hg and zofran

[seuttech]

I was wondering if anyone had advice about starting zofran at the first sign of nausea? I have had two
hg pregnancies and this is my third and last. I am about 4 weeks along, confirmed, and I am nauseated but it's not full blown. Is it safe to start zofran now or should I wait until I'm further along and it's worse. Any advice would help.

[carriedodson]

Congratulations! I am on my second pg and am 10 wks pg. I have been on 24 mg zofran since around 4.5 wks. I needed it and it is the one thing that is keeping me going this time. I would start it at the first sign of extreme nausea and or vomiting. Taking it on a schedule is extremely effective in my opinion. I take it at 7 am, 3 pm, and 11 pm. This pg has been drastically different than first and it is because of the higher dose and taking it on a schedule. I refuse to be on a pump and in the hospital with this pg and so far so good. Hope the zofran helps you too!
Carrie

[mammaclare]

If I were ever to get PG again, I don't even know that I would wait for nausea. I think that my plan would be to start B6/Unisom/Zofran immediately. I took the Z from week 7/8-delivery with my son and he is perfect in every way, so I feel safe with it.

I wouldn't wait until I were very sick, as Z works best when you are proactive and hydrated.

All my own opinion, but maybe at least get the script written and filled and sitting by your bed in case it hits like a train at some point and you haven't the energy to call the doc, wait for a call back, have to explain things to an irritating and non-sympathetic nurse, etc (okay, worst case scenario, but I firmly believe in preparing for the worst)!

Congratulations on your pregnancy and I am wishing and praying for you to have an easy time of it!

[seuttech]

Thank you to the both of you who replied. I am calling my doctor today to start on the zofran and the nausea is getting worse but not full blown. I'm going tro get on a schedule and pray for the best. Thanks

[RebeccaM]

I'm copying a reply that Andy wrote to someone else's post that was along these same lines (Andy, I hope that's okay). I think it's a great protocol to follow:

I always recommend trying the Unisom first, for several reasons. Despite how well we all do on Zofran and that there are not signs that it is a risk to our babies, B6/Unisom has actually been tested far longer and is known to be safe for sure. Zofran also brings a nasty side effect of constipation, not fun, and if that can be delayed a bit, all the better.

You indicated that you want to start Zofran or Unisom when the nausea gets really bad. Waiting that long is waiting too long to start anything, because before nausea gets really bad you are already decreasing your solid and liquid intake and then you'd be starting Zofran not fully hydrated, and that is really counterproductive.

The best rule of thumb I have found is to start your next level of proactive planning (do you have a protocol written?) at the first sign of nausea, for example: are on 100 mgs of B6 pre-conception, get pg, slightly nauseas, up B6 to 150 - maxed out. Nauseas a few days later, add 1/2 a Unisom at night. Nauseas again the next day, add 1/2 or 1/4 Unisom in morning, (or you can try 1,000 mgs of powdered ginger root, or you can try Meclizine), nausea held at bay for a few more days, then back, add more of drug of choice, or try adding something new, etc. etc. Always increase or start your next level of proactive fighting at the first sign of nausea that you cannot manage w/ eating or sucking on something. Make sure you are eating small frequent meals, keeping liquids and solids separate. You can follow this proactive plan until you are on the max dose of all of your preferred options and it's just not enough. Sometimes you don't get to that point, and others do, but being proactive means that you will go down that spiral many less times than being reactive to the HG. For some it means IVs before they are super dehydrated, and PICC lines before they've blown all of their veins. Some gals actually avoid IVs or at least PICC lines because of their proactive measures ~ all HGers suffer less fighting proactively.

So, you've already had a little bit of nausea, start Unisom now. Increase as you need according to your nausea up to 3 tabs per day which is the max of Unisom you can be on. If you cannot tolerate Unisom, you'll know right away, and you're early enough it will not effect the HG adversely, and then can explore lesser options to help the Zofran out before you really NEED the help badly. B6 does help w/ the nausea, but the combination is far more effective. I've also seen gals on Zofran still battling horrible nausea at 13 wks add B6/Unisom to their drug routine and recover much more quickly. You have to remember that unless you have an adverse reaction, HG drugs do not tend to "quit working" once they have worked for you, it's that the HG moves up to a level that your drug regimen is not able to handle. If you haven't tried Unisom before, it has such a great history of helping w/ nausea leftover from Zofran, and such a safe rating it's worth seeing if it will be helpful for you. I've seen over and over how lots of little things add up to the best treatment of HG. Zofran is great! I was on it for 31 months, but I had to have the B6/Unisom combo in order to survive as well as I did, and other gals have done well on other combos. It's very uncommon to be able to survive HG on Zofran alone.

Huge hugs, Andy