# Metoclopramide and nausea



## PeanutBean

Hi I was wondering if anyone has taken metoclopramide for their pregnancy sickness or nausea? I've just been prescribed it after reaching the end of my tether with the nausea. Reading the leaflet it said it acts by speeding up digestion but this seems no god for me considering it's having an empty stomach that brings on the sickness which is usually improved for eating all the time. So has anyone used it and found it helpful? I'm waiting for the Doc to ring me back but was wondering if anyone could tell me anything in the mean time.

Thanks!


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## Neecee

It was prescribed to me in my first pregnancy as I had hyperemesis but to be honest I can't recall it working very well.

I had hyperemesis this time round (again!) and was prescribed something different which was a type of antihistamine. I only needed to use it a few times and it worked pretty well. I can't remember the name of it but I'll have a look when I get home. Sorry you're still feeling crook. I know how it feels to be sick all the time and it doesn't make you feel great having to take drugs to deal with it either.


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## PeanutBean

Well first the doc prescribed promethazine (which is cyclizine, an antihistamine) but the chemist said there was some manufacturing error or something so they're not getting any in but there was a syrup available but not from them and they wouldn't order it in but less shit chemists would have it. I don't fancy syrups, the thought makes me nauseous! So the Doc has changed the prescription and instead gone for metoclopramide which sounds more scary as it acts on dopamine receptors!

I'm not being sick, though my nausea now makes me feel like I really will be sick, as opposed to just feeling it, if that makes any sense. I am so full of a terrible cold for the 4th day and feel I can't go on with the nausea and have this week long hotel stay coming up early Sept where I'll be working super hard and not being able to eat when or what I need to. I just feel enough is enough so I rang the doc and he has prescribed this and didn't even feel the need to discuss my nausea with me!

My sister on the other hand had hypermesis and couldn't get anything from them until she ended up in hospital. She says I should be glad they have given me something but I feel more fearful because I've got it so easily!


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## Meels-Spot

I was prescribed Metochlorpramide to take during pregnancy as I am emetophobic, it seems to work for me although I would say it takes a good hour from taking it to work.


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## Neecee

PeanutBean said:


> Well first the doc prescribed *promethazine* (which is cyclizine, an antihistamine)

That's the one!:dohh:

Like your sis said though, they only gave me that once I was in hospital on an IV drip.


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## Holly21

Sorry you're feeling sick - it's really draining feeling constantly nauseous. 

Metoclopramide is a prokinetic drug, which means it pushes food, stomach secretions etc through your stomach and bowels quicker. Pregnancy nausea is partially caused by the hormones acting on an area of the brain which then sends messages to another part of the brain which then sends messages to the stomach and triggers vomiting. Metoclopramide blocks some of the dopamine receptors in the brain, as you've mentioned, and stops this from happening. Cyclizine and promethazine are not the same drug, although both are antihistamines which have anti-sickness effects.

Hope you feel better soon :hug:


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## Poppeteer

Hello i took promethazine syrup, and have to say it did work wonders, BUT it did make me ridiculously drowsy. 
So i was then on a different tablet prochlorperazine, it's meant to be quite strong stuff- but i found i just couldn't get along with it as it made me a lil shaky, and i find it didn't work as well as promethazine
The metoclopramide was never offered? I remember them saying that will be their last resort?


I feel for you, the endless nausea was completely and utterly draining, and i totally understand what you mean when you say you are at the end of your tether.


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## PeanutBean

Thanks for all your replies. Well I took one last night and felt worse for it! It barely took the edge off the nausea and made me so hungry and my stomach so sore from hunger that I felt as bad as if I'd been nauseous anyway! I got about 4 hours sleep after waking up starving at only 2pm even though I'd eaten right before sleep anyway (which normally sees me through the night or at least until about 6am). Had to get up and sit up and eat loads before I could try to get back to sleep which wasn't until about 5pm. I don't think I'll bother with it again!

Maybe I'll try the promethazine syrup. Do you know what flavour it is Poppeteer? I've had cyclizine before with no side effects. I have never suffered drowsiness with any medication that is meant to cause it so that's promising - I've seen others fall asleep practically on the same meds!

I think this pushing food through quick smart is just the opposite of what I need and counteracts the effect on the nausea centre.


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## FEDup1981

Im a nurse, and cyclizine and metoclopramide are the main two anti-emetics we use in the hospital, and they are both good. They can be taken on an empty stomach.


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## Tiff

I had crazy nausea in the beginning, but my doctor perscribed me Dyclectin (sp?) and it worked wonders! I feel for you, it sucks feeling sick all the time.


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## PeanutBean

FEDup1981 said:


> Im a nurse, and cyclizine and metoclopramide are the main two anti-emetics we use in the hospital, and they are both good. They can be taken on an empty stomach.

Yeah, my sister is a paediatric theatre nurse and she said they give it to kids all the time and not to worry. I was anxious because really it's the first thing I've taken since getting pregnant. But it was crap anyway, so I'm going to try and get something else!


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## Poppeteer

The promethazine did not taste great if im honest, but i used to gulp it down and follow with something else.

It is also available in tablet form, phenergan is promethazine under a different name and I've taken that in tablet form. 
It did work for me, and i did take it in the first tri, but i found the drowsiness unbearable, i wouldn't have been able to drive or work for example.


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## PeanutBean

Poppeteer said:


> The promethazine did not taste great if im honest, but i used to gulp it down and follow with something else.
> 
> It is also available in tablet form, phenergan is promethazine under a different name and I've taken that in tablet form.
> It did work for me, and i did take it in the first tri, but i found the drowsiness unbearable, i wouldn't have been able to drive or work for example.

The tablet is what I was initially prescribed but there has been a manufacturing error so they've all be recalled. I just wanted to check it wasn't mint as it will interfere with my homeopathy. Thanks!

As it happens my doctors seems to be closed today (?!) so I have to ring tomorrow.


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## Holly21

That's a shame that you didn't improve on the metoclopramide. Most doctors will prescribe promethazine or cyclizine before metoclopramide. Promethazine is well documented to cause drowsiness - some people use it to aid sleep. Cyclizine can cause drowsiness but this is much less common and most people tolerate it well. They both work in a similar way to metoclopramide in that they block stimulation of the part of the brain that tells your stomach to vomit, but unlike metoclopramide, they don't push food etc through the stomach and gut more quickly. Hope you find some relief. :hug:


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## Poppeteer

Well at least your doctor is taking your morning sickness seriously, when i told mine all she said was 'I've dealt with hundreds of pregnant women with ms, and i've never needed to prescribe anything' she then went on to suggest ginger biscuits and gaviscon.


I was so close to telling her to stick her ginger biscuits and gavison up her a*se! I'm normally very mild mannered but week in an out of ongoing sickness and vomiting and not being able to walk or move from it.... bleurgh well she just obviously didn't have a clue. Ended up going private to see another doctor.

Holly21 are you a GP?


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## PeanutBean

Holly - the doc prescribed promethazine first but there is a manufacturing error at the moment and there won't be any available for some time. I don't know why he didn't prescribe cyclizine (which I've had before with success and no problems) but as he didn't seem to know it was an antihistamine too... He's not my normal doc and I'ev found him to be crap every time I've gone to him. I'm going to ring and see if I can get cyclizine.

Poppeteer - your doc sounds a bit of a knob! Have a look here: https://cks.library.nhs.uk/nausea_vomiting_in_pregnancy#-326110 particularly at the treatments NOT recommended! lol


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## brownhairedmom

I don't know if you have the same drugs over there, but I've been on Diclectin since 13 weeks. I was actually getting sick between 3-5 times a day, and I haven't been sick once since being on it. Best thing I've ever had. Its really expensive(almost 100 dollars for 60 pills), but its completely worth it.

You could read up on it maybe? https://diclectin.com/


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## Holly21

Hope you get some relief Peanutbean - I can totally sympathise, half a stone lighter than I was this time last month! If you don't feel you have a good rapport with your doctor or you feel you're not being taken seriously, then you're entitled to a 2nd opinion by another GP. Have you got a midwife who you can talk to?

Popetteer - no, not a GP but a Hospice doctor - hence most of my patients will have nausea/vomiting issues at some point. Thankfully for everyone, pregnant women don't usually present to Hospices - so the only contact I've really had with pregnancy nausea/vomiting is with relatives of patients. I do feel quite impotent, curing other people's nausea and vomiting every day and being unable to do anything about my own nausea - as long as I can struggle into work, I'm going to try and avoid antiemetics - though if I did get really ill through not drinking/eating, I'd do something about it! In saying that, there are some women who have a horrific time with nausea/vomiting and need drugs/rehydration with intravenous fluids.

On the ginger biscuit etc front, I use ginger for some mild-moderate cases of nausea but have found that although it helped in my 1st couple of weeks, it does nothing now the nausea is worse. I also acupunctured myself for a while, and although it helped initially, it's stopped helping now. 

Roll on the 2nd trimester!


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## PeanutBean

Rae - thanks for the info. We don't have the same. The two most commonly prescribed are both antihistamines as is the main active ingredient in Diclectin so presumably they have a similar effect. I wonder why we don't have it over here though...?

Holly - I've not been sick (only twice properly in the whole pregnancy) it's just the eternal nausea getting me down, but thanks for your sympathy! My Doctor has been fine. The first one wasn't my normal one and he has been crap on all occasions I've seen him. My own GP has been excellent through this pregnancy though. He called me in when I had a migraine with vomiting (I get migraine all the time anyway) to test my pee and take my BP and signed me off work for two days to recover. He has prescribed Prochlorperazine now which I've taken twice. It helped with my nausea yesterday, not so much today but then I've only been taking one a day not the 3 max. I don't know why I've not been prescribed cyclizine though (the other is off the shelves), I even mentioned it specifically as I've taken it before. Anyway, my GP wants me in to do bloods if this doesn't help and the nausea persists.

On the ginger biscuits again, I only posted about the GOP recommendations because it was funny for one to suggest that when they are told not to because of lack of evidence! lol I've been taking homeopathy for my nausea which really helped for a few weeks but it's different now. I've no aversion to complementary or alternative medicines in the right places though I draw the line at ginger as it'll make me gag in itself!


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## Holly21

Poor old you. Nausea is so wearing. Glad you have a good doctor, it makes all the difference.

I came across diclectin when I was researching nausea in pregnancy and you're right, we don't have it in the UK. I asked our Pharmacist last week who hasn't come across it before either. Prochlorperazine seems to be safe in the 1st and 2nd trimester so good luck.

I had a day when it got better and I've managed to eat a bit more, including something in the evenings so I'm hoping it will start to tail off over the next few weeks - hope yours goes too so we can get on and enjoy our pregnancies. :hug:


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## PeanutBean

Holly21 said:


> Prochlorperazine seems to be safe in the 1st and 2nd trimester so good luck.
> :

Not 3rd?


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## Holly21

There has been some concern about using prochlorperazine in the 3rd trimester as extrapyramidal side effects in newborn babies have been reported. Extrapyramidal side effects include involuntary movements, tremors, restlessness and rigidity. I hadn't noticed how far on you are (keep thinking I'm in the 1st trimester forum) - poor you, that's awful having nausea so far on. :hug:


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## PeanutBean

Holly21 said:


> There has been some concern about using prochlorperazine in the 3rd trimester as extrapyramidal side effects in newborn babies have been reported. Extrapyramidal side effects include involuntary movements, tremors, restlessness and rigidity. I hadn't noticed how far on you are (keep thinking I'm in the 1st trimester forum) - poor you, that's awful having nausea so far on. :hug:

Do you have any links I can follow to look up on this? I'm going to be anxious taking it now... It's not even helping much anyway!


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## Holly21

I get my information on drugs in pregnancy from the British National Formulary, which is the most reliable drug information source and 1 that every UK doctor uses. It comes in the form of a book (you can usually buy them off Ebay, but note that they're updated regularly - a couple of times a year I think) or you can access it online www.bnf.org

You have to register - nurses, pharmacists etc use the BNF so I would imagine members of the public can register to access it too.

This is what the page says (I've edited the irrelevant bits about other drugs):

"Home > British National Formulary > Appendix 4 Pregnancy > Table of drugs to be avoided or used with caution in pregnancy > Antipsychotics > Phenothiazines
Prochlorperazine
Third trimester: Extrapyramidal effects in neonate occasionally reported"


When we use a drug for one purpose, we often find that it has uses in other conditions too e.g. prochlorperazine is actually an antipsychotic drug but has a good antisickness effect, cyclizine is an anti-itch medicine but is also good for certain types of nausea (hence why you see antipsychotic up there). Prochlorperazine is a member of a class of drugs known as the phenothiazines, like cyclizine is a member of a class of drugs known as antihistamines.


This site is a bit more worrying https://drugsafetysite.com/prochlorperazine

You can find any amount of info if you google it - in general, reputable sites are those from a respected company e.g. a national family planning association, a medical site etc. 

All medical students have it drummed into them not to prescribe anything to pregnant women unless absolutely necessary - we all know how very vulnerable babies are to drugs so it would have to be a very brave (or very stupid) doctor who prescribed anything without thoroughly checking it over. Aside from the obvious duty of care to you and your baby and the need to make sure you're both as protected as possible, doctors get sued very easily these days, especially in the field of Obstetrics, and this makes doctors think very carefully before prescribing anything for pregnant women.

No-one is going to run a drug trial comparing how drugs affect babies in utero - the risk would be too big so all we really know about drug safety in pregnancy is gained from seeing side-effects in babies whose mothers took drugs during pregnancy and feeding this back to the drug companies, BNF, other doctors etc. 

As I said, I don't often come across pregant women these days but if I did any someone needed anti emetics, I would go for cyclizine over prochlorperazine. However, your doctor knows you, not me and I'd hope he/she has checked out hat is best for you. Go back and see them again if you're not satisfied and hope the nausea settles (I threw up in the shower today. Not nice. Glad I am on annual leave for a week!). :hug:


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## PeanutBean

Thanks for all the info Holly. I'm a scientist so well aware of the implications in assessing drug (or anything) safety in pregnant women. I have access to various scientific journals but only those subscribed to by the uni I am affiliated with. I was getting info on the drugs I've been prescribed from an NHS site (https://cks.library.nhs.uk/home) but it didn't say anything about contraindications in 3rd tri though obviously it can take time for such things to filter down.

Unfortunately despite constantly asking for my GP, who has always been very good, I've been receiving treatment from another doctor at the practice (who I've always thought was rubbish). He's not even seen me. I managed to get him to phone me and we talked for about two minutes so he doesn't really know my background or anything about me except what is in my notes. I think I mentioned further back in the thread somewhere that when I asked if the promethazine he originally prescribed (that is unavailable) was similar to cyclizine he said no, it's an antihistamine. When I asked for something other than the metoclopramide as it made my stomach wreck I specifically mentioned cyclizine and that I've had it before with success. I listened while the receptionist typed it all up and she read it back to me. But he just did the new prescription for the prochlorperazine and nothing was said about cyclizine. I don't know what to think about it all now!


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## Holly21

Hmm, perhaps time to start seeing your old GP or a new one - there's a time and a place for phone advice but unless a doctor really knows the patient well or it's a simple problem, or is advising another doctor about a patient, face to face is always best. I've not used the above site before but as an NHS site it should have accurate information on it.


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