Medically reviewed by: Brad Campbell, MD, McLeod OB/GYN Assoc. & Paul Chandler, MD, McLeod Women’s Care
For a number of years, the drug Ondansetran, sold as Zofran, has been used in the first trimester of pregnancy to help women control their nausea. The drug’s primary use is helping cancer patients deal with nausea from chemotherapy, radiation treatments and surgery.
Zofran’s ability to control nausea attracted interest from obstetricians, who were helping their pregnant patients control nausea and related weight loss.
Several years ago, research led the US Food and Drug Administration to issue a “warning” about Zofran’s use. Although the FDA did not require the drug to be withdrawn, it asked physicians to explain the risks to their patients.
McLeod OB/GYNs Brad Campbell, MD and Paul Chandler, MD recently addressed the issue of Zofran and discussed a new, possibly safer, drug:
Here are the major points Drs. Campbell and Chandler made:
Brad Campbell, MD
We’ve been using Zofran for years for women during pregnancy because so many women get nausea at the early part of pregnancy. I think all of my practice partners have used it.
There’s always been this question of safety with medications in pregnancy. I’ve read the study that caused some concern. It has some faults to it. I would say it doesn’t tell you a definite “yes” or “no.” It simply raises a question for consideration.
Whenever people say, “Hey, this drug isn’t safe during pregnancy; it can cause your baby to have birth defects,” the entire medical community draws back and says, “We use this medication all the time to treat nausea.”
As a result, everyone is a little reluctant to use it. We’re currently using it as a second-line medication. We use other medications first. I tell patients it could potentially cause birth defects; we just don’t know with certainty either way.
But so many women are uncomfortable with the nausea, they would take anything to control it. And it’s typically safe. My wife used it during her pregnancies.
Paul Chandler, MD
I think the association of Zofran was with some type of cardiac septal (heart) defect. That’s what they were seeing in the literature. And it was not a real strong association from what I understand.
But we now have an FDA-approved medication for nausea in pregnancy called Diclegis. It’s really a preventative medication for nausea. Diclegis is “Category A,” meaning it’s safe in pregnancy. Guess how many “Category A” drugs there are? Only two: Diclegis and Synthroid, a drug that’s taken for thyroid conditions.