Metoclopramide can be safely used during pregnancy

Even though nausea and vomiting are common effects during pregnancies, the most commonly used antiemetic, metoclopramide (Primperan®), is often avoided in these patients because it is considered to be associated with a higher risk of fetal malformations.

Not anymore. According to an article just published in the New England Journal of Medicine, metoclopramide is not associated with significantly increased risks of major congenital malformations (5.3% and 4.9%, respectively; odds ratio, 1.04; 95% confidence interval [CI], 0.89 to 1.21), low birth weight (8.5% and 8.3%; odds ratio, 1.01; 95% CI, 0.89 to 1.14), preterm delivery (6.3% and 5.9%; odds ratio, 1.15; 95% CI, 0.99 to 1.34), or perinatal death (1.5% and 2.2%; odds ratio, 0.87; 95% CI, 0.55 to 1.38).

The study which investigated the safety of metoclopramide use during the first trimester of pregnancy in a district in Israel, evaluated 113,612 singleton births. In this large cohort of infants, exposure to metoclopramide in the first trimester was not associated with significantly increased risks. This is an important conclusion because it will allow us to have a useful treatment against nausea and vomiting during pregnancy, which are often dealt with dubious treatments like doxylamine (NyQuil®).