Are anti-nausea drugs safe during pregnancy? a Danish study of metoclopramide (plasil)

During pregnancy it is usually always advisable to avoid any type of drug and in particular in the first trimester of gestation.

There are serious situations of hyperemesis gravidarum (which should not be confused with normal morning sickness in pregnancy), in which some women are forced to take drugs but are always under strict medical supervision.

One such drug is  metoclopramide. Generally in Italy it is known by the name of Plasil prescribed to treat nausea, even that caused by chemotherapy, but also in cases of gastroesophageal reflux disease.

It is not recommended during pregnancy except in cases of particular gravity (linked to malnutrition and dehydration) and at the discretion of the attending physician.

A study was recently published that looked at 1 .2 million pregnancies that occurred in Denmark between 1997 and 2011. Women who used this drug and those who did not used it were compared to highlight any adverse effects of the drug (article published October 16, 2013 in the Journal of the American Medical Association).

The researchers compared 28,486 newborns exposed to metoclopramide in the first trimester to 113,698 unexposed newborns, and found no associations between the antinausea drug and a range of 20 malformation categories such as: neural tube defects, transposition of the gross vessels, ventricular septal defect, atrial septal defect, tetralogy of Fallot, coarctation of the aorta, cleft lip, cleft palate, anorectal atresia/stenosis, and limb reduction.

Of course, more studies and more research on drugs for the treatment of hyperemesis gravidarum will be needed. In the meantime, for the treatment of the classic nausea of ​​pregnancy, it is better to rely on natural methods  . 

However, if the symptoms are very strong, it is important to talk to your doctor who will evaluate the need or not to resort to anti-nausea drugs to avoid dehydration and/or malnutrition.