title: Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities.
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 world wide, 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 wide-spread pathology in order to improve a woman's quality of life.
authors.affiliation: Super-Pharm Professional, Petach-Tikva, Israel. eyalz@super-pharm.co.il
authors.forename: Eyal
authors.initials: E
authors.lastname: Zur
mesh_terms: D000465:Algorithms; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D004025:Dicyclomine; D004111:Dimenhydrinate / Q000008:administration & dosage / Q000627:therapeutic use; D004319:Doxylamine; D004338:Drug Combinations; D004339:Drug Compounding / Q000379:methods*; D005260:Female; D006801:Humans; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011398:Promethazine / Q000008:administration & dosage / Q000627:therapeutic use; D011736:Pyridoxine; D011788:Quality of Life; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000932:Antiemetics; D004338:Drug Combinations; C004454:dicyclomine, doxylamine, pyridoxine drug combination; D004025:Dicyclomine; D004319:Doxylamine; D011398:Promethazine; D004111:Dimenhydrinate; D011736:Pyridoxine