Mechanism information is still being processed. Check the DailyMed link in the sidebar for the official prescribing information.
Dosing & administration
Dosing varies by indication and patient profile. Always follow your institution's current prescribing guidelines.
Renal impairment
Consult protocols for adjustment.
Liver impairment
Consult protocols for adjustment.
Use during pregnancy
1st trimester
Use if first-line options (pyridoxine/doxylamine, ginger, antihistamines) fail. Current evidence does not confirm teratogenicity; residual uncertainty remains for cardiac defects.
2nd trimester
Generally safe. Effective for continued management of HG.
3rd trimester
Generally safe. Monitor neonate for serotonin effects if used at high doses near delivery.
Clinical note
Effective for moderate-to-severe nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG) refractory to first-line agents. Early reports of cleft palate risk (Danish cohort, Pasternak 2010) were not consistently replicated in subsequent larger studies including a 2014 Swedish cohort (>1.8 million pregnancies) which found no significant increase in major malformations. Current consensus supports use when first-line options fail, with shared decision-making in T1. Small signal of cardiac septal defects in some studies has not been confirmed.
Breastfeeding
Likely safe. Monitor infant for sedation and constipation.
