Doxylamine + Pyridoxine

• Nausea & vomiting of pregnancy (NVP)

Central H1 antagonism + B6 cofactor — antiemetic via vomiting centre.

• 10 mg + 10 mg combo, nocte starts
• Up to QDS — drowsiness common

NVP

2 tabs PO nocte → titrate up to 4 tabs/day (1 morning, 1 midday, 2 nocte)

• CautionMAOI use, closed-angle glaucoma

• Drowsiness, dry mouth
• Headache

• • Extensive safety data — first-line.

• CNS depressants / alcohol

  Caution

  ↑ sedation

• MAOI

  Avoid

  ↑ anticholinergic

• 💡 Step-up: ginger/B6 → doxylamine-B6 → cyclizine/promethazine → metoclopramide/ondansetron → steroids.
• 💡 Counsel re driving.