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Medicines for nausea and vomiting in pregnancy

Nausea and/or vomiting is quite common, especially in the initial ten to fourteen weeks of pregnancy. Many women manage without any drugs but some need some kind of medication to relieve the symptoms. This is particularly significant not only because it is so common but also because of the infamous Thalidomide saga from the late 1950s to the early '60s.

The devastating limb deformities that resulted from women taking Tha Thalidomide was used for morning sickness lidomide in pregnancy are well known. There are hundreds of men and women, now in middle age, who live with the consequences. It was used in Germany, Britain, Japan and Canada.

Stemetil® and Cyclizine in Pregnancy

Currently, commonly used drugs are Stemetil® (generic name Prochlorperazine), Buccastem® - which is the same as stemetil, Maxolon® (Metoclopromide) and occasionally Cyclizine (Valoid®) and Promethazine (Phenergan®). All these are regarded to be safe in pregnancy as there have never been any reports of birth defects associated with their use in pregnancy. Generally, as for all drugs, use is recommended only when necessary.

However, for Promethazine (Phenergan®, Romergan, Farganesse, Fargan etc.) there is a slight worry that it may increase incidence of congenital dislocation of the hip. Evidence to this effect is weak.

Ondansetron use in Pregnancy

This is on Zofran is used in pregnancy only in exceptional circumstances e of the most widely used of the anti-sickness drugs known as 5HT2 antagonists. It is available under the brand name Zofran®. Other drugs in this group include Dolasetron, Palonosetron, Granisetron etc.

There is little information about their effect on the pregnancy and the fetus in particular. Because of that, the standard advice is to avoid unless absolutely necessary. They are quite potent anti-sickness drugs and sometimes when the problem is very severe and intractable they are employed.

A ‘Thalidomide child’. This is probably the most emblematic of what drugs can do when used in pregnancy. Thalidomide was used for nausea and vomiting and over 12,000 children were affected.