Can you take Zofran while pregnant?

If you're pregnant, there's a good chance you're familiar with morning sickness. For many women, nausea and vomiting during pregnancy is unpleasant; for others, it's debilitating.

In some cases, morning sickness can be serious enough to require hospitalization. Fortunately, a number of treatments – including Zofran – can help to relieve and manage symptoms.

What is Zofran (ondansetron)?

Zofran (ondansetron) is a prescription medication that helps ease nausea and vomiting in people undergoing chemotherapy or surgery. It's also often taken by women experiencing morning sickness during pregnancy.

Is Zofran safe during pregnancy?

Doctors frequently prescribe ondansetron to treat nausea and vomiting during pregnancy. It's usually considered "when other medications fail," says Layan Alrahmani, M.D., a board-certified ob-gyn and maternal-fetal medicine specialist and member of the BabyCenter Medical Advisory Board. In other words, your doctor will likely only recommend Zofran if other morning sickness remedies haven't helped.

The potential risks of Zofran during pregnancy remain controversial, as studies over the years have been inconsistent, explains Dr. Alrahmani, a clinical faculty and assistant professor at Loyola UniversityOpens a new window in Chicago.

Although large studies have concluded that the medication doesn't appear to cause birth defects or other health problems in babies, some research has linked Zofran to a very small (less than 1 percent) increase in the chance of a baby developing cleft palate and heart defects.

Zofran is used "off-label" for pregnancy symptoms, meaning it's not officially approved by the FDA to treat morning sickness. But doctors prescribe lots of other medications off-label to pregnant women, explains Dr. Alrahmani, since very few drugs have been thoroughly vetted in pregnancy.

If your doctor prescribes ondansetron and you're concerned, she suggests waiting to take Zofran until you're at least 10 weeks pregnant. After this critical period of development, organs have taken shape and babies are at a lower risk of developing birth defects.

Your doctor should do a physical exam and discuss your medical history before prescribing Zofran. Be sure to bring up any other prescription drugs or supplements you're taking, as a number of medications – including antidepressants and medications to treat migraines – can interact with ondansetron. Also let your doctor know about any history of heart conditions, liver disease, or low blood levels of magnesium or potassium.

Side effects of Zofran in pregnancy

As with any medication, Zofran can cause side effects. The most common side effects of taking ondansetron in pregnancy may include:

• headache
• fatigue
• constipation
• drowsiness

What dose of Zofran is given in pregnancy?

Zofran is usually prescribed to treat nausea and vomiting in pregnancy in 4 mg doses, either as a pill or through an IV, every eight hours as needed.

Alternatives to Zofran during pregnancy

Before your doctor prescribes any medications or supplements for morning sickness, you may want to try a few lifestyle adjustments. Keep track of your symptoms, and avoid any odors and foods that you notice trigger symptoms. Eat five to six smaller meals throughout the day instead of three large meals, since a too-full or empty stomach can make you nauseous. Sipping on cold and carbonated beverages can help ease nausea, as can sucking on ginger or peppermint candies. An acupressure band may also offer relief.

If lifestyle changes don't make your morning sickness manageable, your doctor may recommend supplements or prescribe medications such as:

• ginger capsules
• folic acid
• vitamin B6
• antihistamines including doxylamine (Unisom), alone or in combination with vitamin B6
• Bonjesta or Diclegis, the prescription versions of doxylamine and vitamin B6
• promethazine (Phenergan)
• prochlorperazine (Compazine)
• metoclopramide (Reglan)
• proton pump inhibitors, which may help if acid reflux is causing nausea

When to talk to your doctor

Although it has a mild-sounding name, morning sickness is no joke. Talk to your doctor or midwife about an individualized plan to ease your symptoms, and don't feel guilty using the medications they recommend.

Check in with your provider as soon as possible if you're having severe morning sickness. This could mean you struggle to keep down any food or water, have little to no appetite, or are losing weight (more than just a few pounds). You may have hyperemesis gravidarum, a more serious form of nausea and vomiting in pregnancy. The condition can put you at risk of dehydration and weight loss, which can be dangerous for you and your baby.

If your doctor does prescribe Zofran, they should share the potential drug side effects that warrant a call right away. Some of these include:

• allergic reactions, such as a rash or swelling in the throat
• chest pain
• changes in your heart rhythm, such as an irregular or fast heartbeat
• trouble breathing
• symptoms of a bowel blockage, including the inability to have a bowel movement or pass gas
• signs of serotonin syndrome, such as high fever, irritability, confusion, or seizure