Reglan During Pregnancy

by on April 19, 2012

The FDA categorizes Reglan as a Pregnancy Category B medication which means that there is no proven harm to the unborn fetus if Reglan is taken during the first trimester of pregnancy. Category B medications are those that haven’t been adequately studied in human subjects but have shown no harmful effects on animals. However, this does not clear the drug from any potential risk. Animals and humans do not always respond to medications in the same way.

Can Reglan be used by pregnant women?

Yes but it should be given only if necessary. Several studies conducted by different medical specialists around the world suggest that exposure to metoclopramide (Reglan) during the first trimester does not cause direct harm on the fetus. The use of metoclopramide for the management of pregnancy-related nausea and vomiting is more common in some European countries and Israel than in the U.S.

A recent study published in the New England Journal of Medicine provides substantial reassurance to the safety of metoclopramide in pregnant patients. The retrospective cohort study revealed that metoclopramide does not cause congenital anomalies. However, this dopamine antagonist can cause maternal side effects such as tardive dyskinesia and acute dystonic reactions.

Although FDA does not indicate Reglan as a treatment for pregnancy-related nausea and vomiting, some physicians do prescribe this medication for this purpose. The usual oral dose of metoclopramide for morning sickness is 5 mg.

The FDA indicates Reglan as a treatment for symptomatic relief of GERD and other medical conditions requiring increased gastrointestinal emptying. For pregnant women experiencing symptoms of nausea and heartburn, Reglan may be prescribed but it should not be considered the first-choice.

What are the possible side effects of Reglan for pregnant patients?

Pregnant patients taking Reglan for the management of GERD, heartburn, diabetic gastroparesis and nausea should discuss with their physician the possible side effects of the treatment. Even mild side effects can be quite disturbing especially when compounded by common complaints of pregnancy.

Some of the common maternal side effects of Reglan include breast tenderness or swelling, diarrhea, dizziness, headache, insomnia, frequent urination, and increased risk for high blood pressure.

Neuroleptic malignant syndrome and tardive dyskinesia, the two most troubling side effects of Reglan cannot be ruled out.