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Nausea and Vomiting in Pregnancy: A Review of the Pathology and Compounding Opportunities

Author(s):  Zur Eyal

Issue:  Mar/Apr 2013 - Volume 17, Number 2
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Abstract:  Nausea and vomiting in pregnancy can have serious adverse effects on the quality of a woman’s life, affecting her occupational, social, and domestic functioning and her general well-being; therefore, it is very important to treat this condition appropriately and effectively. Evidence-based algorithms support the use of oral pyridoxine alone or combined with doxylamine as first-line treatment. Promethazine or dimenhydrinate, known as a second-line treatment, should be added to the first-line treatment or should be added only to pyridoxine according to different algorithms. In most of the world, there is a lack of approved medicines using this combination approach known as the first-line treatment. Therefore, compounding pharmacists should supply the demand by compounding 10-mg pyridoxine hydrochloride and 10-mg doxylamine succinate slow-release capsules. Since transdermal promethazine does not exist worldwide, and, since this medicine has significant added values compared to the oral/rectal dosage forms, compounding pharmacists should offer physicians transdermal promethazine as a second- line therapy in nausea and vomiting in pregnancy. This review summarizes the nausea and vomiting in pregnancy problems and discusses the compounding opportunities that exist in this common and widespread pathology in order to improve a woman's quality of life.

Related Keywords: Eyal Zur, RPh, MBA, nausea, vomiting, pregnancy, hyperemesis gravidarum, pyridoxine, vitamin B6, doxylamine, antihistamine, dehydration, promethazine, dimenhydrinate, transdermal administration, formulation, slow-release capsules, Diclectin, American College of Obstetrics and Gynecology, algorithm, metoclopramide, trimethobenzimide, ondasetron, methylprednisolone, morning sickness


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