Home Drug Guide Doxylamine Succinate and Pyridoxine Hydrochloride

Drug Guide

Generic Name

Doxylamine Succinate and Pyridoxine Hydrochloride

Brand Names Diclegis, Bonjesta

Classification

Therapeutic: Antiemetic for nausea and vomiting during pregnancy

Pharmacological: Antihistamine (Doxylamine), Vitamin B6 supplement (Pyridoxine)

FDA Approved Indications

  • Nausea and vomiting of pregnancy

Mechanism of Action

Doxylamine is an antihistamine that relieves nausea by blocking H1 histamine receptors, and Pyridoxine (vitamin B6) is involved in amino acid metabolism and neurotransmitter synthesis, which helps reduce nausea.

Dosage and Administration

Adult: Typically, 10 mg of Doxylamine and 10-25 mg of Pyridoxine at bedtime or divided throughout the day. Specific dosing depends on the formulation and patient response.

Pediatric: Not established for pediatric use; consult healthcare provider.

Geriatric: Use with caution; start at lower doses due to increased sensitivity and risk of side effects.

Renal Impairment: Adjust dose based on severity of impairment.

Hepatic Impairment: Use caution; no specific adjustments established.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract.

Distribution: Widely distributed; crosses blood-brain barrier.

Metabolism: Hepatic metabolism for Doxylamine; Pyridoxine metabolized in the liver.

Excretion: Renal excretion of metabolites.

Half Life: Doxylamine approximately 10 hours; Pyridoxine approximately 25-33 hours.

Contraindications

  • Known hypersensitivity to Doxylamine or Pyridoxine.
  • Narrow-angle glaucoma.
  • Acute asthma exacerbation.
  • Pregnancy and lactation (see notes).

Precautions

  • Use with caution in elderly, patients with urinary retention, BPH, or gastric retention.
  • Potential for sedation and anticholinergic effects.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Dry mouth (Common)

Adverse Reactions - Serious

  • Sedation leading to impairment of daily activities (Serious if excessive)
  • Hypersensitivity reactions (Rare)
  • Potential exacerbate glaucoma or urinary retention (Serious in susceptible individuals)

Drug-Drug Interactions

  • Centrally acting CNS depressants, alcohol may increase sedative effects.
  • Anticholinergic drugs may have additive effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of excessive sedation, anticholinergic effects, and pregnancy symptoms.

Diagnoses:

  • Risk for injury related to sedation
  • Risk for falls in elderly

Implementation: Administer at recommended doses, assess patient response, and educate on sedation precautions.

Evaluation: Efficacy in reducing nausea, minimal adverse effects.

Patient/Family Teaching

  • Take as directed, preferably at bedtime.
  • Caution about drowsiness and operating machinery.
  • Avoid alcohol and other CNS depressants.
  • Report any unusual side effects or allergic reactions.

Special Considerations

Black Box Warnings:

  • Use during pregnancy has been associated with a potential increased risk of fetal harm, though benefits may outweigh risks in certain cases.

Genetic Factors: Genetic variations in metabolism may affect drug levels.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Extreme drowsiness, confusion, hallucinations, anticholinergic effects, potentially coma.

Treatment: Supportive care, activated charcoal if within 1 hour of ingestion, airway management, and symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under normal conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.