• Popular Morning Sickness Drug Safe in Pregnancy, Study Finds

    Women taking metoclopramide can be reassured by the findings, expert says
    TUESDAY, Oct. 15 (HealthDay News) -- The anti-nausea medication metoclopramide appears to be a safe and effective treatment for morning sickness, Danish researchers report.
    More than 40,000 women exposed to metoclopramide while pregnant did not face any increased risk of birth defects or miscarriage, according to a study published Oct. 16 in the Journal of the American Medical Association.
    "This is by far the largest study on metoclopramide safety in pregnancy, and as such it expands substantially on the published evidence," said co-author Dr. Bjorn Pasternak of the Statens Serum Institute in Copenhagen. "It found that metoclopramide use in pregnancy was not associated with increased risk of major adverse outcomes, including major malformations and fetal death, and as such supports what is known about the safety profile of this drug."
    More than half of pregnant women experience nausea and vomiting, usually early in their pregnancy, the study authors noted.
    Most women deal with these symptoms with little treatment, but about 10 percent to 15 percent eventually will require medication because they face more serious complications such as dehydration or weight loss.
    But many pregnant women have grave concerns regarding any sort of nausea medication because of the horrific birth defects associated with the drug thalidomide, which was used to treat morning sickness in the late 1950s and early 1960s. Thalidomide's tragic history led to the strengthening of the U.S. Food and Drug Administration (FDA) and the development of regulations regarding medication use during pregnancy.
    "There's a general feeling to take no medications during pregnancy," said Dr. Siobhan Dolan, associate professor of obstetrics and gynecology at Montefiore Medical Center in New York City and medical adviser to the March of Dimes. "The truth is in the first trimester when the organs are forming we're cautious about any medication the women take. But there's a growing appreciation that there can be risks to not treating symptoms like nausea and vomiting."
    Metoclopramide, sold under the brand name Reglan, is one of the most commonly used prescription medications in pregnancy, the authors noted.
    The drug has FDA approval for use as a treatment for patients suffering heartburn and esophagitis due to acid reflux. It's also used to treat nausea caused by surgery or chemotherapy, and is often recommended as a treatment for morning sickness if other therapies have failed.
    Pasternak said there aren't many alternatives for the treatment of nausea and vomiting in pregnancy. "There appears to be some degree of individual variation in response to drug treatment, so some women may be helped by one drug and others by another. Therefore, different treatment alternatives are needed," he said.
    In this study, researchers reviewed more than 1.2 million pregnancies in Denmark from 1997 to 2011 and compared outcomes between women who used metoclopramide and those who did not.
    The investigators compared 28,486 infants exposed to metoclopramide in the first trimester of pregnancy to 113,698 unexposed infants, and found no associations between the nausea drug and any major malformations.
    The study also found no increased risk of miscarriage, stillbirth, preterm birth, low birth weight or fetal growth restriction associated with metoclopramide use in pregnancy.
    Because birth defects are rare, it can be difficult to assess a drug's safety in small-scale studies, Dolan said. A study looking at tens of thousands of pregnancies is more likely to find patterns and associations between a medication and the risk of birth defects, if such risk exists.
    "We can take from this some reassurance" of metoclopramide's safety, Dolan said. "What's powerful about a study like this is they looked at all the births in Denmark between 1997 and 2011. That's a lot of births."
    Regardless, Dolan said further study into the safety of this and other medications used during pregnancy will always be needed.
    "We need good data to have good understanding so women can be cared for, and their symptoms can be treated and they can have successful pregnancy outcomes," she said. "Women need to understand the risks of any medication they choose to take."
    More information
    Visit the U.S. National Library of Medicine to learn more about morning sickness (http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000604.htm ).
    SOURCES: Bjorn Pasternak, M.D., Ph.D., Statens Serum Institute, Copenhagen, Denmark; Siobhan Dolan, M.D., M.P.H., associate professor, obstetrics and gynecology, Montefiore Medical Center, New York City, and medical adviser, March of Dimes; Oct. 16, 2013, Journal of the American Medical Association
  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.