Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities

Int J Pharm Compd. Mar-Apr 2013;17(2):113-23.

Abstract

Nausea and vomiting in pregnancy can have serious adverse effects on the quality of a woman's life, affecting her occupational, social, and domestic functioning, and her general well-being; therefore, it is very important to treat this condition appropriately and effectively. Evidence-based algorithms support the use of oral pyridoxine alone or combined with doxylamine as first-line treatment. Promethazine or dimenhydrinate, known as a second-line treatment, should be added to the first-line treatment or should be added only to pyridoxine according to different algorithms. In most of the world, there is a lack of approved medicines using this combination approach known as the first-line treatment. Therefore, compounding pharmacists should supply the demand by compounding 10-mg pyridoxine hydrochloride and 10-mg doxylamine succinate slow-release capsules. Since transdermal promethazine does not exist world wide, and, since this medicine has significant added values compared to the oral/rectal dosage forms, compounding pharmacists should offer physicians transdermal promethazine as a second-line therapy in nausea and vomiting in pregnancy. This review summarizes the nausea and vomiting in pregnancy problems and discusses the compounding opportunities that exist in this common and wide-spread pathology in order to improve a woman's quality of life.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Antiemetics / administration & dosage
  • Antiemetics / therapeutic use*
  • Dicyclomine
  • Dimenhydrinate / administration & dosage
  • Dimenhydrinate / therapeutic use
  • Doxylamine
  • Drug Combinations
  • Drug Compounding / methods*
  • Female
  • Humans
  • Nausea / drug therapy*
  • Nausea / etiology
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Promethazine / administration & dosage
  • Promethazine / therapeutic use
  • Pyridoxine
  • Quality of Life
  • Vomiting / drug therapy*
  • Vomiting / etiology

Substances

  • Antiemetics
  • Drug Combinations
  • dicyclomine, doxylamine, pyridoxine drug combination
  • Dicyclomine
  • Doxylamine
  • Promethazine
  • Dimenhydrinate
  • Pyridoxine