Studying the antiemetic effect of vitamin B6 for morning sickness: pyridoxine and pyridoxal are prodrugs

Ilan Matok, Shannon Clark, Steve Caritis, Menachem Miodovnik, Jason G. Umans, Gary Hankins, Donald R. Mattison, Gideon Koren

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Vitamin B6 has been known to possess antiemetic effects since 1942. This water soluble compound has several forms in the circulation including pyridoxine, pyridoxal, and pyridoxal phosphate. The active antiemetic form of vitamin B6 is unknown. This was a pre-specified substudy of a randomized, placebo-controlled trial comparing the antiemetic effect of the doxylamine-vitamin B6 combination (Diclectin®) (n = 131) to placebo (n = 126) in women with nausea and vomiting of pregnancy. Serum concentrations of pyridoxine, pyridoxal, and pyridoxal 5' phosphate (PLP) and doxylamine were measured on Days 4, 8, and 15. With Diclectin® exhibiting a significant antiemetic effect in pregnancy, serum concentrations of pyridoxine were unmeasurable in almost all patients and those of pyridoxal were undetectable in half of patients. In contrast, PLP was measurable at sustained, stable steady-state levels in all patients. Our data suggest that there is a correlation between PLP levels and PUQE score of morning sickness symptoms when pyridoxine and pyridoxal levels are undetectable, and hence they might be prodrugs of PLP, which may be the active antiemetic form of vitamin B6.

Original languageEnglish (US)
Pages (from-to)1429-1433
Number of pages5
JournalJournal of clinical pharmacology
Issue number12
StatePublished - Dec 1 2014
Externally publishedYes


  • morning sickness
  • nausea and vomiting of pregnancy
  • prodrug
  • pyridoxine

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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