Pregnancy Paranoia - Diclegis Edition
March 9, 2016 6:46 AM Subscribe
YANMD - should I take Diclegis while 7 weeks pregnant?
(Hello Everyone - Sidenote first I really want to thank everyone, I am pregnant in help by the great advice I received on the green. If I could hug and kiss each of you I would. My husband and I are so excited and ClearBlue Fertility Monitor and syringe FTW!)
The nausea has been debilitating but Sunday night I had diarrhea, nausea and vomiting all night. I went to my first check-up with my OBGYN nurse Monday morning and she gave me samples of Diclegis. I took them Monday night and Tuesday I felt a little nausea but a million times better. The nurse said these are Category A pills, but I still can't help but worry. I started googling and came across this article, what are you experiences with this pill? Should I continue to take them or stop? I took half a dose last night and woke up feeling like crap all over again. I need some guidance, I am not normally a pill taker and avoid taking medication as much as possible. I'm 7 weeks pregnant, if that matters.
(Hello Everyone - Sidenote first I really want to thank everyone, I am pregnant in help by the great advice I received on the green. If I could hug and kiss each of you I would. My husband and I are so excited and ClearBlue Fertility Monitor and syringe FTW!)
The nausea has been debilitating but Sunday night I had diarrhea, nausea and vomiting all night. I went to my first check-up with my OBGYN nurse Monday morning and she gave me samples of Diclegis. I took them Monday night and Tuesday I felt a little nausea but a million times better. The nurse said these are Category A pills, but I still can't help but worry. I started googling and came across this article, what are you experiences with this pill? Should I continue to take them or stop? I took half a dose last night and woke up feeling like crap all over again. I need some guidance, I am not normally a pill taker and avoid taking medication as much as possible. I'm 7 weeks pregnant, if that matters.
If you do feel uncertain about the medication, you can always call the infantrisk.com hotline for questions about OTC or prescriptions while pregnant or nursing: (806) 352-2519. They are open business hours in the central time zone.
posted by jillithd at 7:12 AM on March 9, 2016
posted by jillithd at 7:12 AM on March 9, 2016
Women take the B6/Unisom combo for morning sickness regularly, and there has been no indication of any birth defect issues. You're all good. :)
Also, speaking as a currently-pregnant person myself, stop listening to people's horror stories now, stop looking stuff up on the internet, just stop. There appears to be a subset of the population that delights in scaring pregnant women, and there is no reason to let them into your head.
posted by antimony at 7:12 AM on March 9, 2016 [9 favorites]
Also, speaking as a currently-pregnant person myself, stop listening to people's horror stories now, stop looking stuff up on the internet, just stop. There appears to be a subset of the population that delights in scaring pregnant women, and there is no reason to let them into your head.
posted by antimony at 7:12 AM on March 9, 2016 [9 favorites]
Don't ask us, ask Motherrisk. You can look up the drug there and find out what the research (if any) says. You can also call them and have them explain any possible risks to you, or explain what is and isn't known. They're whole mandate is monitoring and compiling research on what is and isn't safe during pregnancy. They are real doctors/researchers, not woo practitioners or paranoid don't-do-anything-while-pregnant nutjobs.
posted by If only I had a penguin... at 7:13 AM on March 9, 2016
posted by If only I had a penguin... at 7:13 AM on March 9, 2016
You always want to ask yourself is this worth the risk. In this case, it is. You becoming dehydrated is more dangerous to the baby than this medication. Take the pills.
posted by myselfasme at 7:48 AM on March 9, 2016
posted by myselfasme at 7:48 AM on March 9, 2016
You becoming dehydrated is more dangerous to the baby than this medication.
I came here to say something like this. One thing I've tried to remember is that nutrition and exercise are linked by lots of science to so many good outcomes. When I tried to eat only organic food, it became so time consuming that I couldn't find time to exercise. Moderate approaches (rather than perfectionism) to many of these questions will leave you more energy to focus on what will really matter to the health of your baby. Congratulations!
posted by slidell at 8:09 AM on March 9, 2016 [4 favorites]
I came here to say something like this. One thing I've tried to remember is that nutrition and exercise are linked by lots of science to so many good outcomes. When I tried to eat only organic food, it became so time consuming that I couldn't find time to exercise. Moderate approaches (rather than perfectionism) to many of these questions will leave you more energy to focus on what will really matter to the health of your baby. Congratulations!
posted by slidell at 8:09 AM on March 9, 2016 [4 favorites]
Anecdata: I'm 33 weeks in, and have been on Diclegis since roughly week 10. It's probably saved my sanity and possibly my pregnancy, because I was vomiting 6 times a day, becoming dehydrated, not gaining weight like I was supposed to, and basically lying in bed with nausea-triggered migraines, weeping from frustration and pain.
Consequently, my ob was 10000000% comfortable with me taking Diclegis. In fact, not only did she write me a prescription for it, but she actually gave me a frowny face when I told her about my vomiting frequency and how I'd been putting up with it for weeks because of societal/parental pressure on WHAT ABOUT THE BABEH and OH NO DRUGZ. And she said, WHY DIDN'T YOU COME IN FOR DICLEGIS EARLIER, and whipped me off a prescription. I took it, and it was like night and day.
In fact, a couple weeks ago, when I mentioned that I was still on it at week 30 and asked if it was OK, she told me it was completely fine, though I could stop if I wanted. Which I tried. 8 hours later, it's vomit migraine nausea standing on the subway platform vomiting into a trash can while people judge me for being visibly pregnant and presumably drunk because why else am I vomiting at 6PM at night????
And yet, with all that about my level of dependence on Diclegis, the baby is riotously healthy, and actually woke me up this morning by kicking so hard I could watch my belly ripple like something out of a horror movie.
(And yeah, read Expecting Better. It's fantastic for managing the kind of worry/anxiety that's a combo of early-pregnancy hormones and societally-imposed fear about how BREATHING WRONG WILL HARM THE BABY and YOU MUST ENDURE INCREDIBLE AMOUNTS OF PAIN AND DISCOMFORT IF YOU WANT TO CARRY A HEALTHY BABY TO TERM and SUFFER SUFFER THIS IS YOUR LOT SMILE AND BEAR IT
In particular, as kat518 indicates, Expecting Better specifically explains why Diclegis was pulled under it's prior name -- essentially, IIRC, it was incredibly widely prescribed in the US back in the day, which I've anecdotally confirmed by talking to a women of Mr. Machine's mothers' generation who were in the US at the time of their pregnancy. Because it was so widely prescribed, some women who took it gave birth to kids with defects, just by luck of the draw. They sued, and eventually, even though there was no scientific evidence, the manufacturer pulled it from the US market.
However, it continued to be prescribed in number of developed countries overseas, and repeated, repeated research and incredibly wide trials have shown that it does not cause issues whatsoever. It is very, very widely studied.)
tl;dr: Diclegis saved me, and there is an incredible amount of actual hard evidence that it makes life better for mothers with nausea at the level that you and I have without harming fetuses in any way whatsoever.
posted by joyceanmachine at 8:15 AM on March 9, 2016 [7 favorites]
Consequently, my ob was 10000000% comfortable with me taking Diclegis. In fact, not only did she write me a prescription for it, but she actually gave me a frowny face when I told her about my vomiting frequency and how I'd been putting up with it for weeks because of societal/parental pressure on WHAT ABOUT THE BABEH and OH NO DRUGZ. And she said, WHY DIDN'T YOU COME IN FOR DICLEGIS EARLIER, and whipped me off a prescription. I took it, and it was like night and day.
In fact, a couple weeks ago, when I mentioned that I was still on it at week 30 and asked if it was OK, she told me it was completely fine, though I could stop if I wanted. Which I tried. 8 hours later, it's vomit migraine nausea standing on the subway platform vomiting into a trash can while people judge me for being visibly pregnant and presumably drunk because why else am I vomiting at 6PM at night????
And yet, with all that about my level of dependence on Diclegis, the baby is riotously healthy, and actually woke me up this morning by kicking so hard I could watch my belly ripple like something out of a horror movie.
(And yeah, read Expecting Better. It's fantastic for managing the kind of worry/anxiety that's a combo of early-pregnancy hormones and societally-imposed fear about how BREATHING WRONG WILL HARM THE BABY and YOU MUST ENDURE INCREDIBLE AMOUNTS OF PAIN AND DISCOMFORT IF YOU WANT TO CARRY A HEALTHY BABY TO TERM and SUFFER SUFFER THIS IS YOUR LOT SMILE AND BEAR IT
In particular, as kat518 indicates, Expecting Better specifically explains why Diclegis was pulled under it's prior name -- essentially, IIRC, it was incredibly widely prescribed in the US back in the day, which I've anecdotally confirmed by talking to a women of Mr. Machine's mothers' generation who were in the US at the time of their pregnancy. Because it was so widely prescribed, some women who took it gave birth to kids with defects, just by luck of the draw. They sued, and eventually, even though there was no scientific evidence, the manufacturer pulled it from the US market.
However, it continued to be prescribed in number of developed countries overseas, and repeated, repeated research and incredibly wide trials have shown that it does not cause issues whatsoever. It is very, very widely studied.)
tl;dr: Diclegis saved me, and there is an incredible amount of actual hard evidence that it makes life better for mothers with nausea at the level that you and I have without harming fetuses in any way whatsoever.
posted by joyceanmachine at 8:15 AM on March 9, 2016 [7 favorites]
Yeah, Diclegis is considered super-safe and it's the first line of defense against morning sickness. Personally every pregnancy I made it up to the third line of defense (zofran) because diclegis and whatever the second step is didn't work for me and CONSTANT VOMITING IS BAD FOR BABY. With my second pregnancy I was hospitalized FOUR TIMES for IV rehydration when the vomiting couldn't be controlled even with zofran. If you can get this shit under control with Diclegis, don't even think twice. Much better to get a little extra spine-healthy B6 than to end up in the hospital for 12 hours with IVs stuck in you, after they refuse you at the first ER and transfer you to the one with the high-risk NICU in case you deliver at 30 weeks, weak and shaky and down five more pounds, while they monitor the fetus for stress because its heart rate has shot up because you're so dehydrated and you get your blood pressure taken every 2 minutes. That is the outcome you are trying to avoid.
Much love,
Queen of Hyperemesis
posted by Eyebrows McGee at 9:04 AM on March 9, 2016 [1 favorite]
Much love,
Queen of Hyperemesis
posted by Eyebrows McGee at 9:04 AM on March 9, 2016 [1 favorite]
joyceanmachine and I are apparently pregnancy twins, except that I'm only at 26 weeks. I've regularly taken a small combo of B6 and Unisom every night since nausea reared its ugly head at week 6 (along with an oh-so-sadly-required stool softener and my prenatal - take it right before bed, since the iron in prenatal can also cause nausea). I'm a pretty high-risk pregnancy due to a blood-clotting disorder, and every maternal-fetal medicine specialist that I've seen (at least 5 or 6) has 100% okayed B6+Unisom/Diclegis throughout this pregnancy. And nthing reading Expecting Better - it is my absolute favorite pregnancy book ever written, and Emily Oster is one of the best economists of our generation (she's done some incredible work in development microeconomics).
I (foolishly) stopped taking B6+Unisom for a couple of days last week since I'd run out, and, hey, I'm in the third trimester, do I really need to still worry about nausea? Hahahahaha, yes, yes I do. Two solid days of puking later, and I'm stocked up to last through the rest of this pregnancy.
posted by Jaclyn at 10:15 AM on March 9, 2016
I (foolishly) stopped taking B6+Unisom for a couple of days last week since I'd run out, and, hey, I'm in the third trimester, do I really need to still worry about nausea? Hahahahaha, yes, yes I do. Two solid days of puking later, and I'm stocked up to last through the rest of this pregnancy.
posted by Jaclyn at 10:15 AM on March 9, 2016
Congratulations! Also, this:
stop listening to people's horror stories now, stop looking stuff up on the internet, just stop.
If you spend the next 32 weeks Googling for potential issues, you will end up paralyzed by fear and miserable. Please, please ignore the fearmongers. Hell, ignore the kindly folks and their unsolicited advice, too, even though it may be well-meaning at heart. Trust the people you trust (hopefully you have access to good healthcare and this can include your prenatal care provider), and mentally tell everyone and everything else to put a sock in it.
posted by jesourie at 11:03 AM on March 9, 2016
stop listening to people's horror stories now, stop looking stuff up on the internet, just stop.
If you spend the next 32 weeks Googling for potential issues, you will end up paralyzed by fear and miserable. Please, please ignore the fearmongers. Hell, ignore the kindly folks and their unsolicited advice, too, even though it may be well-meaning at heart. Trust the people you trust (hopefully you have access to good healthcare and this can include your prenatal care provider), and mentally tell everyone and everything else to put a sock in it.
posted by jesourie at 11:03 AM on March 9, 2016
I really struggled with whether or not to post this, because lord knows you've got enough on your mind without worrying about physical discomfort, but I thought I could engage with that "everyone with advice on the internet tells horror stories but they're all third-hand" sentiment I'm seeing.
I am That Guy Who Knows Someone With A Birth Defect Caused By Doxylamine. My wife was born about three years before Bendectin was pulled off the US shelves, and while I can't be positive, I believe she's the "Maryland girl" referenced in this article about liability in medications prescribed to pregnant women. I do know that the (dozens of) reconstructive surgeries that she had before the age of 8 were financed by a settlement with Merrell Dow, though I don't think they ever admitted responsibility, and I do know that her mother was terrified of taking so much as Tylenol while she was pregnant, and only grudgingly acquiesced when the hyperemesis became incapacitating (so there is zero chance that another teratogenic medication was at fault).
She was born with syndactyly of all appendages, a club foot, and various other minor odd things that have popped up unexpectedly over the years. (MeMail me if you'd like the gritty details) I haven't gone into much depth with her mother about this, but all indications are that this was the most difficult 8-year-stretch that any person I have ever known has endured--medical issue after medical issue in a tiny human being, compounded by the creeping guilt at the prospect that it was her own fault. I cannot even imagine.
I don't really have a point here. Chances are overwhelmingly high that you can take it and be fine--data suggests that it's correctly used as a first-line against nausea. Her congenital abnormalities are quite possibly due to random chance, though the odds against all four limbs being affected are pretty infinitesimal. However, if you or anyone else reading wants to put a face to what can result from using doxylamine during pregnancy: hi. Shoot me a MeMail, and I'll talk to you about it.
posted by Mayor West at 11:48 AM on March 9, 2016
I am That Guy Who Knows Someone With A Birth Defect Caused By Doxylamine. My wife was born about three years before Bendectin was pulled off the US shelves, and while I can't be positive, I believe she's the "Maryland girl" referenced in this article about liability in medications prescribed to pregnant women. I do know that the (dozens of) reconstructive surgeries that she had before the age of 8 were financed by a settlement with Merrell Dow, though I don't think they ever admitted responsibility, and I do know that her mother was terrified of taking so much as Tylenol while she was pregnant, and only grudgingly acquiesced when the hyperemesis became incapacitating (so there is zero chance that another teratogenic medication was at fault).
She was born with syndactyly of all appendages, a club foot, and various other minor odd things that have popped up unexpectedly over the years. (MeMail me if you'd like the gritty details) I haven't gone into much depth with her mother about this, but all indications are that this was the most difficult 8-year-stretch that any person I have ever known has endured--medical issue after medical issue in a tiny human being, compounded by the creeping guilt at the prospect that it was her own fault. I cannot even imagine.
I don't really have a point here. Chances are overwhelmingly high that you can take it and be fine--data suggests that it's correctly used as a first-line against nausea. Her congenital abnormalities are quite possibly due to random chance, though the odds against all four limbs being affected are pretty infinitesimal. However, if you or anyone else reading wants to put a face to what can result from using doxylamine during pregnancy: hi. Shoot me a MeMail, and I'll talk to you about it.
posted by Mayor West at 11:48 AM on March 9, 2016
I have been pregnant two times. I took B6 and Unisom throughout my entire first pregnancy at the advice of a midwife friend, since I didn't have insurance to cover zofran at the time. I had extreme morning sickness (borderline hyperemisis) my entire pregnancy, and the B6 and Unisom did help a bit but not much. My second pregnancy I took zofran and phenargen the entire time.
B6 and Unisom are extremely safe, have been used for a very long time and are usually the first recommendation given for nausea before resorting to the "big guns" aka zofran.
posted by celtalitha at 12:52 PM on March 9, 2016
B6 and Unisom are extremely safe, have been used for a very long time and are usually the first recommendation given for nausea before resorting to the "big guns" aka zofran.
posted by celtalitha at 12:52 PM on March 9, 2016
Another anecdote: I took Diclegis. And when that stopped working, its big brother Zofran. Perfectly healthy baby and not feeling like death was soooo worth any anxiety over drugs.
posted by whitewall at 3:06 AM on March 10, 2016
posted by whitewall at 3:06 AM on March 10, 2016
Response by poster: To wrap this thread up, an update:
I ended up taking it for a week and a half.. and this crap did not work. Only thing that is helping the nausea now is Sour Patch Kids -- I know, I know crap, but a few when I feel it coming on and it helps a bit. Ginger, no. Lemon, no. Mint, I can only take so much. Seabands, I don't think so? Food and water and sparkling water, helps until it doesn't and then it makes everything worse.
posted by xicana63 at 7:28 AM on March 21, 2016
I ended up taking it for a week and a half.. and this crap did not work. Only thing that is helping the nausea now is Sour Patch Kids -- I know, I know crap, but a few when I feel it coming on and it helps a bit. Ginger, no. Lemon, no. Mint, I can only take so much. Seabands, I don't think so? Food and water and sparkling water, helps until it doesn't and then it makes everything worse.
posted by xicana63 at 7:28 AM on March 21, 2016
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Oster actually wrote about Diclegis so that may be interesting for you. Her mother in law took Diclegis while pregnant with her husband and it really helped her but then it was off the market when she got pregnant again so she was miserable for weeks. But Diclegis is just a combination of B6 and Unisom, so even before it was reintroduced as Diclegis, women took it to help with morning sickness as two separate pills (I did and I'll be 26 weeks tomorrow). When the FDA looked at the children of mothers who took Diclegis when it was first on the market compared to mothers who did not, they actually found higher incidence of birth defects among mothers who were not taking it. Even that article you linked to said there's no evidence that it causes problems.
I'm biased because in general, I'm happy to take pills to make me feel better though I've tried to be a little more reserved since I've been pill-popping for two. I love medicine and I don't see any reason to suffer unnecessarily, especially when you're going through something that's hard enough. I don't think anyone gets a medal for making things harder on themselves just because. At the same time, your doctor prescribed this for you so she clearly thinks that the benefits of taking it will outweigh the harms. Talk about it with your doc but I don't think you should feel badly about taking it. If you want, maybe only take it during the week so you feel okay at work or take it every other day. And keep in mind that whatever you do, the morning sickness should get better within a few weeks. I haven't been sick since maybe week 14 (knock on wood). Good luck!
posted by kat518 at 7:08 AM on March 9, 2016 [3 favorites]