Abstract
Purpose
Hyperemesis gravidarum is the third leading cause of hospitalization during pregnancy. 5-HT3-receptor antagonists are the most effective against chemotherapy-induced nausea and vomiting and radiation. This randomized study aimed to compare and evaluate the efficacies of granisetron and promethazine for controlling nausea and vomiting of pregnancy.
Methods
The included patients were administered (oral and intravenous) granisetron and promethazine randomly. The patients were evaluated for nausea and vomiting by a senior gynecology resident blinded to designated drugs.
Results
This study revealed that granisetron significantly decreased nausea and vomiting in pregnant women (p < 0.05). Greater patient satisfaction and lesser adverse drug reactions in women receiving granisetron observed in this study suggest that it can be introduced as a more effective and safer drug in comparison with promethazine.
Conclusions
Considering the prevalence of nausea and vomiting of pregnancy and hyperemesis gravidarum, we can state that it is a health-related problem with economic, social and psychological dimensions. All efforts especially simple outpatient strategies to reduce its severity will help the pregnant woman continue her pregnancy with more satisfaction.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Badell ML, Ramin SM, Smith JA. Treatment options for nausea and vomiting during pregnancy. Pharmacotherapy. 2006;26(9):1273–87.
Bottomley C, Bourne T. Management strategies for hyperemesis. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009;23:549–64.
Tan PC, Khine PP, Vallikkannu N, et al. Promethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. 2010;115(5):975–81.
Goodwin TM. Nausea and vomiting of pregnancy. OBG Manag. 2004;16:54–67.
Ebrahimi N, Maltepe C, Garcia Bournissen F, et al. Nausea and vomiting of pregnancy: using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) scale. J Obstet Gynaecol Can. 2009;31(9):803–7.
Hsu ES. A review of granisetron, 5-hydroxytryptamine3 receptor antagonists, and other antiemetics. Am J Ther. 2010;17(5):476–86.
Board T, Board R. The role of 5-HT3 receptor antagonists in preventing postoperative nausea and vomiting. AORN J. 2006;83(1):209–20.
Einarson A, Maltepe C, Navioz Y, et al. The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study. BJOG. 2004;111(9):940–3.
Tincello DG, Johnstone MJ. Treatment of hyperemesis gravidarum with the 5-HT3 antagonist ondansetron (Zofran). Postgrad Med J. 1996;72(853):688–9.
Barrett TW, DiPersio DM, Jenkins CA, et al. A randomized, placebo-controlled trial of ondansetron, metoclopramide, and promethazine in adults. Am J Emerg Med. 2011;29:247–55.
Ferreira E, Gillet M, Lelièvre J, et al. Ondansetron use during pregnancy: a case series. J Popul Ther Clin Pharmacol. 2012;19(1):e1–10.
Bhatnagar S, Gupta D, Mishra S, et al. Preemptive antiemesis in patients undergoing modified radical mastectomy: oral granisetron versus oral ondansetron in a double-blind, randomized, controlled study. J Clin Anesth. 2007;19:512–6.
Contreras-Dominguez V, Carbonell-Bellolio P. Prophylactic antiemetic therapy for acute abdominal surgery. A comparative study of droperidol, metoclopramide, tropisetron, granisetron and dexamethasone. Rev Bras Anestesiol. 2008;58:35–44.
Gan TJ, Candiotti KA, Klein SM, et al. Double-blind comparison of granisetron, promethazine, or a combination of both for the prevention of postoperative nausea and vomiting in females undergoing outpatient laparoscopies. Can J Anesth. 2009;56:829–36.
McCarthy FP, Khashan AS, North RA. A Prospective Cohort study investigating associations between Hyperemesis Gravidarum and cognitive, behavioural and emotional well-being in pregnancy. PLoS One. 2011;6(11):e27678.
Acknowledgments
The authors would like to thank the Aburaihan Pharmaceutical Company for their support to this study. Furthermore, we also wish to thank the nursing staff of the Gynecology ward, who kindly participated in our study.
Compliance with Ethical Requirements and Conflict of Interest
The authors also state that the protocol for the research project has been approved by a suitably constituted Ethics Committee of the institution within which the work was undertaken and that it conforms to the provisions of the Declaration of Helsinki (as revised in Tokyo 2004). We state our study does not violate the policies and/or procedures established by journals such as those described in “Specific Inappropriate Acts in Publication Process”. The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Additional information
Ashraf Aleyasin is a Professor in Tehran University of Medical Sciences, Tehran, Iran; Elham Saffarieh is Ob/Gyn Specialist in Tehran University of Medical Sciences, Tehran, Iran; Atossa Mahdavi is Professor Assistant in Tehran University of Medical Sciences, Tehran, Iran.
Rights and permissions
About this article
Cite this article
Aleyasin, A., Saffarieh, E., Torkamandi, H. et al. Comparison of Efficacy of Granisetron and Promethazine in Control of Hyperemesis Gravidarum. J Obstet Gynecol India 66, 409–414 (2016). https://doi.org/10.1007/s13224-015-0709-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13224-015-0709-6