From the Guidelines
Motilium (domperidone) is safe to use in pregnancy, particularly for the management of Hyperemesis Gravidarum, as indicated by recent guidelines. According to the EASL clinical practice guidelines on the management of liver diseases in pregnancy 1, domperidone is listed as a second-line recommended treatment for Hyperemesis Gravidarum, with compatibility indicated for use in all trimesters, as well as during breastfeeding and paternal exposure. This suggests that, based on current evidence, domperidone can be considered a viable option for managing severe nausea and vomiting during pregnancy when first-line treatments are not effective.
Key points to consider when prescribing domperidone during pregnancy include:
- Monitoring for potential side effects, although the guidelines suggest that available data do not indicate an increased risk of adverse effects on the fetus.
- Ensuring that the benefits of using domperidone outweigh the risks, particularly in cases where severe nausea and vomiting pose a significant risk to the mother's health.
- Considering alternative treatments, such as metoclopramide or certain antihistamines, which may have better-established safety profiles.
- Non-pharmacological approaches, like dietary modifications, ginger supplements, acupressure, and small frequent meals, should also be explored as initial management strategies for nausea during pregnancy.
It's crucial for healthcare providers to consult the most recent guidelines and evidence when making decisions about medication use during pregnancy, as recommendations can evolve based on new research findings. The AGA clinical practice update on pregnancy-related gastrointestinal and liver disease 1 provides additional context on managing gastrointestinal issues during pregnancy but does not specifically address the safety of domperidone. Therefore, the EASL guidelines 1 remain the most relevant and up-to-date source for information on domperidone use in pregnancy.
From the FDA Drug Label
Small amounts of the drug cross the placenta in rats5. Pregnant and lactating women should use caution when handling EQUIDONE Gel, as systemic exposure to domperidone may affect reproductive hormones.
The use of domperidone in pregnancy is not explicitly stated as safe in the provided drug labels.
- Key points:
- Small amounts of domperidone cross the placenta in rats.
- Pregnant women should use caution when handling the drug.
- Clinical decision: Due to the lack of direct information on the safety of domperidone in human pregnancy, it is recommended to exercise caution and consult a physician before using the drug during pregnancy 2 2.
From the Research
Motilium Safety in Pregnancy
- There is limited information available on the safety of Motilium (domperidone) in pregnancy from the provided studies.
- However, one study 3 mentions domperidone as a prokinetic agent used in the treatment of gastroparesis, but does not specifically discuss its safety in pregnancy.
- Another study 4 discusses the treatment of constipation during pregnancy and mentions that laxatives such as bulk-forming agents, lubricant laxatives, stool softeners, osmotic laxatives, and stimulant laxatives might be considered, but does not mention Motilium.
- A study on the use of non-steroidal anti-inflammatory drugs in pregnancy 5 highlights the importance of considering the potential fetal risks when using medications during pregnancy, but does not mention Motilium.
- A study on prescription medications for use in pregnancy 6 emphasizes the need for more research on the safety of medications during pregnancy, but does not provide specific information on Motilium.
- A study on thrombophilia and anticoagulation in pregnancy 7 does not mention Motilium or its safety in pregnancy.