Q: My wife is pregnant and is in the 13th week. She has lot of problems, like she had a miscarriage at seventh month and again at the 4th month. Doctor did some tests and could not find any reason. There were thyroid tests, blood tests, biopsy done and everything was normal. After that we went to another doctor and she did Laparoscopy. She found that her left side of uterus is not fully developed due to that the tube connecting left ovary is also not usable or it is blocked. After that she asked us to go for Artificial insemination and now she got pregnant. But she is suffering a lot as she is having nausea, vomiting sensation all the time. If she gets up from bed, she feels dizzy. Doctor has given some tablets Perinorm CD, Pregnindoxin, Zincovit, Bio-E, Loprin, Folvite, Susten 400 and one injection Profassi 5000 once in 4 days. She is taking all this since she was diagnosed pregnant. My worry is that whether all these medicines are safe in pregnancy. I would also like to know the complications that could happen in this case and the precautions and medication she should take in the due course?

A:Perinorm CD contains metoclopramide. It is not approved for use during pregnancy either in India or in the western countries including USA, Britain etc. I do not know why it was prescribed. Same is the situation with Pregnidoxin that contains meclizine. For nausea and vomiting of pregnancy, the only safe medicine is doxylamine sold under the trade name of Doxinate (dose: 2 tablets at bedtime; if required one in the morning and one in the afternoon). No other drug is allowed to be used for nausea and vomiting of pregnancy. Zincovit contains many vitamins and minerals including vitamin A (5,000 IU). It is not clear as to how many tablets are being taken. In general the use of high-dose vitamin A must be avoided during pregnancy because it can lead to malformations. The use of a multi-vitamin preparation with either no vitamin A or very low-dose is safer such as Vitexid that contains other vitamins except vitamin A. Bio-E contains vitamin E which is also an ingredient of Zincovit. There is no need to taken vitamin E twice. Besides the dose of vitamin E in Bio-E is 200 IU. We recommend low-dose vitamin E. Hence Bio-E can be safely discontinued. Folvite (folic acid 5 mg) must be continued. It is appropriate during pregnancy. Use of Profassi 5000 once every 4 days is essential and appropriate. It is being given due to past history of miscarriages. Susten-400 contains progesterones. It is a useful adjunct to Profassi and is appropriate. In general medicines of reputed, quality-conscious manufacturers should be prescribed and consumed. Every day newspapers are full of stories of sub-standard and fake drugs. Consumers should always go through the ingredients of multi-drug combinations and the accompanying literature.