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Anti-nausea drug not harmful to unborn babies
By Linda A. Johnson
Published in The Saudi Gazette on 13 - 06 - 2009

For the first time, a large study shows that pregnant women who suffer morning sickness are not risking harm to their babies if they take a certain anti-nausea drug. The result may lead more doctors to prescribe the drug metoclopramide and women to feel less guilty about using it during their baby's crucial first few months of development, experts said.
Currently, no drugs are approved in the US for morning sickness, which plagues most women in the first three months of pregnancy — even all day for some. Doctors sometimes use medicines approved for other types of nausea that are thought to be safe in pregnancy, when simple strategies such as eating crackers and frequent, small meals don't help.
The study looked back at nearly 82,000 births and found no difference in birth defects or other problems in newborns of women whether or not they took the drug, sold as Reglan and in generic form.
“I think that women will be comforted by this,” said Dr. Keith Eddleman, director of obstetrics at Mount Sinai Medical Center in New York.
“Most women are reluctant (to take anti-nausea medicine) just because of the stories they've heard and the perception that taking something in the first trimester can cause harm.”
Results of the study, which did not look at the drug's effectiveness, were reported in Thursday's New England Journal of Medicine.
Morning sickness can be more than unpleasant. It can cause some women to lose weight or send them to the hospital. But some doctors and women are reluctant to use medicine because of scares decades ago over a couple drugs used for morning sickness.
Thalidomide, used in Europe and Canada in the 1960s, caused missing or shortened limbs. The maker of another drug, Bendectin, pulled it from the market in 1983 after widely publicized lawsuits alleged it caused limb deformities. Multiple studies and reviews by medical authorities never found such a link.
Despite the millions of births each year there still have been no large, well-designed studies on the safety of medicines in treating morning sickness, mainly due to fears of harming a fetus and triggering lawsuits.
The safety finding may reassure women, who often are more cautious than their doctors about using a drug during pregnancy, said Dr. Laura Riley, a Massachusetts General Hospital obstetrician and spokeswoman for the Society for Maternal Fetal Medicine.
Metoclopramide, which works by speeding emptying of the stomach and reducing heartburn, can have side effects, including sedation, insomnia, depression and anxiety.


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