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Diclegis

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  • Diclegis

    I have a relative who is nursing her 13 month old and is pregnant with baby #3. She has horrible hyperemesis pregnancies. Her dr wants her to try diclegis. I cannot find any info other than the manufacturer insert. Any info would be great!
    Pamela RN IBCLC

  • #2
    Hi, thanks for your post.

    Diclegis is a sustained release version of the classic combination doxylamine and pyridoxine (Vitamin B6). In pregnant women, this treatment is pretty much the best balance of safety and efficacy available. ACOG, the think tank that helps to determine obstetrical practice guidelines, considers this a first-line therapy in this population. See their statement linked at the bottom.

    In breastfeeding women, B6 is secreted into the milk in proportion to maternal intake. Usually, this is in the range of 100-300 ng/mL (emphasis on NANOgrams). Diclegis has 10 mg of B6 in it, which is comparable to a prenatal vitamin. We consider this to be quite safe in breastfeeding women.

    Doxylamine is secreted into milk to some degree, but exactly how much has not been studied. This is an antihistamine like Benadryl, so you might encounter some mild sedation in the child. For some reason, young children and infants sometimes have the opposite reaction and become agitated when exposed to this medication. It is unlikely that the amount in her milk will have a noticeable effect on a 13 month old, but she should still keep an eye out for changes in her child's sleep and activity patterns just the same.

    Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

    -James Abbey, MD

    http://www.guideline.gov/content.aspx?id=10939

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