January 2017: Important update on Diclegis! A medical journal recently published a paper questioning the safety of Diclegis, or at least raising concerns about the quality of the research behind its FDA approval.
Although the components of Diclegis can be easily purchased over the counter, as my post shows, it’s very important that ANY drugs taken during pregnancy be OK’ed by your obstetrician first. FN
I don’t usually pay much attention to media’s almost 24/7 coverage of all things Kardashian, but it’s been hard to miss the news tidbits about Kim Kardashian’s second pregnancy.
And to those that follow her on Twitter or Instagram, she must be consuming a large part of their days.
So I laughed when I read a post by Ob/Gyn Jennifer Gunter, MD, over on the blog KevinMD: Kim Kardashian’s first trimester nausea: The truth behind Diclegis
It was only a matter of time before Kim Kardashian posted a picture on her Instagram account with a bottle of Diclegis, basically announcing her brand partnership with Duchesnay, the manufacturer of the prescription medication for nausea and vomiting in pregnancy. Duchesnay had been tweeting for ages that they were so relieved Kim had found help with Diclegis — so much so that I was wondering if Ms. Kardashian was possibly having the longest first trimester known to womankind.
But the Food and Drug Administration (FDA) was not happy about Kim’s Instagram advertisement for the prescription drug:
Kardashian was careful to follow her testimonial with a link to the drug’s primary information page and another to a prolonged list of safety information.
But the FDA’s Office of Prescription Drug Promotion has ruled in a warning letter…that those URLs were insufficient and inconsistent with the full material information required when such a drug is advertised in any medium. It turns out that this wasn’t just a happy celebrity sharing her health tips with her
464,00040.8 million closest friends (the post alone received 464,000 likes).
As Dr. Gunter put it,
I think promoted tweets with a celebrity name is a pretty sly way around the rules. How many people really click through and read the fine print versus bring up a screen shot of the promoted tweet and ask their doctor for the medication that helped Kim?
The iffy integrity of such a marketing ploy aside, Dr. Gunter pointed out that Diclegis is really an unnecessary expense for women suffering from the nausea of early pregnancy.
While you can buy Diclegis as a prescription it is just a combination of two readily available over-the-counter (OTC) medications—vitamin B6 and doxylamine (an antihistamine)—with slightly different dosing. When taken together, doxylamine and vitamin B6 are mildly to moderately effective for nausea and vomiting in pregnancy.
The big difference between the OTC option and Diclegis is price. You can buy 100 doxylamine 25 mg tablets for $12.79 and 100 vitamin B6 tablets 25 mg for $7.29.
Diclegis is $345 for 60 tablets. The dose is two tablets a day, but some women need four tablets so the cost could be $690 a month (with a discount coupon!). Some may get it covered by insurance, but even then co-payments are likely to be $20 or more.
Her post provides a chart of these pricing details, showing price per pill, per dose and per day.
The OTC dosing is not identical but close enough and before 2013 (when Diclegis wasn’t available) we managed just fine using these slightly different doses.
The other advantage of the OTC route is you can start with vitamin B6 and if that doesn’t work then add in the doxylamine. After all, we recommend a step-wise approach to nausea and vomiting.
Besides Diclegis, there are many prescription drugs that are actually available over the counter at a cheaper price. Ask your health care provider or your pharmacy if that is an option for you and then do your own pricing.
Related post: Nexium—Brand, generic, prescription or OTC?
Oh, and don’t get your health advice from celebrity social media 😉
Over-the-counter Diclegis ingredients: