Doxinate OD Tablet: Complete Guide to Uses, Dosage, and Safety
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Severe allergic reaction: swelling of face, lips, throat, or difficulty breathing.
- Irregular heartbeat or palpitations.
- Severe drowsiness or confusion.
- Hallucinations or unusual thoughts.
- Yellowing of skin or eyes (jaundice).
- Persistent vomiting leading to dehydration.
- Blood in vomit or stool.
If experiencing severe symptoms, call emergency services immediately.
What is alfresh 20mg/20mg tablet used for?
This medicine is a combination of doxylamine and vitamin B6 used to treat nausea and vomiting during pregnancy. It works by blocking histamine receptors in the brain and supporting neurotransmitter function. It is usually taken at bedtime, with additional doses during the day if needed. Common side effects include drowsiness and dry mouth.
- Generic Name: Doxylamine + Vitamin B6
- Manufacturer: Almed Drugs Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 alfresh 20mg/20mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा डॉक्सिलामाइन और विटामिन बी6 का संयोजन है, जिसका उपयोग गर्भावस्था के दौरान उल्टी और मतली (मॉर्निंग सिकनेस) के इलाज के लिए किया जाता है। यह मस्तिष्क में हिस्टामिन रिसेप्टर्स को ब्लॉक करके और न्यूरोट्रांसमीटर के कार्य को सहारा देकर काम करती है। यह आमतौर पर रात में सोने से पहले ली जाती है, और जरूरत पड़ने पर दिन में भी ली जा सकती है।
साइड इफेक्ट्स: इस दवा के आम दुष्प्रभावों में नींद आना, चक्कर आना, मुँह सूखना और धुंधली दृष्टि शामिल हैं। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन अगर आपको सांस लेने में कठिनाई, चेहरे या गले में सूजन, या दिल की धड़कन अनियमित लगे तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। इसे लेने के बाद नींद आ सकती है, इसलिए वाहन चलाने या मशीनरी चलाने से बचें। शराब का सेवन न करें क्योंकि इससे नींद और चक्कर बढ़ सकते हैं। गर्भवती महिलाओं को यह दवा डॉक्टर की सलाह पर ही लेनी चाहिए। अपने डॉक्टर को अन्य दवाओं के बारे में बताएं जो आप ले रहे हैं।
💊 alfresh 20mg/20mg tablet Uses & Benefits
- [{"condition":"Nausea and vomiting of pregnancy (morning sickness)","description":"This medicine is used to treat nausea and vomiting during pregnancy when conservative measures fail.
- It helps reduce the frequency and severity of symptoms.","evidence":"Well-established"},{"condition":"Nausea and vomiting from other causes","description":"Sometimes prescribed for nausea due to motion sickness, vertigo, or other vestibular disorders, though this is not its primary approved use.","evidence":"Limited"}]
Off-label uses: [{"condition":"Insomnia","description":"Doxylamine alone is available over-the-counter as a sleep aid, but the combination with pyridoxine is not typically used for this purpose.","evidence":"Limited"},{"condition":"Allergic rhinitis","description":"The antihistamine component may help with allergy symptoms, but this combination is not primarily indicated for allergies.","evidence":"Limited"}]
Primary treatment for: Nausea and vomiting of pregnancy
Also treats: Motion sickness, Vertigo, Nausea from other causes
📋 Drug Information
| Generic Name(s) | Doxylamine + Vitamin B6 |
| Brand Name | Act NVP Tablet |
| Manufacturer | Almed Drugs Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | GASTRO INTESTINAL |
| Action Class | Antihistamine + Vitamin Supplement |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | The World Health Organization does not have a specific guideline for this combination, but it is included in the WHO Model List of Essential Medicines for the management of nausea and vomiting in pregnancy. |
| ICMR Guideline | The Indian Council of Medical Research has not issued a specific guideline for this combination, but it is commonly prescribed in India for nausea and vomiting of pregnancy. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with complementary actions. Doxylamine is a first-generation antihistamine that competitively blocks histamine H1 receptors in the central nervous system, particularly in the chemoreceptor trigger zone and vomiting center, thereby reducing nausea and vomiting. It also has anticholinergic properties that contribute to its antiemetic effect. Pyridoxine (vitamin B6) is a coenzyme involved in numerous metabolic pathways, including the synthesis of neurotransmitters such as serotonin and dopamine, which are implicated in nausea and vomiting. By supporting these pathways, pyridoxine helps to normalize neurological function and reduce nausea. Together, they provide a synergistic effect that is more effective than either component alone.
Mechanism Steps
💡 How to Take alfresh 20mg/20mg tablet
Strength: Each tablet contains doxylamine 20 mg and vitamin B6 (pyridoxine) 20 mg.
Dosage Information
| Adult Dosage | The usual adult dose for nausea and vomiting of pregnancy is one tablet taken at bedtime. If symptoms persist during the day, an additional tablet may be taken in the morning and one in the afternoon. The maximum recommended dose is typically 4 tablets per day. However, the exact dose and frequency must be individualized by a qualified clinician based on the severity of symptoms, response to treatment, and individual patient factors. Do not self-adjust the dose. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients may be more sensitive to the side effects of this medicine, particularly drowsiness, confusion, and anticholinergic effects. A lower starting dose may be considered, and caution is advised. Dose must be individualized by a qualified clinician. |
| Renal Impairment | In patients with severe renal impairment, dose adjustment may be necessary. Consult a clinician for individualized dosing. |
| Hepatic Impairment | In patients with severe hepatic impairment, this medicine should be used with caution or avoided. Dose reduction may be required. Consult a clinician for individualized dosing. |
| Maximum Daily Dose | The maximum recommended daily dose is typically 4 tablets (80 mg doxylamine and 80 mg pyridoxine). However, this may vary based on clinical judgment. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of alfresh 20mg/20mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Alcohol | Major | |
| Opioids | Major | |
| MAO inhibitors | Major | |
| Tricyclic antidepressants | Moderate | |
| Fluoxetine | Moderate | |
| Paroxetine | Moderate | |
| Levodopa | Minor | |
| Hydralazine | Minor |
🚨 Major Interactions
- CNS depressants (e.g., alcohol, opioids, benzodiazepines)
- MAO inhibitors
⚡ Moderate Interactions
- Anticholinergic drugs (e.g., atropine, tricyclic antidepressants)
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
🍷 Alcohol Interaction
Alcohol should be avoided while taking this medicine because it can significantly increase drowsiness, dizziness, and impair your ability to drive or operate machinery. It may also increase the risk of central nervous system depression.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to doxylamine, pyridoxine, or any component of the formulation","Untreated narrow-angle glaucoma","Severe liver disease","Concurrent use with MAO inhibitors","Breastfeeding without medical advice"]
⚠️ Warnings & Precautions
["May cause drowsiness; avoid driving or operating machinery until you know how it affects you.","Avoid alcohol and other CNS depressants.","Use with caution in patients with asthma, COPD, or sleep apnea.","Use with caution in elderly patients due to increased risk of confusion and falls.","Do not exceed the recommended dose.","Consult your doctor if symptoms persist or worsen."]
🤱 Lactation Safety
Doxylamine is excreted in breast milk and may cause drowsiness in the nursing infant. Pyridoxine is also excreted in breast milk but is considered safe. Consult your doctor before using this medicine while breastfeeding; it may be necessary to monitor the infant for sedation.
💊 Overdose Management
Overdose of this medicine can cause severe drowsiness, confusion, hallucinations, seizures, and respiratory depression. If you suspect an overdose, seek emergency medical attention immediately. Treatment is supportive and symptomatic, including gastric lavage if within 1-2 hours of ingestion, activated charcoal, and monitoring of vital signs. There is no specific antidote.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor. Do not increase the dose or take it more often than directed. Because this medicine can cause drowsiness, avoid driving or operating heavy machinery until you know how it affects you. Alcohol can increase drowsiness and should be avoided. If you are pregnant, this medicine is often prescribed for morning sickness, but you should only use it under medical supervision. Inform your doctor about all other medicines you are taking, including over-the-counter drugs and supplements, as interactions can occur. Do not stop taking this medicine suddenly without consulting your doctor. Store it at room temperature, away from moisture and heat. Keep out of reach of children.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more sensitive to the side effects of this medicine, especially drowsiness, confusion, and anticholinergic effects. Use with caution and consider a lower dose. Regular monitoring for falls and cognitive changes is advised.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before using this medicine. It is considered safe for use during pregnancy when prescribed, but pre-conception use should be discussed with a healthcare provider.
🏥 Post-Surgery Considerations
This medicine may be used for post-operative nausea and vomiting, but it should only be used under medical supervision. Inform your surgeon and anesthesiologist if you are taking this medicine before surgery.
🦷 Dental Procedures
Inform your dentist if you are taking this medicine, as it can cause dry mouth and may interact with sedatives used during dental procedures.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Avoid strenuous exercise or activities that require alertness until you know how this medicine affects you. Drowsiness and dizziness can increase the risk of falls or injuries.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause drowsiness, which may affect your ability to drive or operate machinery. It is best to avoid these activities until you know how the medicine affects you. If you work in a job that requires alertness, discuss with your doctor about timing the dose to minimize impact.
🛑 When to Stop This Medicine
Do not stop taking this medicine without consulting your doctor. If you experience severe side effects or your symptoms improve, your doctor may advise tapering or stopping. Abrupt discontinuation is not typically associated with withdrawal, but medical guidance is recommended.
📅 Long-Term Use Effects
Long-term use of this medicine is generally not recommended unless under medical supervision. Prolonged use may lead to tolerance, dependence, and increased risk of side effects such as confusion, constipation, and urinary retention. Regular monitoring by a doctor is advised if long-term use is necessary.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Eating small, frequent meals and avoiding trigger foods can help manage nausea.
Evidence: Well-establishedGinger has been shown to reduce nausea and vomiting in pregnancy.
Evidence: ModerateWristbands that apply pressure to the P6 acupoint may help some women.
Evidence: Limited💉 Vaccination Considerations
💉 If You're Getting Vaccinated
There are no known interactions between this medicine and vaccines. However, if you are pregnant, discuss vaccination timing with your doctor.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging along with a copy of your prescription. Store it at room temperature and protect it from extreme heat or moisture. If you are crossing time zones, continue taking your doses at the same intervals as prescribed, but consult your doctor for specific advice. Keep it in your carry-on luggage to avoid loss.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine usually starts working within 30 to 60 minutes after taking a dose. The full effect may take a few days of regular use.
A: You should always inform your doctor about all other medicines you are taking, as this medicine can interact with certain drugs, especially those that cause drowsiness or affect liver enzymes.
A: This medicine can pass into breast milk and may cause drowsiness in the baby. Consult your doctor before using it while breastfeeding.
🤔 Common Patient Concerns
🔄 Substitutes for alfresh 20mg/20mg tablet
View AllAlternative brands with exact same active ingredient:
-
doxylam 20mg/20mg/5mg tabletEuro Organics ₹18.75 58.3% CHEAPER
-
dom forte tabletEdmund Healthcare ₹25.31 43.8% CHEAPER
-
medfol-plus tabletAbia Pharmaceuticals Pvt. Ltd. ₹27.19 39.6% CHEAPER
-
doxyfem b6 tabletDabur India Ltd ₹28.85 35.9% CHEAPER
-
doxipreg od 20mg/20mg tabletBewell Labs Pvt Ltd ₹29.77 33.8% CHEAPER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine is only for morning sickness.
Fact: While it is primarily used for morning sickness, it can also be prescribed for other types of nausea under medical supervision. - Myth: It is safe to take this medicine without a prescription.
Fact: This is a prescription medicine. It should only be taken under the guidance of a qualified clinician. - Myth: This medicine will harm my baby.
Fact: When taken as prescribed, this medicine is considered safe and effective for managing nausea and vomiting during pregnancy.
🔄 Alternative Options
Generic Alternatives
- Doxylamine and Pyridoxine Tablets
Brand Alternatives
- Doxinate OD Tablet