– This has been called for for a long time. Nausea of pregnancy is very common, reduces the quality of life for women and often results in sick leave. Getting a safe medication can make many pregnant women feel better. That’s what Jone Trovik wrote to news. She is a specialist in obstetrics and women’s diseases, senior physician at Haukeland University Hospital and professor at the University of Bergen. In January, the pharmaceutical company Xonvea became available in Norway. It is the first time that a drug designed for pregnancy sickness has become available in the country. One of those who has struggled with pregnancy sickness is Ida Kristin Dølmo (34) from Bodø. She suffered through nine months of extreme pregnancy sickness during both of her pregnancies. – It was absolutely terrible to be pregnant, from start to finish. I was nauseous before I knew I was pregnant, and it lasted until the day I gave birth, she told news in 2018. – Worst thing I’ve experienced in my life When it was at its worst, she had thrown up twelve times before the clock was 14. Three years later she became pregnant again. – When the test showed positive, I felt a joy mixed with horror and was very afraid of going through the same thing again. Ten days later I threw up and immediately went to the basement, she says today. Dølmo tried both Afipran, Stemetil and Phenergan, but it was only Zofran that gave her an effect. She was still nauseous, but not throwing up as much as before. Ida Kristin Dølmo and Magnus Kvarsnes Steinbakk right after they found out they were going to have another child. Ten days later Dølmo threw up and went to the cellar. Photo: Elise Pedersen / news – I was completely useless as a mother, roommate and colleague and had to go on sick leave from week six. The nausea went away the day I gave birth, and I will never get pregnant again. It’s the worst thing I’ve experienced in my entire life, she says. According to the Health Library, as many as eight out of ten pregnant women suffer from nausea, and half of all pregnant women vomit. Pregnant women have previously had access to anti-nausea drugs, but these medicines have not been approved for pregnancy nausea, Trovik says. Two out of five have considered abortion One of the most common drugs used against nausea of pregnancy is Metoclopramide, also known as Afipran. There is a warning against using it for more than five consecutive days due to the risk of side effects. Senior doctor Jone Trovik at Haukeland University Hospital’s women’s clinic. Photo: Anne Sidsel Herdlevær / UiB – Studies have shown that in the year Afipran was restricted in use, an increase in the number of women hospitalized with extreme nausea of pregnancy who ended their pregnancy, Trovik says. Xonvea has been possible to use in the past, but then with registration measures. – It had to be ordered in at individual pharmacies, and that is cumbersome. This meant that not all GPs took the time to do so, writes Trovik. In the case of extreme nausea of pregnancy, the woman usually has to go to hospital. Two out of five women have considered abortion because of such nausea, showed a national study in 2019 carried out by Relis and the universities in Oslo and Bergen. Extreme nausea of pregnancy Extreme nausea of pregnancy, hyperemesis gravidarum, is a condition characterized by severe nausea and vomiting to such an extent that the general condition is affected. The vomiting can create fluid and electrolyte changes (changes in the concentration of salts in the blood), which in turn explains the general effects. A widely used definition is nausea and vomiting before the 20th week of pregnancy, and which leads to more than 5 percent weight loss compared to the weight before the pregnancy started, detection of ketones in the urine and dehydration, as well as fluid and electrolyte disturbances. The extreme nausea usually improves later in the pregnancy. Hyperemesis gravidarum was previously associated with severe morbidity and in some cases death in the mother. Correct fluid supply and nutrition directly in the blood mean that morbidity is now much lower, and mortality is close to zero. Source: Norwegian health informatics Xonvea is used for normal pregnancy sickness, but will still also be used for extreme pregnancy sickness together with other medicines. – My hope with having Xonvea formally approved is that more women who need treatment for pregnancy sickness will actually receive it. I also hope that such necessary use will hopefully prevent the nausea from becoming so severe that she has to go to hospital, says Jone Trovik. For now, Xonvea is not subject to a blue prescription. This means that pregnant women must pay NOK 300 for 20 tablets. – My concern is that someone cannot afford to use the drug for a long time, as it is not approved on a blue prescription. Do not dare to take medicine for nausea According to a study from 2016, discussed at Forskning.no, there are several pregnant women who do not dare to take medicine for nausea. As many as one in three with severe nausea who took part in the study refused to take medication. Most of the women stated that they had a higher threshold for using medicine during pregnancy, and that they were anxious about how the medicine would affect the foetus. Nevertheless, Trovik and senior physician in the Norwegian Medicines Agency, Ingrid Aas, assure that it is safe to use Xonvea. Senior physician in the Norwegian Medicines Agency, Ingrid Aas. Photo: Caroline Roka / Statens Legemiddelverk – Xonvea is a combination preparation of vitamin B6 and antihistamine. A very common side effect is fatigue. Other common side effects are dizziness and dry mouth, says Aas. Xonvea has been used in, among other places, the USA, Canada and the UK for several years. – In other countries, the drug combination has been approved since the 1960s. No risk of birth defects has been observed, underlines Trovik. Thalidomide Thalidomide is a drug that was sold in the late 1950s and 1960s as a sleeping aid and to pregnant women to relieve morning sickness. After a while, it was discovered that the medicine was very harmful to the fetus, which was either stillborn, or born with major deformities. The most common was missing or short arms and legs. Thalidomide is now banned for its original intended use, but the drug has proven effective in the treatment of other diseases. The Norwegian Women’s Health Association says that drug use during pregnancy has long been a focus area for them, especially because many women are restless. – Many remember the scandal surrounding Thalidomide. That we have now received a publicly approved drug is good news for the women who suffered, says special adviser for women’s health, Elisabeth Torstensen Svärd. Xonvea is intended to help women with moderate to severe complaints. – For the milder forms of pregnancy sickness, we more often give advice on diet and lifestyle measures, says Aas in the Norwegian Medicines Agency. Lifestyle and diet advice for pregnant women Make sure you drink plenty of fluids, a total of 2 litres, or around 8 glasses. Eat some food regularly, preferably every 1-2 hours, so that your stomach is never completely empty. Try with dry biscuits, toast and the like. The nausea is often worst on an empty stomach. If you feel nauseous in the morning, try to eat a little before you get up. Try to get some rest. It can improve nausea. Try to avoid: Fatty foods Strongly spiced foods Caffeinated drinks The advice should also be followed even if you are using medication for pregnancy sickness. Other advice is to get ginger, vitamin B6, or to try acupressure. Contact a doctor if the advice does not help, you think you need anti-nausea drugs, you are losing weight because you are not getting enough nutrition, or you have signs of dehydration (dizziness, dry mouth, chapped lips and small, dark urine). Source: The Health Library
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The drug Xonvea for pregnancy sickness approved in Norway – news Rogaland – Local news, TV and radio
