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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant. Taking Duphaston. History Of Miscarriage. Tiredness, Nausea. Should I Take Navidoxine?

Hi,
I first found out I was pregnant in aug 2012, had a miscarriage in oct 2012. I am now 7 weeks pregnant. My Dr is making me take Duphaston (one tablet am and one tablet pm, everyday). I am also taking my folic acid, however, I am tired ALL the time, I can't do anything, I spend all my time lying down as I am suffering from very bad nausea (no vomiting, just constant nausea). My Dr has prescribed me with Navidoxine for the nausea. Can you please shed any light on whether it is safe to be taking nausea pills during pregnancy (are there any 'safer' pills that I can be taking?).
Any help would be much appreciated!
Many thanks
Wed, 3 Jul 2013
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General & Family Physician 's  Response
Hello,

Warm welcome to HCM, congratulations to the would be mother :)

Coming to your query, Navidoxin contains meclozine (or meclizine, both are same, antihistaminic drug) and pyridoxine (vitamin). As you may be knowing that vitamins are useful and safe during pregnancy when they are taken in regulated doses. Meclizine is drug usually given for nausea/ vomiting of pregnancy. This drug is old enough and given to so many women suffering from nausea/ vomiting of pregnancy and was not found to be significantly associated with any birth defects. But large population clinical trials are not conducted for the same and hence it is included in a category of drugs which is to be taken only when detrimental effects of nausea/ vomiting (like dehydration and risk of miscarriage) are more to pregnant lady than probable side effects (here, birth defect in baby to be specific and drowsiness, dry mouth, and tiredness to the pregnant lady) of drug itself. So, what I suggest is, if you are just uncomfortable with nausea/ vomiting and nothing else than just try the following non drug measures and even if you are not relieved then take the drug which is prescribed to you (i.e. Navidoxin).

(1) You should take your meals and breakfast in small divided quantity but more frequently may be every one to two hourly to avoid full stomach. You should eat before, or as soon as, you feel hungry to avoid an empty stomach, as on empty stomach you may feel more nauseated. A dry toast before getting up from bed in the morning can be helpful. You may also try foods rich in protein like pulses / dairy products as, there is some evidence that protein rich foods help in decreasing in nausea.

(2) Fluids are better tolerated if cold, clear, or sour and if taken in small amounts between meals. You can also try using a straw to drink liquids. Lemon juice (lemonade)or orange juice are found to useful.

(3) You should also avoid factors which may increase your nausea/ vomiting like stuffy rooms, odors (eg, perfume, chemicals, some food, smoke) , heat, humidity, noise, and visual or physical motion (eg, flickering lights, driving). Quickly changing position and not getting enough rest, particularly after eating, may also aggravate symptoms. Lying down soon after eating and lying on the left side are additional potentially aggravating factors because these actions may delay gastric emptying. Brushing teeth after a meal can be helpful.

(4) Taking prenatal vitamins before bed with a snack, instead of in the morning or on an empty stomach, may also be helpful .

(5) Clinical trials suggest that ginger (1 to 1.5 grams in divided doses over 24 hours) is more effective than placebo, and equivalent to vitamin B6 (pyridoxine) for treatment of nausea and vomiting of pregnancy. You may give this a try using ginger in any form, may be in tea/ juice.

If these measures don’t help you than you can take medications prescribed to you.

Hope this will help you.

References:-
(1) Meclizine in pregnancy in relation to congenital malformations. by S Shapiro, D W Kaufman, L Rosenberg, D Slone, R R Monson, V Siskind, and O P Heinonen
(2) Treatment and outcome of nausea and vomiting of pregnancy by Judith A Smith, Jerrie S Refuerzo, Susan M Ramin (http://www.uptodate.com/contents/treatment-and-outcome-of-nausea-and-vomiting-of-pregnancy)

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Pregnant. Taking Duphaston. History Of Miscarriage. Tiredness, Nausea. Should I Take Navidoxine?

Hello, Warm welcome to HCM, congratulations to the would be mother :) Coming to your query, Navidoxin contains meclozine (or meclizine, both are same, antihistaminic drug) and pyridoxine (vitamin). As you may be knowing that vitamins are useful and safe during pregnancy when they are taken in regulated doses. Meclizine is drug usually given for nausea/ vomiting of pregnancy. This drug is old enough and given to so many women suffering from nausea/ vomiting of pregnancy and was not found to be significantly associated with any birth defects. But large population clinical trials are not conducted for the same and hence it is included in a category of drugs which is to be taken only when detrimental effects of nausea/ vomiting (like dehydration and risk of miscarriage) are more to pregnant lady than probable side effects (here, birth defect in baby to be specific and drowsiness, dry mouth, and tiredness to the pregnant lady) of drug itself. So, what I suggest is, if you are just uncomfortable with nausea/ vomiting and nothing else than just try the following non drug measures and even if you are not relieved then take the drug which is prescribed to you (i.e. Navidoxin). (1) You should take your meals and breakfast in small divided quantity but more frequently may be every one to two hourly to avoid full stomach. You should eat before, or as soon as, you feel hungry to avoid an empty stomach, as on empty stomach you may feel more nauseated. A dry toast before getting up from bed in the morning can be helpful. You may also try foods rich in protein like pulses / dairy products as, there is some evidence that protein rich foods help in decreasing in nausea. (2) Fluids are better tolerated if cold, clear, or sour and if taken in small amounts between meals. You can also try using a straw to drink liquids. Lemon juice (lemonade)or orange juice are found to useful. (3) You should also avoid factors which may increase your nausea/ vomiting like stuffy rooms, odors (eg, perfume, chemicals, some food, smoke) , heat, humidity, noise, and visual or physical motion (eg, flickering lights, driving). Quickly changing position and not getting enough rest, particularly after eating, may also aggravate symptoms. Lying down soon after eating and lying on the left side are additional potentially aggravating factors because these actions may delay gastric emptying. Brushing teeth after a meal can be helpful. (4) Taking prenatal vitamins before bed with a snack, instead of in the morning or on an empty stomach, may also be helpful . (5) Clinical trials suggest that ginger (1 to 1.5 grams in divided doses over 24 hours) is more effective than placebo, and equivalent to vitamin B6 (pyridoxine) for treatment of nausea and vomiting of pregnancy. You may give this a try using ginger in any form, may be in tea/ juice. If these measures don’t help you than you can take medications prescribed to you. Hope this will help you. References:- (1) Meclizine in pregnancy in relation to congenital malformations. by S Shapiro, D W Kaufman, L Rosenberg, D Slone, R R Monson, V Siskind, and O P Heinonen (2) Treatment and outcome of nausea and vomiting of pregnancy by Judith A Smith, Jerrie S Refuerzo, Susan M Ramin (http://www.uptodate.com/contents/treatment-and-outcome-of-nausea-and-vomiting-of-pregnancy)