Reglan Safe During Early Pregnancy

Pregnancy Morning Sickness
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Reglan (metoclopramide) has been shown to be safe to use during early pregnancy by a large Israeli study. This is good news for anyone who has ever had severe morning sickness, one of the early signs of pregnancy.

Morning sickness can be a problem during pregnancy for many women. When the simple remedies (avoiding odors that trigger the nausea, avoiding greasy food, eating small meal every few hours, saltines, Vitamin B6, ginger, etc), then the woman and her physician may turn to anti-nausea drugs. Safety of any drugs used during pregnancy is always a concern.

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The researchers looked at medical records from 1998 to 2007 for woman who delivered during that time frame. They found 81,703 singleton live births and 3458 (4.2%) of these woman were exposed to Reglan during the first trimester of pregnancy. No increase risk of major congenital malformation in the babies were found in those exposed to Reglan (5.3%) compared to those not (4.9%). No dose-response effect was found.

Reglan has been more widely for treating women with nausea and vomiting during early pregnancy in Israel and some European countries than in the U.S. This large, retrospective cohort study backs up the previous small studies which had suggested that use during pregnancy was not linked to incidence of congenital anomalies.

Reglan is a dopamine antagonist and can cause maternal extrapyramidal symptoms (i.e., acute dystonic reactions and tardive dyskinesia).

Source
Matok I et al. The safety of metoclopramide use in the first trimester of pregnancy. N Engl J Med 2009 Jun 11; 360:2528.

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