From the Guidelines
For hyperemesis gravidarum, vitamin B6 (pyridoxine) is recommended at a dose of 10-25 mg orally three to four times daily, for a total daily dose of 30-100 mg, as first-line therapy for mild symptoms or in combination with doxylamine for more severe cases, as suggested by the American College of Obstetricians and Gynecologists (ACOG) 1.
Key Considerations
- The dosage of vitamin B6 can be started with 25 mg three times daily and continued throughout pregnancy as needed for symptom control.
- Pyridoxine can be used alone or combined with doxylamine, an antihistamine, for more severe cases of hyperemesis gravidarum.
- The combination of pyridoxine and doxylamine is available as a prescription medication, such as Diclegis or Bonjesta, containing 10 mg pyridoxine and 10 mg doxylamine per tablet.
Safety and Efficacy
- Vitamin B6 is generally considered safe during pregnancy, with minimal side effects even at higher doses, as reported in a study published in Gastroenterology 1.
- However, excessive amounts of vitamin B6 (typically over 100 mg daily for extended periods) should be avoided as they may cause peripheral neuropathy.
Additional Treatment Options
- If symptoms persist despite vitamin B6 therapy, consultation with a healthcare provider is recommended to explore additional treatment options, such as metoclopramide, ondansetron, or methylprednisolone, as suggested by the American College of Obstetricians and Gynecologists (ACOG) 1.
- Hospitalization may be required for severe cases of hyperemesis gravidarum, with IV hydration and replacement of electrolytes, vitamins, and nutrients.
From the Research
Formulation and Dosage of Vitamin B6 for Hyperemesis of Pregnancy
- The appropriate formulation of Vitamin B6 for hyperemesis of pregnancy is often in combination with doxylamine, as seen in the drug Diclectin 2, 3, 4.
- The recommended dosage of Vitamin B6 for mild to moderate nausea and vomiting during pregnancy is 10mg four times a day, alone or in combination with doxylamine 5.
- For women taking Diclectin, the recommended dose is 4 tablets a day, with each tablet containing 10mg of Vitamin B6 and 10mg of doxylamine 4.
- The dosage may need to be adjusted according to body weight and individual symptoms, with some women requiring a higher dose to achieve optimal relief from nausea and vomiting 4.
- It is essential to note that the harmlessness of oral Vitamin B6 during pregnancy has been established for doses up to 40-60mg/day, mainly in combination with doxylamine 5.
Safety and Efficacy
- Studies have shown that Vitamin B6, alone or in combination with doxylamine, is effective in reducing nausea and vomiting during pregnancy 2, 3, 5, 4.
- The safety of Vitamin B6 during pregnancy has been established, with no significant adverse effects reported at recommended doses 5.
- However, it is crucial to follow the recommended dosage and consult with a healthcare provider before taking any medication during pregnancy 2, 3, 4.