Bonjesta is a pregnancy specific antiemetic drug suitable for the prevention and treatment of pregnancy related nausea and vomiting. Special attention should be paid to dosage adjustment, contraindications, and drug interactions when using it. The following provides a detailed explanation from three aspects: the scope of indications, medication for special populations, and precautions.

1. Scope of indications

(1) Pregnancy vomiting: Suitable for symptomatic treatment of moderate to severe nausea and vomiting during pregnancy, with better efficacy than single vitamin B6 preparations.

(2) Prophylactic medication: Patients with a history of severe morning sickness can use prophylactic medication in early pregnancy, but the benefit risk ratio needs to be evaluated.

2. Medication for special populations

(1) Pregnancy period: FDA Class B drugs for pregnancy in the United States may increase the risk of respiratory depression in newborns during late pregnancy. It is recommended to discontinue the medication 2 weeks before delivery.

(2) Breastfeeding period: Medications can cause drowsiness in infants through milk secretion, and breastfeeding should be avoided or suspended during lactation.

(3) Liver damage: CYP2D6 slow metabolizers need to reduce their dosage by 50%, and severe liver dysfunction patients should not use it.

3. Medication precautions

(1) Dose adjustment: The starting dose is 1 tablet per day before bedtime, and the maximum dose should not exceed 2 tablets per day (taken in divided doses).

(2) Contraindications: Not recommended for patients with angle closure glaucoma, severe asthma, and prostate enlargement.

(3) Drug interactions: Avoid combination with central nervous system inhibitors (such as opioids and benzodiazepines) as they may enhance sedative effects.

(4) Adverse reaction monitoring: Be alert to anticholinergic side effects (dry mouth, constipation, urinary retention) and excessive sedation during medication.