Metoclopramide Experiences pls

[TorrentialHighSeas]

Hi I’m 8 weeks into my second pregnancy.

in my first pregnancy, I had really bad pregnancy sickness for the whole time (just nausea but incredibly intense). I was really unable to do much and became incredibly low. I didnt try medication til quite late, maybe 16+ weeks into the pregnancy. Cyclizine and promethazine. Neither worked unfortunately.

midwife recommended I nip it in the bud this time. I wanted to try Xonvea but my GP wouldn’t prescribe. She gave me Metoclopramide instead. I’m pretty concerned about the “Common” side effects of my medicine: twitching, jerking, uncontrollable movements, muscle spasms, may not be safe to drive. Has anyone else taken or experienced this drug?

appreciate your insights and inputs.

any people who are anti-drug for pregnancy sickness & HG pls just save yourself the bother and don’t comment. I’d like to hear from those who know just how severe this can be.

thank you!

Hiya, I did a 5 day course when I was about 9 weeks. It made me incredibly tired and gave me headaches, but it did nix my nausea! They would only prescribe it to me for five days though due to the side effects you describe. After that I was on a combination of cyclizine and prochloperazine, which took the edge off but I still felt crappy.

My advice is don't be afraid to go back to your gp and ask for something different. I got referred to the hospital gynae team who were super helpful.

Best of luck - hope your sickness eases soon. Mine started lifting at 15 weeks and I feel great now (20 weeks). It's so hellish when you're going through it!

So the GP never mentioned the five day course to me. Hmm, maybe I start and go in on Monday again. I’m quite confused!

im glad you’re feeling better. I was so ill right up til birth last time and it was intense!

You can try it, just watch out for side effects. I tried cyclizine then when it stopped working, metaclopramide which made my heart race, so I went off it and did promethazine, which worked on the nausea but made me a zombie. I’d been so miserable I didn’t notice the zombie bit though until a month later when I was feeling a bit better. Ondansetron is what I’ve taken ever since for pregnancy sickness after taking it in labour with my first, that works. I have no idea if having a different experience with cyclizine and promethazine to you means you are also likely to react differently to metaclopramide to me.

Xonvea is a first line anti- emetic for pregnancy sickness and the only medication available in the UK that is actually licenced for pregnancy sickness.

Metoclopramide on the other hand is a second line medication with a much bigger, more serious side-effect profile and outside of pregnancy and palliative care, is usually only given for very short courses as PP alluded to.

Personally if I were you I would make another GP appt with a different GP! I didn't know about Xonvea in my two previous HG pregnancies and tried it for the first time this time and although I did still develop HG, this time has been the mildest yet. I'm still on it at 22 weeks pregnant and I have never had any side effects.

Metoclopramide I took for about a week or so in my second pregnancy (after already trying a first line drug that didn't work). I did actually find it helpful, but I developed tremors and was advised to stop taking it immediately and that I can't go on it again in future. It's rare but it can cause permanent tremors in some people you see. I was reluctant to go on it in the first place because of that and am very grateful that they did cease once I'd stopped the meds. I've been advised never to go back on it and it's been logged as an adverse reaction on my medical records.

Yeah, I wanted Xonvea but she wouldn’t prescribe. Something about an amber warning. Gah. So frustrated as now I have to wait til Monday to see another doctor.

Metoclopramide makes me worse for some reason. Cyclizine makes me extremely sleepy. I've been taking ondansetron for a while now and that seems to work best. I wanted to try xonvea as well, as I'd heard good things on the HG forum, but my GP also did not know it's recommended as it's quite a new change. The NICE guidelines were only updated in February 2024. When I run out of this current prescription for ondansatron I'm going to reference the new guidance to push to try xonvea.

I had metaclopramide for several weeks. It was transformational and saved my physical and mental health. No side effects for me.

I was on it for a few weeks - it didn't help much with the sickness - I did however experience severe depression. Googled and its a common side effect! Told my midwife and I came off it, went on something else and the depression lifted. Ondansetron is the only thing for me that's helped take the edge off and hasn't given me any awful side effects

Long post, but I wish I'd known of all this before… Metoclopramide makes me feel a lot better immediately (2-4 hours), then I crash into a really deep sleep of a few hours. Not practical with a todder to care for, so I only use it as a back up/ at weekends. I haven't had any of the other side effects, but I did with prochlorperazine - I think the only way to find out is to try it. Metoclopramide does speed up the emptying of your stomach (into your bowel, not as vomit!) so I feel that it exacerbates the need to eat regularly.

In terms of which medicine they'll prescribe, the GP is limited by what the trust allows them to prescribe. My trust, like many, works on a “traffic light” system - grey is do not prescribe (the trust doesn't fund those drugs), green is any can prescribe (Incl GP, nurse practitioner etc), amber is specialist only (GP can't prescribe, you'd need to see someone in the antenatal department at the hospital for these). Not sure about red because none of the antiemetics were red here…

With a bit of googling, I found the website which lists all the drugs and their traffic light rating in my trust. I printed out the royal college of gynecologists and obstetricians list of recommended medicines (if you Google RCOG green top guidelines no. 69, it's appendix 3), and wrote next to them what their rating was. Then I took the list to the GP and said, “I know you can prescribe x, y, z, I want to try them as per the advice to tackle pregnancy sickness early” (I was 6 weeks and only mildly nauseous at that point so he wasn't keen, but taking them early made a huge difference).

Your GP probably can't prescribe xonvea - I don't think it's funded almost anywhere in the UK. That's because it's recently licensed and so only the brand name is available so it's far, far more costly to the NHS than the alternatives.

The RCOG guidelines have various bits of helpful information in them, including some comments which set my mind at ease re: side effects, and also the fact that many women need 2-3 drugs in combo to effectively manage their nausea. I'm pretty sure that they address the 5 day recommendation and say that if you don't have the side effects in the first five days, you are safe to continue, although that may have been somewhere else… My GP wanted me to swap between metaclopramide and onsansetron, alternating each for five days, but it didn't work because I have to be awake to look after my toddler…

Currently taking cyclizene at night (it makes me fall asleep, but if I take it at night, it helps with the morning's nausea), and onsansetron in the day. I really rate them both, despite cyclizene alone being useless, it's helpful with the onsansetron and if I miss the dose, I vomit the next day. If you do go with onsansetron, I'd 100% push for a laxido prescription and take one sachet for every onsansetron tablet (hard to do when nauseous, but you really need it with onsansetron!)

You could also contact the charity pregnancy sickness support for help and advice. They were quite quick to respond to my WhatsApp

Hope you get something that works for you! I'm sorry, it's so grim isn't it

Metaclopramide left me in a twitching heap on the bed!

I was hospitalised twice in my second pregnancy with HG and ended up on a concoction of cyclezine, Metoclopramide and promethazine which stopped me vomiting but did nothing for the very extreme nausea. I also had a couple of doses of ondansetron in hospital (as I was severely dehydrated despite the multiple fluids drips they were pushing through) which was extremely effective but they wouldn't let me stay on citing an increased risk to baby's development?

About 18/19 weeks the nausea lifted and I'm able to mostly survive without any meds although still often feel nauseous and occasionally sick at 30 weeks.

I will say don't assume because you had a rough ride last time you automatically will this time. With my first I wasn't sick once and had a brilliant pregnancy. Second time severe sickness/hospitalised and way more pain/discomfort generally. All worth it when bubs has a dance of course! Good luck

Hi op. Not pregnancy related but I took it during chemo. I've been known to use it since for a hangover 😂
It really helped me. May have made me tired too but k was wiped out anyway so not sure x

Thanks so much everyone. Really appreciate the advice. I felt totally at sea in my first pregnancy and didn’t know where to turn, feel like I have more info this time and also appreciate everyone’s viewpoints!

Gave me the runs really badly. Switched to prochlorperazine to have alongside cyclizine.

Omg I’ve started and I am so tired. I was tired before but I feel so heavy. It’s worked immediately on the sickness tho! So I don’t know what to think. Might the heavy drowsiness go away do you reckon? I’ve taken one at night and one in the AM, maybe I’ll see if I can just get away with the night time one!

I know this was from last year but how did it go? I was on cyclizine but that was working so just been prescribed metaclopramide but very stressed because all I’ve seen it’s bad things about it