dox-il-a-meen peer-ih-dox-een

Trade Name(s)

  • Bonjesta
  • Diclegis
  • Diclectin Canadian Tradename

Ther. Class.

Pharm. Class.
vitamin B6 analogues


Treatment of nausea and vomiting during pregnancy that has not responded to conservative management.


Combination of an antihistamine and a vitamin B6  analog. Mechanism not known.

Therapeutic Effect(s):

Decreased nausea and vomiting associated with pregnancy.


Absorption: Well absorbed following oral administration. Food delays/↓ absorption.

Distribution: Doxylamine probably enters breast milk

Metabolism and Excretion: Doxylamine is mostly metabolized by the liver, inactive metabolites are renally excreted. Pyridoxine is a pro-drug, converted to its active metabolite by the liver.

Half-life:  Doxylamine– 12.5 hr;  pyridoxine– 0.4–0.5 hr

TIME/ACTION PROFILE (anti-emetic effect)

POunknownunknown8–24 hr


Contraindicated in:

  • Hypersensitivity to doxylamine or pyridoxine
  • Concurrent use of MAOIs
  • Lactation: Doxylamine probably enters breast milk and may cause irritability, excitement, or sedation in infants; breast feeding should be avoided.

Use Cautiously in:

  • Asthma
  • ↑ intraocular pressure or narrow angle glaucoma
  • Stenosing peptic ulcer or pyloroduodenal obstruction
  • Urinary bladder-neck obstruction
  • Pedi:  Safety and effectiveness not established

Adverse Reactions/Side Effects

CNS: drowsiness

* CAPITALS indicate life-threatening.
Underline indicate most frequent.



  • ↑ risk of CNS depression with other  CNS depressants  including alcohol, other antihistamines, opioid analgesics, and  sedative/hypnotics.
  • Concurrent use of  MAOIs  ↑ intensity/duration of adverse CNS (anticholinergic) reactions


Delayed-Release Tablets

PO (Adults):  Day 1– 2 tablets (doxylamine 10 mg/pyridoxine 10 mg) at bedtime; if symptoms are controlled continue this regimen;  Day 2, if symptoms persist into afternoon on day 2– 2 tablets at bedtime on day 2 and then 1 tablet in the morning on day 3 and 2 tablets in the evening; if symptoms are controlled, continue this regimen;  Day 4, if symptoms persist– 1 tablet in the morning, 1 tablet mid-afternoon and 2 tablets at bedtime (not to exceed four tablets daily).

Extended-Release Tablets

PO (Adults):  Day 1– 1 tablet (doxylamine 20 mg/pyridoxine 20 mg) at bedtime; if symptoms are controlled, continue this regimen;  Day 2, if symptoms persist on day 2– 1 tablet in AM and 1 tablet at bedtime on day 2; if symptoms are controlled, continue this regimen (not to exceed two tablets daily).

Availability (generic available)

Delayed-release tablets (Diclegis): doxylamine 10 mg/pyridoxine 10 mg

Extended-release tablets (Bonjesta): doxylamine 20 mg/pyridoxine 20 mg


  • Assess for frequency and amount of emesis daily during therapy. Reassess need for medication as pregnancy progresses.
  • Monitor hydration status to prevent dehydration.

Lab Test Considerations:

May cause false positive urine screening tests for methadone, opiates, and PCP.

Potential Diagnoses


  • PO Administer on an empty stomach with a full glass of water; food delays onset of medication. Swallow tablets whole; do not crush, break, or chew.

Patient/Family Teaching

  • Instruct patient to take as directed. Do not take more than prescribed amount.
  • May cause drowsiness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
  • Advise patient to avoid alcohol and CNS depressants, including sedatives, tranquilizers, antihistamines, opioids, and some cough and cold medications with doxylamine pyridoxine.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
  • Advise female patient to avoid breast feeding during therapy.

Evaluation/Desired Outcomes

Decrease in frequency of nausea and vomiting during pregnancy.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. .