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Off-label use of ondansetron in pregnancy in Western Australia

There is an increasing trend to prescribe ondansetron although its safety for use in pregnancy has not been established.

Authors:
Colvin L, Gill AW, Slack-Smith L, Stanley FJ, Bower C

Authors notes:
BioMed research international. 2013;2013:909860

Keywords:
Pregnancy, nausea, ondansetron, adverse outcomes, safety

Abstract:
Nausea and vomiting of pregnancy is the most common medical condition in pregnancy.

There is an increasing trend to prescribe ondansetron although its safety for use in pregnancy has not been established.

There were 96,968 births from 2002 to 2005.

Ondansetron was dispensed to 251 pregnant women during this period.

The women dispensed ondansetron were more likely to be privately insured, to be Caucasian, not to smoke during their pregnancy, to have a multiple birth , and to have used fertility treatment.

There was a small but not significantly increased risk of a major birth defect with first trimester exposure.

Our study did not detect any adverse outcomes from the use of ondansetron in pregnancy but could not conclude that ondansetron is safe to use in pregnancy.