Regalan

[Csgreen2005]

I was given an rx for reglan for nausea is it safe? I am currently 15 wks pregnant
thanks !

[Sandra]

Csgreen2005,

Reglan (metoclopramide) is rated a P2-benefits likely to exceed the risk. "Human experience has not identified an increase risk of congenital anomalies.[1] Metoclopramide is an antiemetic and GI stimulant medication often used during early pregnancy for nausea and vomiting. Multiple studies have reported no increase in the risk of congenital anomalies with metoclopramide.[1-4] Metoclopramide has also been used successfully in the prevention of aspiration during Caesarean section.[5, 6] Askenasy et al reported a rare dyskinetic-dystonic reaction in two pregnant patients who used metoclopramide.[7] In summary, metoclopramide does not appear to increase the risk of congenital anomalies but as with all medications during pregnancy should only be used if the benefit to the mother outweighs the risk to the fetus."
(Medications and Mothers' Milk database, Dr Thomas Hale PhD). Do not use Reglan more than 2-3 months because of the risk of tardive dyskinesia.

1.##The REPROTOX? System. Georgetown University Medical Center and Reproductive Toxicology Center, Columbia Hospital for Women Medical Center, Washington, D.C. (electronic version). Thomson Reuters, Greenwood Village, Colorado, USA. Available at: [url]http://csi.micromedex.com[/url] (Jun/1/2010)
1.##Berkovitch M, Mazzota P, Greenberg R, et al. Metoclopramide for nausea and vomiting of pregnancy: a prospective multicenter international study. Am J Perinatol. Aug 2002;19(6):311-316.
2.##Briggs G, Freeman, R., and Yaffe, S. Drugs in Pregancy and Lactation. Vol Seventh Ed. Philadelphia PA: Lippincott, Williams, and Wilkins; 2005.
3.##Matok I, Gorodischer R, Koren G, Sheiner E, Wiznitzer A, Levy A. The safety of metoclopramide use in the first trimester of pregnancy. N Engl J Med. Jun 11 2009;360(24):2528-2535.
4.##Sorensen HT, Nielsen GL, Christensen K, Tage-Jensen U, Ekbom A, Baron J. Birth outcome following maternal use of metoclopramide. The Euromap study group. Br J Clin Pharmacol. Mar 2000;49(3):264-268.
5.##Lussos SA, Bader AM, Thornhill ML, Datta S. The antiemetic efficacy and safety of prophylactic metoclopramide for elective cesarean delivery during spinal anesthesia. Reg Anesth. May-Jun 1992;17(3):126-130.
6.##Orr DA, Bill KM, Gillon KR, Wilson CM, Fogarty DJ, Moore J. Effects of omeprazole, with and without metoclopramide, in elective obstetric anaesthesia. Anaesthesia. Feb 1993;48(2):114-119.
7.##Askenasy JJ, Streifler M, Felner S. The synaptic significance of metoclopramide induced dyskinetic-dystonic head and neck movements in pregnancy. J Neural Transm. 1978;42(1):73-84.

Sandra Lovato R.N.
InfantRisk Center