From the Guidelines
Diclectin should be dosed as 2 tablets at bedtime for pregnant women experiencing nausea and vomiting, with a possible increase to a maximum of 4 tablets daily if symptoms are not adequately controlled, as recommended by the American College of Obstetricians and Gynecologists (ACOG) 1. The dosage can be adjusted based on the severity of symptoms, which can be quantified using the Motherisk Pregnancy Unique Quantification of Emesis score (Table 1) 1. Key considerations for dosing include:
- Starting treatment as soon as symptoms appear
- Continuing treatment throughout pregnancy if needed
- Taking the medication consistently for optimal effect
- Being aware that it may take a few days to achieve full benefit
- Seeking medical attention if severe vomiting prevents oral medication. Each tablet contains 10 mg of doxylamine succinate and 10 mg of pyridoxine hydrochloride, which work together to reduce nausea and regulate hormonal changes that contribute to morning sickness 1. The bedtime dosing is strategic because the medication causes drowsiness, and taking it before sleep helps minimize this side effect. Early intervention and treatment of nausea and vomiting of pregnancy (NVP) may help prevent progression to hyperemesis gravidarum (HG) 1.
From the Research
Diclectin Dosing
- The standard dose of Diclectin is 2-4 tablets per day, with each tablet containing 10 mg of doxylamine succinate and 10 mg of pyridoxine hydrochloride 2.
- However, the optimal dose may vary depending on individual symptoms and body weight, with some studies suggesting that women should receive a dosage according to their body weight and severity of their symptoms 2.
- A study found that women who received a mean doubling of the dose to 4 tablets a day experienced a significant decrease in length of nausea, frequency of vomiting, and overall PUQE score 2.
- The pharmacokinetics of Diclectin have been studied, with results showing that the drug exhibits similar oral bioavailability to oral solutions of its two components, but with a delayed-release characteristic 3.
- The relative bioavailability of pyridoxine in Diclectin was calculated to be 100%, with interindividual differences in metabolism being a potential source of variability in dosing guidelines 4.
Factors Affecting Diclectin Dosing
- Body weight: studies suggest that women should receive a dosage according to their body weight 2.
- Severity of symptoms: women with more severe symptoms may require higher doses of Diclectin 2.
- Metabolism: interindividual differences in metabolism may affect the efficacy of Diclectin, with some women requiring adjusted doses 4.
Clinical Guidelines
- The combination of doxylamine succinate and pyridoxine hydrochloride is recommended as first-line pharmacologic treatment for nausea and vomiting of pregnancy (NVP) 5, 6.
- Diclectin is approved by the US Food and Drug Administration (FDA) for the treatment of NVP and has a pregnancy safety rating of A 5, 6.