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Study Finds Little Risk From a Morning Sickness Medication

Study Finds Little Risk From a Morning Sickness Medication

June 11, 2009

Medical Research, Social Sciences & Humanities

As many as 80% of pregnant women suffer morning sickness in the first trimester of pregnancy. For the lucky ones, it can be controlled with saltines and frequent small meals.

When such strategies do not work, physicians often prescribe drugs to control the nausea — even though none are approved for such use in the U.S.

Now, in the first study of any of these medications in pregnant women, one has been found unlikely to affect the health of the fetus.

The drug, metoclopramide — sold generically and under the brand names Reglan, Octamide and Maxolon — is occasionally used for more severe cases in this country.

It is used more commonly in Europe and Israel, although there has previously been little information about its safety. The drug speeds emptying of the stomach and reduces heartburn.

In this country, the medications Compazine, Phenergan and Zofran are the most frequently prescribed for morning sickness.

Two other drugs once used for morning sickness were pulled from the market over serious concerns, leading many women and doctors to fear any anti-nausea medication. Thalidomide, used in Europe and Canada in the late 1950s and 1960s but never approved in the U.S., caused missing or shortened limbs.

Bendectin was withdrawn from the market in 1983 after lawsuits alleging similar problems.

“Most times, we try to avoid using drugs, period,” said Dr. James Moran, chairman of obstetrics and gynecology at St. John’s Health Center in Santa Monica. He said that he thinks the new findings should be replicated but that he “wouldn’t hesitate to use Reglan at all.”

In the new study, a team led by Ilan Matok of Ben-Gurion University of the Negev in Beersheba, Israel, studied 81,703 births among women enrolled in Israel’s largest health maintenance organization; 3,458 of the women used metoclopramide during their pregnancies.

Matok and colleagues report in today’s New England Journal of Medicine that there were no statistically significant differences between those who took metoclopramide and those who did not.

The findings, researchers said, “provide reassurance regarding the safety of metoclopramide for the fetus when the drug is given to women to relieve nausea and vomiting during pregnancy.”