Trifluoperazine
  • Topiramate
  • Sufentanil
  • Tizanidine
  • Prochlorperazine
  • Tolonium Chloride
  • Temazepam
  • Promazine
  • Triflupromazine
  • Tapentadol
  • Promethazine
  • Sulpiride
  • Propofol
  • Zopiclone
  • Remoxipride
  • Thiethylperazine
  • Secobarbital
  • Thiopental
  • Sertindole
  • Tramadol
  • Thiopropazate
  • Trimeprazine
  • Thioridazine
  • Zolpidem
  • Tilidine
  • Zaleplon
  • Triazolam

Patients should also be aware that ethanol, or alcohol, can interact with Doxylamine and Pyridoxine and should not be consumed while patients are taking this medication. However, patients are routinely advised not to consume alcohol whilst pregnant anyway as it could cause harm to the unborn baby.

It's also important to be aware that drug interactions can occur between over-the-counter medicines, supplements and vitamins, as well as prescribed medicines. Patients should seek medical advice before taking any of these substances whilst using Doxylamine and Pyridoxine.

Warnings

Before being prescribed any medication, patients should disclose their medical history to their physician. There are some pre-existing conditions which may mean that Doxylamine and Pyridoxine shouldn't be prescribed for the patient or that alterations to their dose should be made. These include:

  • Peptic ulcer
  • Asthma
  • Narrow angle glaucoma
  • Bowel blockage
  • Bladder blockage

Although Doxylamine and Pyridoxine has been deemed safe for pregnant patients, it has not been determined whether this medication is safe if patients are breastfeeding. Due to this, patients should seek medical advice before breastfeeding whilst taking Doxylamine and Pyridoxine. As medication can remain in your system for some time, patients should not start breastfeeding immediately after taking Doxylamine and Pyridoxine, unless they have discussed this with their physician.

If patients notice their symptoms becoming worse whilst taking Doxylamine and Pyridoxine, they should contact their doctor for advice. Similarly, if patients don't experience any reduction in their symptoms whilst taking Doxylamine and Pyridoxine, they should seek further advice.

Patients should not take Doxylamine and Pyridoxine alongside a monoamine oxidase (MAO) inhibitor. Taking these two medications together can have harmful effects and is never recommended.

When patients are taking Doxylamine and Pyridoxine, they may feel drowsy or experience increased tiredness. Due to this, patients should not drive, operate heavy machinery or carry out tasks which require their full attention until they know how the medication affects them.

Doxylamine and Pyridoxine add to the effect of central nervous system depressants and, if taken in conjunction with these medicines, patients may notice an increase in side effects. Patients may become extremely drowsy if they take Doxylamine and Pyridoxine at the same time as central nervous system depressants, for example. These medications may include:

  • Allergy remedies
  • Hay fever solutions
  • Cough and cold syrups
  • Tranquilizers
  • Sedatives
  • Medications to induce sleep
  • Muscle relaxants
  • Barbiturates
  • Anesthesia

Patients should, therefore, seek medical advice before taking any other medicines. In addition to this, patients should notify their dentist that they are taking Doxylamine and Pyridoxine before undergoing any dental work. This medication may increase the effects of dental anesthetic, as well as other types of anesthetics.

Patients may experience a dry mouth whilst taking Doxylamine and Pyridoxine and this could be harmful to teeth and/or gums. To counteract this, patients should maintain a good oral hygiene routine and brush their teeth at least twice per day. If patients are concerned about this, they should seek advice from their physician and/or their dentist.

Before taking Doxylamine and Pyridoxine, patients should discuss any allergies they have with their doctor. In rare cases, patients could experience an allergic reaction whilst taking this medication. If so, patients may exhibit the following symptoms:

  • Hives
  • Itching
  • Wheezing
  • Trouble breathing
  • Difficulty swallowing
  • Swelling of the lips, tongue, throat and/or face

This type of allergic reaction constitutes a medical emergency and patients will need to obtain urgent medical assistance. When anaphylaxis occurs, patients should call 911 in order to access immediate medical help.

Storage

As Doxylamine and Pyridoxine is normally taken on a daily basis, patients will need to keep their medication at home. Alternatively, if patients are advised to take a delayed-release tablet in the afternoon, they may need to take their medication out with them.

When patients are required to do this, it's vital that they keep their medication somewhere safe. If pets and/or children are present in the home, for example, Doxylamine and Pyridoxine must be kept out of their reach. Similarly, patients must take care not to lose or misplace their medication if they need to take it out of the home for any reason.

When storing Doxylamine and Pyridoxine, patients should follow the manufacturer's instructions which are printed on the medicine packaging or in the medication guide. In general, Doxylamine and Pyridoxine can be kept at room temperature but should be stored in a closed container. In addition to this, patients should keep this medication out of direct light and away from heat and/or moisture.

If patients are advised to stop taking Doxylamine and Pyridoxine, they will need to dispose of the medication. Similarly, if the medication reaches its use-by date, it should be disposed of. Rather than throwing medication out with normal household waste, patients should contact their pharmacist and make use of appropriate disposal methods.

Summary

Due to the debilitating effects of morning sickness, it's vital that patients have access to effective treatments. If lifestyle modifications or alternative treatments are not successful in reducing the patient's symptoms, Doxylamine and Pyridoxine may be prescribed. Whilst one tablet per day is often enough to relieve the patient's symptoms, their dose can be increased if necessary.

As pregnant patients are unable to take a considerable amount of medications, Doxylamine and Pyridoxine is often the first-choice medicine for patients with morning sickness. Deemed to be safe for patients who are pregnant, Doxylamine and Pyridoxine can be extremely effective in reducing nausea and vomiting associated with morning sickness.