Zofran for sickness

[Sirenetta]

Hi everyone-

I'm 8 wks pg and live in the US these days. I'm struggling with sickness (surprise surprise) - it's not bad enough that I've had to take time off work or have actually vomited, but it's constant nausea/queasiness that gets worse or better in waves of a few hours at a time. In other words, it's probably pretty standard -- bearable but definitely wearing thin psychologically and I'd love some relief.

My doctor here has prescribed Zorfan (ondansetron) - she said she standardly gives it to pg women experiencing sickness; it's perfectly safe; she has even given it to her own 2 yo son etc etc. It was designed for cancer patients having chemo and works on the specific part of the brainstem that controls nausea.

Of course, though, I have been googling the heck out of it before I put the first one on my tongue :)... according to both US and UK websites, "its safety has not been proven in pregnancy. It is not recommended for pregnant women unless considered essential."

So, has anyone here taken it? If so, what advice did you get? My strong hunch is that it's fine, just not tested to the usual clinical trial standard in pg because it's an "off label" use, hence the cautionary language. But somehow I can't bring myself to take one having seen those websites.

Thoughts much appreciated!
x

Hi. I had to take it throughout both my pregnancies as had hyperemesis. I was hospitalized a lot, could not keep water down etc.

I was told its "probably safe". A decision had to be made to take it because my health could not go on as it was.

Both of.my kids are totally fine but personally I'd try not to take anti emetics unless I was actually being sick.

I am on it (as well as cyclizine, metoclopramide and ranitidine), also for hyperemesis. Now 16 weeks and have been on a cocktail of drugs since first hospital admission at 5 weeks. They didn't give me ondansetron (zofran) until I was hospitalised for the second time, as there are older drugs with a longer established safety record. Like tara I was told it was probably OK but all the same it was a fairly last resort and they didn't bump me up to the max dose until my third admission. My understanding is that it has been used for about a decade with no evidence of ill effects on babies or mothers, but obviously that's not very long in the scheme of things.

In your situation I think I would ask to try things like cyclizine or stemetil first, which have been used for much longer. If you do go on the ondansetron (zofran) be warned that it makes you very constipated. Treat for constipation from the off, I ended up in a ghastly state for weeks and being seriously constipated makes it hard to eat and makes the nausea/vomiting worse.

Ondansetron wasn't a magic bullet for me and doesn't stop me throwing up. I had a very severe case though and it does seem to be a big help for lots of people.

Forgot to say - it is quite expensive too which I'm sure is one factor in why the NHS is reluctant to prescribe it! Not sure if that might be an issue for your insurance company.

Thanks so much, Tara and Kalidasa. Humbling that you both are having/had so much nastier experiences with the sickness than me. In the grand scheme of things I don't have much to complain about ! All the best for the rest of your pregnancy, Kalidasa.

Think I'll avoid taking the Zofran. Not worth the extra stress or side effects (which I didn't know about - thank you!).

Sirenetta there are no recorded side effects. I've thoroughly researched this for a book I'm currently writing on pregnancy/parenting. And I've taken Zofran myself in my third pregnancy (didn't have m/s w/ the first two).

What you have to understand is how doctors present side effects to you, especially during pregnancy: They can't say anything is 100% safe because there are always idyosynchratic (sorry - can't spell today and too tired to spell check!) side effects they can't vouch for. Simply put, no one could tell you e.g. the safe amount of sunshine you should be exposed to when pregnant. There are complicated enviro-genetic synergies no one is prepared to vouchsafe for. Additionally there is the problem of trials of drugs on pregnant women (understandably...) Zofran has been around for a decade: Drugs, such as thalidomide, which act as teratogens (agents causing birth defects) during pregnancy have all been disclosed as such after a few years (four is the most I know a drug has taken for its full side effects to become known). I would trust ten years with no known side effects. tbh. All anyone can ever say with certainty is what you've been told so far, aka 'it's probably safe' - it doesn't actually mean they don't think it's safe, it means they are covering their legal arses!

Also, there have been (few) clinical trials involving Zofran as used during pregnancy. Again, there have been no recorded side effects.

This is a bit rambly cos I'm v pregnant and tired, but the bottom line is, it's really fine. Your choice, of course, but m/s is devastating, and it really does work for most people.

P.S. I live in the States, too