Cerucal in the first trimester. Cerucal® during pregnancy: what you need to know? Contraindications for Cerucal during pregnancy

The metoclopramide-based drug Cerucal is used during pregnancy to combat frequent vomiting. Often used in the early stages, when women suffer from. The drug should be used carefully and only on the recommendation of a doctor.

Reception during pregnancy

The first trimester of pregnancy is different for women. Many girls face the problem of nausea, frequent vomiting, and general malaise. Due to poor health, mood deteriorates and loss of strength is observed. A woman cannot lead a full life and suffers greatly because of this. Establishing normal nutrition at this time is also not easy. Sometimes any food eaten causes vomiting. A pregnant woman loses weight, which negatively affects the development of the embryo. Against the background of this condition, there is a threat of miscarriage.

If you are suffering from severe vomiting or toxicosis, you should visit a doctor and tell about all the symptoms. He will prescribe antiemetic drugs. Cerucal has this effect.

The instructions indicate that during pregnancy you should use it only when absolutely necessary.

You cannot prescribe for yourself, but if a medicine is recommended by a doctor, it is better to follow his advice. Constant vomiting, malnutrition and other symptoms will cause more harm to the baby than this drug.

Indications for use

All indications for the use of Cerucal are described in the relevant official instructions:

• nausea and vomiting due to injuries, operations;
• irritable bowel syndrome;
• preparation for gastrointestinal tract examinations;
• heartburn;
• nausea caused by taking medications.

It is also stated here that the drug is prohibited in the early stages, but many doctors take this responsibility upon themselves, prescribing Cerucal for toxicosis. Such prohibitions in the instructions are due to the fact that mandatory studies that confirm or refute the dangers of a certain medication are never conducted among pregnant women in the first trimester. Therefore, such prohibitions apply to almost all medicines.

Often, Cerucal in the form of an injection solution is used in a hospital setting, when, due to exhaustion associated with toxicosis, a woman is admitted for preservation.

Instructions for use

The drug is available in tablet or injection format.

The maximum daily dose is 40 mg of metoclopramide, that is, 4 Cerucal tablets.

Take half an hour before meals. Take the tablet with a small amount of water. The active substance of the drug blocks receptors in the stomach that are responsible for nausea and vomiting. They send a signal to the corresponding part of the brain. After taking the pill, relief comes soon. A pregnant woman can eat normally.

In injection form, the drug is administered intramuscularly or intravenously. Its dosage is the same - 10 mg (1 ampoule) 3-4 times per day.

Risks in early pregnancy

The need to take this antiemetic drug in pregnant women arises in the early stages, when severe toxicosis begins. Only a doctor can prescribe it. He assesses the patient’s condition, her weight, pregnancy characteristics, duration, and other factors. The daily dosage is determined individually. Sometimes 2 tablets a day are enough for a woman to eat normally without experiencing severe nausea. The drug is prescribed if refusing to use antiemetics will harm the baby even more than using them. Only a specialist can sensibly assess all the risks, so you cannot choose your own treatment.

Contraindications

Antiemetics should not be used in the following cases:

• individual intolerance to the active substance and components of Cerucal;
• gastrointestinal bleeding;
• bronchial asthma;
• epilepsy;
• some types of cancer.

Almost all of the above factors are incompatible with pregnancy. When taking the drug for the first time, it is advisable to reduce the single dosage by half in order to monitor the body’s reaction. If allergies or other negative manifestations do not occur, then you can use the medicine in accordance with the specific recommendations of the gynecologist.

Analogs

Cerucal is an effective drug, but its price may seem overpriced. In this case, you should pay attention to analogues of this drug:

• Metoclopramide;
• Domrid;
• Metukal;
• Kinedryl.

Some of the above drugs are based on the same active ingredient as Cerucal. This category includes Metukal and Metoclopramide. Dormid and Kinedryl contain other active ingredients. They are used for individual intolerance to metoclopramide.

If you are concerned about severe nausea and constant vomiting during pregnancy, you should know the following information about Cerucal:

• the drug is taken as prescribed by a doctor;
• do not exceed the daily dose;
• the medicine fights nausea, relieves vomiting;
• long-term use is not recommended.

In most women, it is accompanied by toxicosis, the most common signs of which are nausea, vomiting, drooling and general malaise. To a greater or lesser extent, all expectant mothers are susceptible to toxicosis, but sometimes its symptoms become very strong, especially in the first 12 weeks. If nausea is accompanied by frequent vomiting, this can lead to dehydration, in which case the woman needs to be hospitalized and given intravenous medicinal solutions.

The fact is that pregnancy dramatically changes hormonal levels, which, in turn, affects the nervous system. In addition, the growing embryo releases metabolic products that have a bad effect on the mother's condition. Already by the beginning of the second trimester, it begins to function, which eliminates the phenomena. Expectant mothers often wonder if it is possible to take any medications in the early stages to help? In pharmacies they are often offered a fairly common antiemetic - cerucal.

Cerucal during pregnancy: instructions

Cerucal is a drug that blocks receptors located in the stomach and duodenum and transmitting signals to the vomiting center in the brain. Under its action, the brain does not receive information about the irritation of these receptors, therefore, there is no vomiting, the contents of the stomach normally pass into the duodenum and then actively move through the small and large intestines, as expected.

Cerucal is recommended for those who have nausea, vomiting and hiccups of various types, accompanied by weakened activity of the stomach, intestines and biliary tract, constant regurgitation of food, stomach cramps, etc. That is, it is an antiemetic and antihiccup drug.

If the condition is not critical, then patients are prescribed Cerucal in tablets: it begins to act within half an hour. In acute situations, when an attack of vomiting must be stopped urgently, cerucal is administered intravenously (the therapeutic effect occurs after 1-3 minutes) or intramuscularly (in this case, the effect begins to appear after 15 minutes).

The tablets are taken 30 minutes before meals with water. The dosage should not exceed 3-4 tablets per day, but during pregnancy the dosage is carefully determined by the doctor. The course of treatment can be long if necessary.

Is it possible to have cerucal during pregnancy?

Contraindications to taking Cerucal are gastrointestinal bleeding, gastric obstruction, some types of tumors, high intraocular pressure, and, oddly enough, the first trimester of pregnancy: Cerucal can be used only from the 13th week after consultation with a doctor. It is not recommended to take Cerucal during lactation.

Why can’t you take Cerucal in the early stages? The fact is that it strengthens muscle tone in the gastrointestinal tract, which can also extend into pregnancy, and in the early stages, increased uterine tone can provoke spontaneous miscarriage. This threat continues later, so Cerucal should not be taken even in late pregnancy without first consulting a doctor. In addition, cerucal stimulates the production of the pituitary hormone prolactin, which promotes the production of human milk and at the same time the contraction of the uterine muscles.

There are cases when early toxicosis becomes unbearable; the general condition of the mother suffers greatly from nausea and vomiting, which can also be the cause of uterine tone. At the same time, the risks for the fetus increase if, due to vomiting, a woman is unable to eat and drink. Then a cerucal can be prescribed.

In the second trimester, cerucal is used with greater confidence, because the threat of miscarriage is significantly reduced. However, you need to know that a side effect of cerucal is stimulation of the secretion of the adrenal hormone, which retains fluid and salts in the body, and this can cause and lead to more serious complications. Other possible adverse reactions include headaches and dizziness, panic attacks, tinnitus, feelings of depression and fatigue; changes in blood pressure and heart rate; dry mouth, diarrhea, or constipation; skin rashes, itching.

As you can see, the drug is far from harmless, and during breastfeeding it is completely prohibited for use. Moreover, pregnant women often suffer from kidney problems, and such conditions increase the risk of developing side effects.

During pregnancy, Cerucal can be used only as prescribed by a doctor. And he must take into account possible contraindications to the use of this drug in the patient.

Especially for- Sandra Berezhnaya

From Guest

I have known the cerucal since childhood. I don’t remember the exact year, but something around the early 90s, or even earlier... I was sick often, always with a high fever, and this was automatically accompanied by vomiting. I am still grateful to the gray-haired grandfather from the children’s emergency room who discovered these miracle pills for me. They saved and always save. THANK YOU! :)

Toxicosis becomes a frequent companion of pregnancy. It sometimes becomes impossible to cope with its symptoms, such as nausea, vomiting, and increased salivation, without the use of medications. One of these drugs is the antiemetic drug Cerucal.

Effect of the drug

Early toxicosis is often associated with hormonal changes in a woman’s body. Progesterone (pregnancy hormone) has a relaxing effect on the muscle organs, which allows the uterus not to contract in response to the development of a “foreign” body in it. But at the same time, a similar process occurs in the stomach. As a result, this organ of the digestive system becomes “lazy”: food lingers in it and passes more slowly into the lower sections of the gastrointestinal tract.

The active component of Cerucal - metoclopramide hydrochloride monohydrate - affects the receptors of the digestive organs. This substance blocks irritation of the mucous membrane and prevents stomach cramps, strengthening its muscle tone. Thanks to this action, the drug has the following properties:

• relieves hiccups and heartburn;
• accelerates gastric emptying and movement of food through the small intestine;
• tones the cardiac sphincter, located at the point where the esophagus enters the stomach.

Is it possible: features of prescribing Cerucal in early pregnancy

If pregnancy is accompanied by disturbances in the digestive tract (nausea, gastric hiccups, regurgitation, stomach cramps), the doctor may prescribe Cerucal starting in the second trimester. According to the instructions, no data have been found on the ability of the drug to affect the fetus. However, the medicine should be taken only in the absence of contraindications and under the strict supervision of a doctor.

Cerucal has the ability to increase the level of the hormone prolactin, which can provoke uterine tone and lead to miscarriage. Therefore, in the first three months of pregnancy, it is used in exceptional cases when it is not possible at a certain moment to help the expectant mother in other ways. Uncontrollable vomiting, which accompanies severe toxicosis, can cause no less harm to a woman and baby than taking Cerucal, because in this condition the body suffers from dehydration.

Doctors' opinion

Doctors' opinions about the effectiveness of Cerucal for getting rid of toxicosis symptoms differ. Some experts talk about the possibility of its use despite the restrictions for expectant mothers.

The deadline for toxicosis is up to 16 weeks. Toxicosis decreases with the formation of the placenta. Cerucal for such vomiting is indicated and used during pregnancy.

Didorenko I.Yu., medical advisor on obstetrics and gynecology of the Interdisciplinary Forum of Obstetricians-Gynecologists, Pediatricians, Dermatovenerologists, Endocrinologists and Functional and Ultrasound Diagnostics Specialists

https://health.mail.ru/consultation/1556719/

Others consider the drug useless.

So Cerucal doesn’t really help. I don’t understand why they drip it.

http://www.likar.info/consult/70787/

Injections and tablets - what is prescribed when?

Cerucal is available in two dosage forms. In uncomplicated cases of toxicosis, tablets are prescribed. The substance begins to act 30–40 minutes after administration, and the effect lasts for 12 hours.

In cases where emergency assistance is necessary, the drug is administered as an injection:

• intravenously (relief occurs within a few minutes);
• intramuscularly (the effect is noticeable after 15 minutes).

Contraindications to taking the drug

Contraindications to the appointment of Cerucal are:

• glaucoma and increased intraocular pressure;
• presence of neoplasms;
• stomach bleeding;
• gastric obstruction;
• epilepsy;
• threat of miscarriage;
• individual intolerance.

According to the classification of the US Drug Administration (FDA), Cerucal belongs to group “B”. This means that laboratory experiments on animals did not record the teratogenic (negative) effect of the drug on the fetus, but similar studies have not been conducted on pregnant women.

According to the information described in the instructions, when taking Cerucal, the following side effects may occur:

• increased fatigue;
• weakness;
• dizziness;
• change in heart rate;
• dryness of the mucous membranes of the mouth;
• bowel dysfunction;
• allergy.

If discomfort occurs, the drug should be discontinued.

Cerucal affects the functioning of the adrenal glands and retains fluid in the body. If a pregnant woman suffers from gestosis, the use of the drug may aggravate her condition.

Instructions for use of Cerucal during pregnancy

The recommended dose of the drug and dosage regimen are drawn up by the doctor individually. The medicine can be prescribed in a course of 1 month to six months. The tablets are taken half an hour before meals and washed down with enough water.

Analogues and drugs with similar effects

An analogue of Cerucal in terms of the active substance is Metoclopramide, however, according to the medical instructions, taking this drug is contraindicated during pregnancy. If the appointment of Cerucal is not possible due to contraindications or a negative individual reaction, the doctor can replace it with drugs that have similar pharmacological effects.

Table: medications prescribed for digestive disorders during pregnancy

Excessive drooling can lead to dehydration, as a result of which the pregnant woman is hospitalized in the intensive care unit in order to stabilize her condition and prescribe adequate therapy.

It should be noted, which is the true cause of toxicosis today, so obstetricians-gynecologists have to carry out symptomatic treatment.

In this case it is assigned Cerucal.

Information about the drug

Cerucal belongs to the group antiemetic drugs, which blocks receptors in the stomach and duodenum that transmit signals to the vomiting center, which is located in the brain.

As a result of this blockage, the brain does not receive signals to vomit, and food can pass normally through the intestines.

Cerucal also promotes the rapid passage of food through the gastrointestinal tract and normalizes intestinal function.

Cerucal Available in tablet form, which are intended for oral administration, and in the form of a solution for injection.

The drug is metabolized in the liver, the half-life of cerucal is 3-5 hours, while in chronic renal failure this period increases to 15 hours.

In the form of metabolites, it is excreted by the kidneys within 24 hours. Penetrates the blood-brain barrier and is excreted in mother's milk during breastfeeding, which is why its use is prohibited when breastfeeding children under 2 years of age.

Indications for use

Indications for taking Cerucal during pregnancy they serve:

• nausea and vomiting;
• hiccups of various origins (with the exception of hiccups caused by disturbances in the functioning of the vestibular apparatus);
• disturbance (in this case, weakening) of the motor activity of the intestines, stomach and bile ducts;
• stomach cramps, inflammation of the esophagus, which are constantly accompanied by regurgitation of food (so-called reflux esophagitis).

Contraindications

Contraindications Instructions for taking Cerucal during pregnancy include:

• bleeding of the gastrointestinal tract;
• perforation of the wall of both the intestines and stomach;
• adrenal tumors;
• convulsions;
• some types of hormonal tumors;
• increased intraocular pressure;
• obstruction of the gastrointestinal tract.

Overdose and side effects

TO overdose symptoms Cerucal during pregnancy should include:

• drowsiness and confusion;
• anxiety and ;
• extrapyramidal disorders and seizures;
• bradycardia and arterial hypotension;
• in rare cases, arterial hypertension is observed.

Usually, the listed symptoms disappear within 24 hours after stopping the drug. For now no fatal cases of Cerucal overdose during pregnancy have been identified. Treatment for overdose is symptomatic.

Side effects cerucala during pregnancy boil down to:

• agranulocytosis;
• supraventricular;
• hypotension or hypertension;
• extrapyramidal disorders (rhythmic twitching of the tongue, spasms of the facial muscles, spasmodic torticollis);
• feeling tired;
• feeling of fear, anxiety;
• , drowsiness;
• tinnitus.

Features of using the drug during pregnancy

It should be noted that the appointment of Cerucal during pregnancy not advisable, especially in the first trimester of pregnancy, since the drug has a teratogenic effect (causes fetal malformations).

It is prescribed only for strict indications and only by an obstetrician-gynecologist, when the positive effect of the drug exceeds the possible side effects.

In addition, during pregnancy, a woman’s uterus is in constant hypertonicity, so taking the drug can provoke.

There are often cases when women learn about such a drug and begin to take it on their own without first consulting with their doctor, which leads to serious consequences.

In the 2nd and 3rd trimesters of pregnancy the drug is prescribed only for health reasons.

But even during this period, the prescription of the drug fraught with complications, since Cerucal promotes the production of adrenal hormones, which retain fluid and salts in the body, as a result of which the course of toxicosis can be complicated or provoke its development.

Dosage of Cerucal selected based on creatinine clearance. If its value is less than 10 ml/min, then the drug is prescribed 10 mg 1 time per day. If this indicator is 11-60 ml/min, the dose of the drug is 15 mg, which must be divided into two doses (10 and 5 mg).

Average therapeutic dose Cerucal is 0.1 mg per 1 kg of body weight.

In the early stages of pregnancy, women experience not only the joy of upcoming motherhood, but also manifestations of toxicosis - nausea, vomiting, and general weakness. The severity of such symptoms varies: from mild, when water with lemon and mint helps, to severe, which requires medical attention, including hospitalization. Cerucal during pregnancy is prescribed only in extreme cases when toxicosis threatens the safety of the fetus and the life of the mother.

The main provocateurs of attacks of nausea and vomiting are changes in hormonal levels and the influence of fetal secretions. By the end of the first trimester, the placenta matures, and toxicosis goes away on its own. That is why the question of whether Cerucal can be taken during pregnancy is most relevant before the 12th week.

Cerucal is a drug that has an antiemetic effect. Its effectiveness is due to the presence of metoclopramide hydrochloride monohydrate. After entering the body, it blocks the functions of dopamine receptors and reduces the susceptibility of the nerve endings of the mucous membrane of the stomach and duodenum.

Information about the intake of food is not transmitted to the centers of the brain, and therefore there is no feedback - a command to contract the muscular walls of the organs. As a result of this mechanism of action, nausea, vomiting are prevented, and hiccups are also eliminated.

Cerucal is produced in the form of tablets and solution for intramuscular and intravenous injections. The choice of method of application is selected by the doctor individually and depends on the characteristics of the woman’s body. The cost of one package of tablets (10 mg, 50 pcs.) is about 150 rubles, ampoules (10 mg, 10 pcs.) - about 250 rubles.

Indications and contraindications

Cerucal during pregnancy is used to eliminate the manifestations of toxicosis. It is also indicated if the patient has attacks of vomiting and nausea of ​​various origins, decreased tone (or its complete absence) of the muscles of the stomach and intestines.

The drug helps to cope with the manifestations of reflux esophagitis, gastric paresis due to diabetes, functional stenosis and narrowing of the pylorus, as well as impaired motility of the gallbladder and its ducts (dyskinesia).

In tablet form, Cerucal is prescribed if nausea and vomiting are caused by motion sickness in transport or taking medications. The drug enhances the peristalsis of the digestive organs and is therefore used before some diagnostic procedures.

Cerucal has a number of contraindications. Its use is prohibited for the treatment of patients with pheochromocytoma, intestinal obstruction, bleeding or perforation in the gastrointestinal tract, prolactin-dependent tumor, epileptic seizures and extrapyramidal motor disorders.

The drug should not be prescribed to pregnant women in the first 12 weeks, nursing mothers, children under 2 years of age, as well as people with hypersensitivity to metoclopramide and sodium sulfite (injection form).

For some concomitant diseases of internal organs, taking Cerucal is possible only under medical supervision. It is used with caution in pediatric practice (up to 14 years).

Is it possible to use Cerucal during pregnancy?

In special cases, Cerucal may be prescribed during pregnancy; the instructions for use prohibit its use only in the first trimester.

The drug has a teratogenic effect, that is, it can cause malformations in the fetus. Its use is justified only in cases where the expected benefit outweighs the risk of side effects.

Only a doctor can correctly assess the condition of the expectant mother and the need to take Cerucal. During the course of treatment, it is necessary to periodically inform him about his health; at the first signs of deterioration, the drug will need to be discontinued.

Unfortunately, sometimes, having learned about the effectiveness of Cerucal, pregnant women begin taking it on their own. This leads to serious complications, including increased symptoms of toxicosis.

Instructions for the drug during pregnancy

During pregnancy, the dosage of Cerucal and methods of application are determined by an obstetrician-gynecologist. As a rule, it does not differ from that recommended for the treatment of other groups of patients.

When the symptoms of toxicosis are severe, but vomiting occurs periodically and not constantly, Cerucal is used in tablet form. The active substance begins to act within half an hour. The duration of treatment can be from 4 to 6 weeks. Prescribed 1 tablet 3-4 times a day.

You need to take the medicine half an hour before meals with water. Milk, tea or other drinks can reduce the healing effect . If activated charcoal is prescribed along with Cerucal, then their administration should be separated in time, a break of at least an hour is necessary (Cerucal first, activated charcoal an hour later, or vice versa).

When toxicosis is acute and it is necessary to immediately stop vomiting, Cerucal is used as an injection. The therapeutic effect appears after 3 minutes when administered intravenously, after 15 minutes when administered intramuscularly. A single dose should not exceed 2 ml of solution; up to 25 ml can be administered per day.

Risks and consequences of taking during pregnancy

Cerucal during pregnancy is always prescribed with extreme caution; the consequences of taking this drug can affect both the condition of the mother and the development of the fetus. In the early stages, this drug is prohibited, since the risk of complications is high; in the second and third trimesters it becomes relatively safe.

One of the actions of Cerucal is to enhance peristalsis of the gastrointestinal tract. In the early stages of pregnancy, this effect can lead to miscarriage due to the spread of hypertonicity to the muscular walls of the uterus.

This threat exists throughout the entire period of bearing a child, therefore, even in subsequent trimesters, Cerucal is prescribed only as a last resort.

Under the influence of Cerucal, the pituitary gland begins to intensively produce prolactin, a hormone that promotes the production of breast milk and the contraction of the walls of the uterus. But if early toxicosis is severe, nausea and vomiting quickly worsen the general condition of the pregnant woman, and dehydration develops.

All this in itself can cause increased muscle tone of the uterus. Often, due to toxicosis, a woman cannot drink or eat; the lack of nutrients and fluid has a detrimental effect on the condition of the fetus. In such cases, taking Cerucal is justified.

In the second and third trimesters, the use of Cerucal is safer, since the threat of miscarriage is noticeably reduced.