A message from Kimber:
Hi all.
I know medication safety is of great concern to most mothers, especially first time mothers with HG. A study was done recently on Zofran in children as young as 6 months and found to be effective and safe.
Anti-vomiting drug helps dehydrated kids
Macleans.ca - Thursday June 8, 2006
Ondansetron allows children with an upset stomach to keep fluids down in the emergency department A drug best known for treating chemotherapy-related nausea and vomiting also helps kids keep fluid down after ...
http://www.macleans.ca/topstories/healt ... 22545_5612
When deciding about medications, look at our medication page in the treatment section and you will find links and info on safety and medication usage. Always remember that being sick with HG poses risks to your baby when you are dehydrated, malnourished and very stressed. Zofran and some of the other medications have yet to show any significant risks to the unborn child over the last 15 years of usage. That is not to say there is no risk, but you do have to compare the known risk of being very sick with the benefit of the medications you are given - most of which have no known risks.
We will be publishing results from our research survey which found that women not treated with medications often had more complications or issues with their children than those that were treated. This could support the theory that the risks of HG are greater than the risks of some medications.
Kimber
_________________
Kimber
kimber@HelpHER.org
kimber@hyperemesis.org
HER Foundation Founder
Director of Research & Ed
2 pg w/nine-months of HG each
Mom of two - Conner (1999), Kayleigh (2003)
A must read on Zofran / Unisom / B6
Welcome! This is a post containing information about Zofran/B6/Unisom and a bit more. If you are new to this site, and in the midst of HG, this post is for you.
ZOFRAN Zofran is prescribed in several different forms: Zofran is often prescribed as an oral tablet to be taken by mouth and swallowed in 4 or 8 mgs. Zofran is also available in an Oral Dissolveable Tablet (ODT) - which means it is sublingual, and dissolves in your mouth w/o the need of any liquid to swallow it. It is immediately absorbed into the blood stream, 4 and 8 mgs. Additionally, Zofran can be injected into your IV or PICC line, often in the hospital, but increasingly availably through home health care. Zofran is also available in a subcutaneous pump, which contains a small needle that is inserted barely into the skin, often on the thigh or stomach, and a connected pump ensuring a consistent administration of Zofran. The more direct the route between the medication and your blood stream, the more effective the drug tends to be. In order of effectiveness from least to greatest: Oral, ODT, pump, IV. The biggest adverse reaction to Zofran experienced by HGers here is constipation.
Personally, I took my Zofran around the clock every 6 hours. I was on 16 mgs per day, 4 mgs per dose. I set an alarm at night to wake up during the night, swallow my Zofran, go to the bathroom, eat some graham cracker so my tummy wasn't empty, and then would go back to sleep. Some gals just sleep through the night, and then take it when they get up. It depends on what works better for you, go with your gut feeling - it's usually right. Some women get permission to change their Zofran doses from large occassional doses to smaller more frequent doses. For example, if a woman was on 32 mgs per day, that is 4 different 8 mg doses, each 6 hours apart. Some women react better to 8 doses of 4 mgs each, every 3 hours. Same number of mgs per day, just taken in smaller doses more often. Again, the point is to figure out what works best for you, your HG symptoms, and your pregnancy. Everyone has a slightly different protocol, and regimen that they are ok with.
UNISOM The highest doseage of Unisom is 3 Unisom/day = 75 mgs. There are two types of Unisom on the market. One is the sleep tabs - containing Doxcilimine Succinate. This is the one you DO want. The other is a sleep gel, and contains a different ingredient Diphenhydramine which is also in Benadryl and can also be used for HG, but is not the one used in this protocol. Unisom is a sleep aid, so expect drowsiness, but when taking it at smaller doses, the drowsiness is not so noticeable. Indeed, after several weeks, many HGers report the drowsy effect wearing off, and not being noticeable at all. For comparison purposes, HGers who have taken both Unisom and Phenergan, generally find Unisom to make them much less drowsy.
The limit of 3 Unisom per day is information from Motherisk (a nausea and vomiting support call center in Canada. Phone support is available to the US -
www.motherisk.org - look up morning sickness).
B6 Prolonged useage of B6 at high doses (I think the study was 1,000 mgs a day) can lead to nerve damage. Therefore, Motherisk recommends no more than 150 mgs per day. 200 mgs per day for a month or two is not considered prolonged useage, but they strongly prefer no more than 150 mgs, and recommend that anyone on more than 150 mgs reduce their B6 intake if at all possible. Please remember to include B6 in a B complex Vitamin, or Multi-Vitamin, or Prenatals if you are taking any of them. There are different ways B6 is available. First, it's available over the counter at any grocery or drug store in a tablet, usually 25, 50, or 100 mgs. To save $, buy the 100 mgs, and a pill splitter, as they can be hard to split by hand. B6 must be paired with an enzyme in order to be available for use within the body, and unpaired B6 is just wasted in the urine, so do not take more than 25-50 mgs at a time, and take your doses throughout the day so they are more effectively absorbed. B6 is also available in a sublingual form, which means that it dissolves in your mouth like the Zofran ODT, and is absorbed directly into your blood stream - no water needed. Sublingual is already paired with the neccessary enzyme. Sublingual B6 is available in 25 mgs which also gives you more flexibility in being able to take it as needed. I've heard that the peppermint flavor is preferrable over the orange, and it needs to be special ordered by a health foods store for you, or a vitamin store, or can be purchased on-line. I have tasted the sublingual while pregnant, and found it quite bitter. As long as I didn't move it around too much in my mouth and half-slept through taking it, I was ok. Women who have tasted it NOT pregnant reported no bitter taste. The 3rd form of B6 is referred to as Pyridoxine (B6) Injections. They sting, they hurt, they build scar tissue, but not having any clue about the sublingual B6 when I was pg, I had injections w/ both of mine, and it kept me out of the hospital, and were that last little thing that kept me from going over the edge (in addition to the Phenergan or Zofron/Unisom I was already on). I wonder if sublingual is as effective as the injected, or nearly so, but haven't had that one answered. I do know personally that 100mgs injected was more effective than 200 taken orally. B6 follows the same absorption rules as other meds. Oral least effective, sublingual MUCH MORE effective w/ B6, and injected IM (intramuscularly) is even better. B6/Unisom is more effective taken together, at the same time, but they are individually helpful as well. Some gals do not react well to one or the other, so use them with out the other.
Zofran, though, for most of us is a great vomit handler, unfortunately, it leaves nausea behind. The B6/Unisom for most helps w/ the nausea, and isn't enough for the vomiting - that's why combinations seem to work for so many, because they address different HG issues, even if it's a different combination than Zofran/B6/Unisom. For a few, the Zofran handles nausea, and the vomiting needs to be handled differently (like w/ Meclizine) so be aware that the same medication at the same dose is not equal for all HGers.
Andrea (Andy) - Ivydragon
From Susannah:
I pulled together some information about NJ tubes and PICCs from the threads here. I hope this helps...
Picc pictures thread
http://forums.helpher.org/viewtopic.php?t=7951
NG/NJ tube vs PICC
http://forums.helpher.org/viewtopic.php?t=962
Hydration poll
http://forums.helpher.org/viewtopic.php ... light=picc
PICC line advice from members
http://forums.helpher.org/viewtopic.php ... light=picc
"When to get a PICC" thread
http://forums.helpher.org/viewtopic.php ... light=picc
IV hydration thread
http://forums.helpher.org/viewtopic.php ... light=picc
PICC complication thread
http://forums.helpher.org/viewtopic.php ... viewresult