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Is it safe? · Pregnancy Smart

Is Reglan safe during pregnancy?

Assigned clinical reviewerMatt Stahl· PharmDDraft · pending clinical reviewUpdated

What does the evidence say about Reglan during pregnancy?

  1. Taking metoclopramide during pregnancy has not been shown to increase the chance of birth defects. 1
  2. Among 28,486 women exposed in the first trimester, metoclopramide showed no association with major congenital malformations overall, with any of 20 individual malformation categories, or with spontaneous abortion or stillbirth. 2
  3. A small number of studies have not found an increased chance of miscarriage with metoclopramide in pregnancy, and preterm delivery and low birth weight have not been linked to it either. 1
  4. FDA labeling carries a boxed warning for tardive dyskinesia, a serious movement disorder that is often irreversible, and advises against courses longer than 12 weeks because risk climbs with duration and cumulative dose. 3
  5. In an emergency department cohort of 439 women with nausea and vomiting of pregnancy, metoclopramide was among the first-line antiemetics used, with time from dose to discharge comparable to ondansetron. 4

Is Reglan safe in each trimester?

  • First trimester. First-trimester exposure is the best-studied window. In a Danish cohort of 28,486 women exposed during the first trimester, metoclopramide showed no association with malformations overall or with any of 20 individual malformation categories. Whether it is the right next step is still a decision for the clinician who knows how severe your symptoms are.
  • Second trimester. Nausea that carries past the first trimester deserves an actual plan rather than waiting it out. ACOG's guidance notes that acting in the early stages may head off more serious complications, including hospitalization, and that how severe your symptoms feel to you should shape the decision.
  • Third trimester. Metoclopramide is not meant for open-ended use. FDA labeling advises against courses longer than 12 weeks because the chance of tardive dyskinesia rises with duration and total cumulative dose. Ask what the stopping plan looks like before you start, not after.

Frequently asked questions

How long can you take Reglan while pregnant?

FDA labeling advises against going beyond 12 weeks, because the chance of tardive dyskinesia rises with both duration and total dose. In practice, obstetric use is usually much shorter than that. Ask for a specific stopping point when you get the prescription.

Is Reglan or Zofran better for morning sickness?

They are different bets. In one emergency department cohort, time from dose to discharge was similar for both. ACOG has flagged that ondansetron safety data are less settled, while metoclopramide carries the tardive dyskinesia caution. Your provider weighs your history against both.

What are the side effects of Reglan in pregnancy?

The one FDA singles out is tardive dyskinesia, an involuntary movement disorder that is often irreversible and gets more likely with longer use. Drowsiness and restlessness are more common and short-lived. Report any new twitching, tongue movements, or restlessness straight away.

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References

  1. Metoclopramide: MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/metoclopramide/

  3. REGLAN (metoclopramide) tablets: FDA prescribing information

    FDA · https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017854s062lbl.pdf

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.