Is Perinorm (Metoclopramide) Safe in Pregnancy?
Metoclopramide is safe to use during pregnancy and is not associated with increased risk of major congenital malformations, spontaneous abortion, or stillbirth. 1
Evidence for Safety
The most robust evidence comes from a large Danish registry study of over 1.2 million pregnancies that specifically evaluated metoclopramide exposure in the first trimester. 1 This study found:
- No increased risk of major congenital malformations overall (25.3 per 1000 births in exposed vs 26.6 per 1000 in unexposed women; prevalence odds ratio 0.93,95% CI 0.86-1.02) 1
- No association with 20 specific malformation categories including neural tube defects, cardiac defects (transposition of great vessels, ventricular septal defect, atrial septal defect, tetralogy of Fallot, coarctation of aorta), cleft lip/palate, anorectal atresia, and limb reduction defects 1
- No increased risk of spontaneous abortion (HR 0.35,95% CI 0.33-0.38) 1
- No increased risk of stillbirth (HR 0.90,95% CI 0.74-1.08) 1
Clinical Indications During Pregnancy
Metoclopramide (marketed as Primperan in some countries) has well-established indications in pregnancy: 2
- Nausea and vomiting of pregnancy 2
- Pyrosis (heartburn) 2
- Prevention of Mendelson's syndrome when general anesthesia is required during pregnancy or labor 2
Long-Term Safety Data
Twenty years of pharmacovigilance data confirm good maternal and fetal tolerance of metoclopramide. 2 This extensive post-marketing surveillance provides additional reassurance beyond controlled studies.
Important Caveats
Note on drug naming: If you are specifically asking about "Perinorm" as cyproheptadine (an antihistamine), the evidence is extremely limited. One case report from 1980 described two successful pregnancies in a woman treated with cyproheptadine for Cushing's syndrome, but this single case provides insufficient data to establish safety. 3 However, most "Perinorm" formulations worldwide contain metoclopramide, not cyproheptadine, making the robust safety data above applicable.
Verify the active ingredient in your specific Perinorm formulation, as brand names vary by country and may contain different medications.