The University of Rochester Medical Center's blog, Health Matters, brings some good news for expectant mothers with severe morning sickness in a post today. It reviews a study published in the Oct. 16 Journal of the American Medical Association titled "Metoclopramide in Pregnancy and Risk of Major Congenital Malformations and Fetal Death". Subject matter expert Dr. Loralei Thornburg tells the blog that study brings great news. After reviewing more than 1.2 million pregnancies, the authors found no association between the medication and pregnancy loss or any of 20 common birth defects.
Metoclopramide, sold as the brand name Reglan, speeds the movement of food through the stomach and digestive system. It is often prescribed for severe morning sickness, hyperemesis gravidarum, during pregnancy. The Food & Drug Administration has not approved its use for this condition. The U.S. National Library of Medicine says that the cause of morning sickness is unknown.
It may be caused by hormone changes or lower blood sugar during early pregnancy. Emotional stress, fatigue, traveling, or some foods can make the problem worse. Nausea in pregnancy is more common and can be worse with twins or triplets.
Only one medication is currently approved by the FDA for the treatment of morning sickness, Diclegis. Prescribing Reglan is termed an "off-label use" and the FDA does permit physicians to prescribe medications for conditions other than those intended. Zofran is another medication prescribed off-label for morning sickness.
The study's results show that the use of metoclopramide in not going to result in another thalidomide crisis. All medications carry a risk to the patient, and Reglan and Zofran have several warnings associated with their use. Patients should always ask their physicians about the benefits and risks of prescription medications before taking them.