Is Taking Zofran in Pregnancy the Answer to Your Morning Sickness?
Morning sickness during pregnancy might be common, but it’s decidedly no fun. If you’ve tried all the natural remedies and they haven’t worked, you might be considering taking Zofran for pregnancy nausea. But is Zofran safe during pregnancy? Here’s what you should know about taking Zofran in pregnancy, including potential risks.
Zofran (generic name: ondansetron) is a drug that prevents nausea and vomiting, according to the Cleveland Clinic. While it’s primarily used to treat those going through chemotherapy, radiation or surgery, it’s also prescribed to alleviate nausea and vomiting from morning sickness. It belongs to a class of medications called antiemetics.
Zofran and other antiemetics work by temporarily blocking a type of receptor in the intestines that may cause nausea and vomiting, explains Rachel Newman, MD, MBA, an ob-gyn and assistant professor at UTHealth Houston. This can drastically improve quality of life for pregnant people dealing with severe nausea or vomiting.
In general, experts say that taking Zofran during pregnancy is considered safe. The Zofran pregnancy category is “B,” per the U.S. Food and Drug Administration (FDA). This means “there isn’t data showing it has been harmful in humans, but there also hasn’t been a large study proving conclusively that it’s safe either,” explains Newman. “In animal studies, Zofran hasn’t been associated with birth defects. In practice, this means that we typically counsel patients that Zofran is safe for use without significant concern for causing problems.”
Research suggests there may be a very small increase in cardiac abnormalities and cleft palates in babies exposed to Zofran early in pregnancy. However, a summary of research suggests this increase could be affected by other factors and that “the overall risk of birth defects associated with [Zofran] exposure appears to be low.”
“There are some retrospective, poorly controlled studies that may show a slight increased risk for mild congenital heart defects if taken in the first trimester, and may show a slight increased risk for fetal cleft palate,” says Joseph A. Adashek, MD, FACOG, an ob-gyn in Las Vegas and associate clinical professor of maternal-fetal medicine at the University of Nevada School of Medicine. “Of note, there are other studies with many patients that have not shown an increased risk for these two anomalies.” These include a study from 2013 published in The New England Journal of Medicine and a study from 2014 published in Reproductive Toxicology.
It can be difficult to process all the conflicting advice on which medications to take during pregnancy. Newman suggests talking through treatment options with your doctor to figure out the right choice for you. “When using any medication in pregnancy, the potential risks, benefits and alternative treatments should be discussed,” Newman says.
Whether you’re taking Zofran by mouth or in an IV at the hospital, the typical dose is either 4 or 8 milligrams given every four to six hours, says Newman. The maximum daily dose is 24 milligrams. It comes in the form of a dissolvable pill too, says Adashek. Zofran can be an effective treatment for hyperemesis gravidarum, aka persistent nausea and vomiting during pregnancy.
Zofran is usually very well tolerated in pregnancy, says Newman, with the most common side effects being constipation, fatigue and headaches. If you have any questions or concerns about symptoms you experience while taking Zofran, don’t hesitate to bring them up with your doctor.
You can take Zofran throughout your pregnancy until delivery, Newman says. But for most people, nausea and vomiting symptoms calm down by the time the first trimester comes to a close.
If you’re looking for alternatives to Zofran during pregnancy, there are a few natural remedies you can try for morning sickness. Here’s what the experts recommend.
- Try ginger. In the first trimester, Adashek says he often recommends ginger as a first-line remedy.
- Eat small meals. Prevention is key. Stave off any empty stomach (and ensuing nausea) by eating frequent, small meals, every one to three hours.
- Consider B6 and Unisom. “I like to start patients on vitamin B6 and doxylamine [or Unisom] in the first trimester, which can help prevent symptoms from worsening,” Newman says.
- Try other meds first. Adashek says there are other potential medications to explore, like Phenergan (promethazine), Compazine (prochlorperazine), Reglan (metoclopramide) and Bonjesta (combination of doxylamine and pyridoxine).
Natural remedies for morning sickness are a great place to start. But if you’re experiencing severe nausea and vomiting despite trying various remedies, your doctor might suggest taking Zofran. If you need to take Zofran during pregnancy, know that it’s generally safe. But if you’re at all concerned, it’s important to speak with your provider to discuss the pros, cons and other possibilities available to you.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Joseph A. Adashek, MD, FACOG, is an ob-gyn in Las Vegas and an associate clinical professor of maternal-fetal medicine at the University of Nevada School of Medicine. He earned his medical degree from Penn State College of Medicine.
Rachel Newman, MD, MBA, is an ob-gyn and professor at McGovern Medical School at UTHealth Houston. She earned her medical degree from Tufts University School of Medicine in Boston.
Cleveland Clinic, Ondansetron Solution
Obstetrics & Gynecology, Ondansetron Use in Pregnancy and Birth Defects, May 2016
Mother To Baby, National Library of Medicine, Ondansetron (Zofran), September 2022
The New England Journal of Medicine, Ondansetron in Pregnancy and Risk of Adverse Fetal Outcomes , February 2013
Reproductive Toxicology, Use of Ondansetron During Pregnancy and Congenital Malformations in the Infant, December 2014
Obstetrics & Gynecology, Ondansetron Use in Pregnancy, May 2016
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