Diclegis for Nausea and Vomiting in Pregnancy

Use, Safety, Side Effects and Tips

Young African American woman feeling nausea during breakfast time at dining room

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Morning sickness is one of the most common discomforts of pregnancy. Some expecting moms have mild queasiness in the morning while others have nausea and vomiting all day long. Changing your diet or wearing seasickness bands on your wrists may help. But, if they don't and you need something more, your doctor may order Diclegis. Here are the answers to your questions about taking Diclegis during pregnancy.

Overview

Diclegis is a prescription medication that is FDA-approved to treat nausea and vomiting associated with pregnancy. It is a product of Duchesnay USA, a pharmaceutical company dedicated to women's health. A major focus of their mission is to develop medicines that are safe and effective to use during pregnancy.

Diclegis is a combination of two drugs:

Pyridoxine hydrochloride 10 mg. Pyridoxine is vitamin B6. Low levels of pyridoxine in the body can contribute to morning sickness, so supplementation of vitamin B6 can help reduce nausea and vomiting. 

Doxylamine succinate 10 mg. Doxylamine is an antihistamine and sedative. Antihistamines block a substance in the body called histamine, which helps to treat and prevent allergies. It also helps to decrease nausea and vomiting .

Duchesnay USA also makes Bonjesta. Bonjesta is another prescription medication for the treatment of nausea and vomiting in pregnancy. It is a higher dose of the same medicines in Diclegis. Bonjesta's extended-release tablets contain pyridoxine hydrochloride 20mg and doxylamine succinate 20mg.

Use in Pregnancy

Diclegis treats nausea and vomiting in pregnancy when other treatments do not work. If it’s time to turn to medication, the combination of doxylamine and vitamin B6 is the treatment of choice.

Treatment of nausea and vomiting with Diclegis can:

  • Improve your nutritional status since you may eat more if you’re less nauseous.
  • Prevent dehydration and loss of fluids through vomiting.
  • Prevent nausea and vomiting from getting worse and becoming severe.
  • Prevent complications of severe nausea and vomiting.
  • Prevent the need for other treatments.
  • Prevent taking time off from work. 

Morning Sickness

Morning sickness is nausea with or without vomiting. It is widespread, affecting approximately 70% of expecting mothers. It can be just nausea (about 25% of the time) or both nausea and vomiting (about 50% of the time). It may be called morning sickness, but that's misleading since it can come on at any time of day.

Typical morning sickness begins early in the first trimester at about five to six weeks, and it often ends by 14 weeks. By 22 weeks, about 90% of women find relief. However, for some, the nausea and vomiting of pregnancy can last into the third trimester and even until delivery.

Nausea and vomiting can be mild, moderate, or severe.

Mild morning sickness does not usually interfere with daily activities. It can often be tolerated and controlled with some daily diet changes.

Moderate morning sickness may cause some frustration and affect your daily life. Drug-free treatments may help, but you may something more. Diclegis may be an option for moderate nausea and vomiting.

Severe nausea and vomiting can interfere with your day-to-day activities, and it can be harmful to you and your baby. A form of severe nausea and vomiting called hyperemesis gravidarum is not common and seen in only about 1% of women. Dangerous complications of nausea and vomiting are rare, especially when it is managed and treated right away. Treating mild to moderate nausea and vomiting can prevent it from becoming severe and leading to complications such as:

Is Diclegis Right for You?

If you have morning sickness or all-day sickness, talk to your doctor at your next prenatal visit. Tell your doctor about your symptoms and provide information about:

  • When nausea starts.
  • How long it lasts.
  • How often you feel nauseous.
  • How many times you throw up.
  • What you’re eating.
  • How often you’re eating.
  • The amount of fluid you’re drinking.
  • How nausea and vomiting affect your daily life.

How to Take Diclegis

Diclegis is a pill you swallow by mouth. It is delayed-release, which slowly delivers the medicine into your body over time. After you take it, it continues to work for five to seven hours. 

The doctor will prescribe Diclegis based on your symptoms. You should take this medicine the way your doctor tells you to, but the general directions are :

First Day: Start with two tablets at bedtime. If that is all you need to control your symptoms, then continue to take two tabs each night before bed.

If nausea and vomiting continue with two tablets at night then:

Second Day: Take two tablets at bedtime. 

Third Day: Take one pill in the morning and two at night. If three pills work, then continue to take one in the morning and two at bedtime each day.

If you're still having nausea and vomiting with three tabs then:

Fourth Day: Take one tablet in the morning, one in the middle of the afternoon, and two at night.

Do not take more than four tablets a day. If you still have symptoms with four pills, talk to your doctor.

Tips for taking Diclegis include:

  • You should take Diclegis according to your doctor’s instructions.
  • Take two extended-release tablets at bedtime to relieve nausea and vomiting upon waking up in the morning. The doctor may also recommend one in the morning and one in the afternoon if you still have nausea and vomiting.
  • Take Diclegis on an empty stomach. The medication does not work as well if you take it with food.
  • Swallow it with a full glass of water.
  • Do not use more than four tablets a day.
  • Tell your doctor if you cannot swallow pills because you should take Diclegis whole. You should not break, crush, or chew it.
  • Take it every day. Diclegis is a daily medication, so you should not take it only when you think you need it or skip it if you feel better. Using this medicine every day, helps it to continue working. If you skip or stop it, your condition could get worse.
  • If you feel you no longer need Diclegis or do not wish to take it anymore, talk to your doctor. You should not stop the medication cold turkey. The doctor may want to slowly lower your dose over time to prevent nausea and vomiting from coming back.

Safety and Effectiveness

Researchers have studied doxylamine succinate and pyridoxine hydrochloride for more than 50 years. Their findings show that this medication combination is effective in reducing nausea and vomiting during pregnancy.

The data also shows that it is safe for expecting moms and their babies. The combination of these two drugs does not increase the risk of congenital abnormalities or malformations in babies. It is not harmful at any point during pregnancy, even the first trimester.

Side Effects

Always follow your doctor’s advice. While this medication is not likely to cause any harm to you or your baby, all medicines and supplements can have side effects. You and doctor can weigh the benefits and the risks of this medicine. The side effects are usually not dangerous, but could include: 

  • Drowsiness
  • Headache
  • Dizziness
  • Restlessness
  • Faster heartbeat
  • An upset stomach
  • Loss of appetite
  • Diarrhea
  • Constipation
  • Painful urination
  • Seizures
  • Muscle weakness
  • Sensitivity to sunlight
  • Blurry vision
  • Problems with balance or falls
  • Anxiety
  • Difficulty sleeping

If you experience side effects while taking Diclegis, call your doctor or go to the emergency room.

Warnings

There are also risks with any medication. You should be aware of the following warnings.

  • Do not use this medication without a prescription from your doctor. While it might seem helpful, it is dangerous to try a friend’s leftover pills to see if they work or share your medication with others.
  • This medicine can make you sleepy, so you should not drive or operate potentially dangerous equipment while taking Diclegis.
  • Alcohol, cold medication, and pain medication can make drowsiness worse, so you should avoid them while using Diclegis.
  • Be sure to alert any drug test screener that you are taking Diclegis. It can give a false-positive result on a drug test.
  • To prevent drug interactions, you should talk to your doctor about any other prescriptions, over-the-counter medicines, and herbal or vitamin supplements that you take.
  • Do not take Diclegis if you use MAOI medication.
  • Tell your doctor if you have asthma or problems with your heart, eyes, stomach, or bladder.
  • Talk to the doctor if you have an allergy to Diclegis, any ingredients in this medication, or any other drug allergies.
  • Allergic reactions to Diclegis are rare but dangerous. If you develop a rash, itching, difficulty breathing, or swelling in your body, especially your tongue or throat, seek immediate medical attention. 
  • To prevent side effects, follow your doctor’s orders, and do not take more than four tablets a day.
  • If you take too much Diclegis, the signs of an overdose include a fast heartbeat, dry mouth, large pupils (the black dot in the eye), extreme sleepiness, restlessness, confusion, seizures, kidney failure, and death. If you have symptoms of an overdose, stop taking the medication, call poison control, and seek immediate medical help.
  • Duchesnay USA states that it does not know if Diclegis is safe for those under the age of 18 years old.
  • Do not continue to take Diclegis after your pregnancy is over unless instructed by your doctor. Be sure to tell your doctor if you plan to breastfeed since Diclegis does pass into breast milk and can be harmful to your baby.

Other Medication Treatment Options

Diclegis is FDA approved and the first line of defense to treat nausea and vomiting of pregnancy. However, there are other drugs, vitamins, and supplements that work to combat nausea and vomiting. 

These include: 

  • Unisom Sleep Tabs (doxylamine succinate)
  • Vitamin B6 (pyridoxine)
  • Vitamin B1 (thiamine)
  • Ginger (Zingiber officinale)
  • Zofran (ondansetron hydrochloride)
  • Espazine (trifluoperazine)
  • Reglan (metoclopramide hydrochloride)
  • Compazine (prochlorperazine)
  • Phenergan (promethazine hydrochloride)

You should always talk to your doctor before taking any medication during pregnancy. That includes over-the-counter drugs, vitamins, and herbal supplements. Drugs, vitamins, and herbs can have side effects and interactions. Some medicines for nausea and vomiting could pose a risk to you or your baby, especially during the first trimester when the baby is developing.

Depending on your unique situation and symptoms, you and the doctor can weigh the benefits and risks of taking a specific medicine.

Tips for Dealing with Nausea and Vomiting

Along with medication, you can try to manage morning sickness with the following tips.

  • Eat dry crackers or toast when you feel nauseous.
  • Have small, frequent meals every two to three hours instead of three large ones.
  • Eat snacks rich in protein between meals.
  • Keep salted crackers by your bed to eat when you wake up.
  • Get out of bed slowly.
  • Avoid coffee and fatty, greasy, or spicy foods.
  • Wait a while after meals to brush your teeth.
  • Sip carbonated beverages between meals instead of during meals.
  • Avoid strong smells from foods, perfume, and chemicals that can trigger nausea.
  • Add foods high in vitamin B6 to your diet like chicken, milk, cheese, beans, and spinach.
  • Talk to your doctor about using vitamin B1, vitamin B6, or ginger supplements.
  • Don’t lie down right after you eat.
  • Ask your doctor about taking an antacid, which may help.
  • Take your prenatal vitamin.
  • Get enough rest.
  • Keep your head raised a little higher than the rest of your body when you lie down.
  • Drink plenty of fluids to prevent dehydration.
  • Try acupressure with seasickness wrist bands.

A Word From Verywell

Nausea and vomiting are part of a large percentage of pregnancies. You can probably tolerate a bit of mild morning sickness that eases with a few bites of crackers and doesn't interfere with your day. However, dealing with all-day nausea and vomiting that affects your everyday life can be a challenge.

When the typical medication-free treatments aren't helping, talk to your doctor. Taking Diclegis is a safe and effective way to treat nausea and vomiting during pregnancy. It may also help prevent mild or moderate morning sickness from progressing to a more serious condition. 

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Article Sources

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