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  • Treating morning sickness in the United States--changes in prescribing are needed.

Treating morning sickness in the United States--changes in prescribing are needed.

American journal of obstetrics and gynecology (2014-08-26)
Gideon Koren
ABSTRACT

Presently, 97.7% of prescriptions for the treatment of nausea and vomiting in pregnancy in the United States are with medications not labeled for use in pregnancy, not indicated for nausea and vomiting in pregnancy, and not classified as safe in pregnancy by the Food and Drug Administration. The use of ondansetron for nausea and vomiting in pregnancy has increased from 50,000 monthly prescriptions in 2008 to 110,000 at the end of 2013, despite unresolved issues regarding fetal safety and Food and Drug Administration warnings about serious dysrhythmias. In April 2013, the Food and Drug Administration approved the combination of doxylamine and pyridoxine, specifically for nausea and vomiting in pregnancy symptoms. Now that a safe and effective drug is available in the United States, there is no reason for women to be exposed to a drug of unproven maternal and fetal safety.

MATERIALS
Product Number
Brand
Product Description

Supelco
Pyridoxine hydrochloride, Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Pyridoxine Hydrochloride (B6), analytical standard
Sigma-Aldrich
Pyridoxine hydrochloride, meets USP testing specifications
Sigma-Aldrich
Pyridoxine hydrochloride, ≥98% (HPLC)
Sigma-Aldrich
Pyridoxine hydrochloride, BioReagent, suitable for cell culture, suitable for insect cell culture, suitable for plant cell culture
Pyridoxine hydrochloride, European Pharmacopoeia (EP) Reference Standard
Dicycloverine hydrochloride, European Pharmacopoeia (EP) Reference Standard
USP
Pyridoxine hydrochloride, United States Pharmacopeia (USP) Reference Standard
Sigma-Aldrich
Pyridoxine, ≥98%
Sigma-Aldrich
Dicyclomine hydrochloride, ≥99% (TLC), powder