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NVP Vs Chemo induced Nausea

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Doxinate for Doctors/Guidelines on Management of NVP/SOGC guidelines
The combination of Doxylamine and Pyridoxine is strongly recommended as the standard choice by the Society of Obstetricians and Gynecologists- Clinical Practice Guidelines on the management of Nausea and Vomiting of Pregnancy as the combination has maximum evidence to support its safety and efficacy especially during pregnancy.
The SOGC recommendations are as follows:
  • Dietary and lifestyle changes should be liberally encouraged and women should be counseled to eat whatever appeals to them (III-C)

  • Alternative therapies such as ginger supplementation, acupuncture and acupressure may be beneficial (I-A)

  • A doxylamine- Pyridoxine combination should be standard of care, since it has the greatest evidence to support its efficacy and safety (I-A)

  • H1 receptor antagonists should be considered in the management of acute or breakthrough episodes of NVP (I-A)

  • Pyridoxine monotherapy supplementation may be considered as an adjuvant measure (I-A)

  • Phenothiazines are safe and effective for severe NVP (I-A)

  • Metoclopramide is safe to be used for management of NVP although evidence for its efficacy is limited (II-2D)

  • Corticosteroids should be avoided during the first trimester because of possible increased risk of oral clefting and should be restricted to refractory cases (I-B)

  • When NVP is refractory to initial pharmacotherapy, investigation of other potential causes should be taken (III-A)
You may visit:
http://www.sogc.org/guidelines/public/120E-CPG October2002.pdf to know more.
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