Reassurance needed - metaclopramide

[waxweasel]

I'm 17 weeks and have been constantly ill with nausea, though only being sick occasionally. GP prescribed me metaclopramide a month ago - 3 tablets a day. I was really reluctant to take medication - was sick throughout with DD but didnt take anything. But the GP assured me it was safe, and DH and I both did some research and it did seem very safe. So I took that dose for a couple of weeks, then dropped down to 2 a day to see how I felt, then more lately have just stopped taking it unless I need it.

Saw a different GP today, still suffering with nausea. Told her I was almost out of metaclopramide, and she said she'd do me a new prescription but didnt want me to stay on it much longer. I asked if there were side effects for the baby, and she said 'nothing is without side effects but this is the safest drug available'.

It's really made me panic. I was keeping food down, just nauseous, so I feel like I should have just soldiered on without it. I'm so so so worried I've put my baby at unnecessary risk. Can anyone reassure me?

You haven't.

I hate GPs sometimes. They stopped my antidepressants saying they were risky, I ended up relapsing, when I saw the MH midwife she was quite vocal about how GPs are so risk averse they stop necessary medications in pregnant women even if they're safe.

I took cyclizine for sickness. It didn't harm DS. Neither did anything else I took.

There's this stupid attitude that women can't take anything during pregnancy and just have to suffer - we do not

I took cyclizine, metoclopramde and prochlorperaine throughout my pregnancy with DD2, and she's absolutely fine, I promise you. As Tali says GPs can be very risk-averse when it comes to prescribing medication to pregnant women, but I researched heavily and I found no evidence at all that anti-sickness drugs being prescribed can harm the foetus at all.

OP, I hope you feel better soon. Pregnancy sickness is truly grim.

The below text is from an NHS publication released in 2012, hope it's reassuring. I agree with the GP in that taking meds in pregnancy does involve balancing benefits with risks (I'm a pharmacist and am obliged by my duty of care to tell patients the same thing) but in the case of metoclopramide- evidence suggests it's safe:

Metoclopramide has been used at all stages of pregnancy without evidence of embryo- or feto-toxicity in human (and animal) studies (8). In a study of 126 women who took metoclopramide in the first trimester, data from a Scandinavian Prescription database of 309 women and a US surveillance study in which 192 newborns had been exposed to metoclopramide during the first trimester, the rates of spontaneous abortions, preterm deliveries and congenital abnormalities were no different to those expected in the general population (8). A large retrospective cohort study (3458 singleton pregnancies exposed to metoclopramide during the first trimester) showed that metoclopramide use was not associated with an increased risk of minor congenital malformations, multiple malformations or clusters of anomalies, or an increased risk of pre-term birth, low Apgar scores or perinatal death (15). The investigators did not assess whether metoclopramide caused extrapyramidal side effects in the mothers. Data from a prospective study (n=175 received metoclopramide, with paired, matched controls) conflicts with that above, showing a higher rate of premature births (8.1%) compared with controls (2.4%), but rates of major malformations did not differ between the two groups (3;16).

As stated above, metoclopramide can cause extrapyramidal side effects, particularly in young women, such as dystonic-dyskinetic head and neck movements. There are limited reports of this occurring in women taking metoclopramide during pregnancy. A retrospective chart review of 301 women using subcutaneous metoclopramide reported extrapyramidal symptoms in 11 women (17).

Thank you everyone - that's so reassuring. And thank you CarShare for sharing that excerpt - that has really helped calm me down! I had got the impression it was very widely used in pregnancy, and had been for years, so side effects would be quite well researched even if they hadn't run clinical trials. Still, it doesn't take much more than a passing comment to make hormonal pregnant women panic

Sorry to the other women who have suffered horrible pregnancy sickness too

Glad you feel reassured. It's such a worrying time. I'm 26 weeks and freak out at least once a day about something or other. I think the nhs are super cautious with meds in pregnancy (which is a good thing in the main in my opinion) and wouldn't take a chance with drugs that don't have a good safety profile. I think the second dr didn't convey that message in quite the right way though so not surprising it worried you. Hope the rest of your pregnancy runs smoothly!

waxweasel I posted on your other thread, glad you are ok. I took lots of different anti sickness drugs throughout both of my HG pregnancies until I found one that at least reduced the vomiting (never fully stopped) and both my babies are absolutely fine. I personally had some side effects such as headaches and constipation but no side effects for the baby

Thank you! And hellohello I've also had some mega headaches and constipation - could be linked to the drug then. I hadn't twigged that it might be that.

Really hoping for an uneventful few weeks now...scan is only 2 weeks away so have that to look forward to

I also had metaclopromide for a while and baby is perfectly fine. I was glad when I came off the as they made me feel zombie like.