Zofran question

[silverspoon]

I'm sort of curious about this myself.

I wanted to try to avoid taking anything, but if they just offer me up a Rx I'll probably fill it because this has just been so miserable. It's all day all the time nausea. I don't throw up as much as the first day so that's been a relief.

I wonder if this is standard practice. I've always been one to just say everything's fine to the doctor. It's probably just dependent on your practices policy, but I'm curious as to how common it is.

[itsmeally]

I think it's just that particular provider's preference. Maybe she would rather you have the script and "use it if you need it" rather than calling her in desperation from the toilet?

Shrug.

[itsmeally]

May 17, 2015 12:43:29 GMT -5 @loonylove said:

May 17, 2015 12:11:35 GMT -5 itsmeally said:

I think it's just that particular provider's preference. Maybe she would rather you have the script and "use it if you need it" rather than calling her in desperation from the toilet?

Shrug.

I get the preemptive aspect, but I won't ever see her again, because she doesn't even work in the OB department.

If it was actually the OB or nurse from the OB office, it would be less odd to me.

If she's not in an OB specialty, maybe she doesn't realize it's not super common practice to RX zofran from the get go. She probably thought she was just being helpful.

[icequeen]

It seems like it isn't as common as I first believed. My OB doesn't prescribe it unless you are vomiting every day with it interfering with your routine, and you are losing weight as a result. I do know that the women who have taken it usually only need it for a few weeks and it is very helpful, but my own preference is to not take any meds unless they are deemed necessary by my psych. I find it a little strange that she wanted to give it to you so early without you even seeing the OB. I don't think that is all too common.

[Sparkly]

May 17, 2015 12:11:35 GMT -5 itsmeally said:

I think it's just that particular provider's preference. Maybe she would rather you have the script and "use it if you need it" rather than calling her in desperation from the toilet?

Shrug.

I agree with this, though it seems like in your situation maybe a little odd. I was a little surprised the NP at my appointment offered it so readily as soon as I mentioned nausea, but she's a provider I could see regularly if I chose and I was planning on asking for it anyway, so meh.

For me zofran is absolutely necessary. I wish it weren't, but I'm at the point of barely functioning already. I didn't want to take it last time and suffered through weeks of feeling awful, thinking it wasn't "that bad," until I got to the point of not keeping anything down for days...then it was desperation which got me the script and it took awhile for me to recover. So, hindsight being 20/20, I'd take it and just don't take it if you don't need it (hopefully)!

[wholenewworld]

I think that is very strange considering the American College of OB/GYN recommends vitamin B6 and doxylamine as first line drug therapy for nausea and vomiting in pregnancy.

[valie]

May 17, 2015 17:51:13 GMT -5 wholenewworld said:

I think that is very strange considering the American College of OB/GYN recommends vitamin B6 and doxylamine as first line drug therapy for nausea and vomiting in pregnancy.

This. I have started taking my Diclectin. If my MS is as bad as last time I'm going to need Zofran eventually, but my HCP and I agree that it comes after a max dose of Diclectin (B6 and doxylamine) isn't enough.

[itsmeally]

May 17, 2015 19:06:54 GMT -5 valie said:

May 17, 2015 17:51:13 GMT -5 wholenewworld said:

I think that is very strange considering the American College of OB/GYN recommends vitamin B6 and doxylamine as first line drug therapy for nausea and vomiting in pregnancy.

This. I have started taking my Diclectin. If my MS is as bad as last time I'm going to need Zofran eventually, but my HCP and I agree that it comes after a max dose of Diclectin (B6 and doxylamine) isn't enough.

Just wanted to say I agree with you guys as zofran not being first line for MILD pregnancy induced nausea/vomiting. BUT, (I'm just playing devil's advocate), she said this lady was NOT her OB.  Sounds like she went to her PCP first so she could be referred to an OB.  As an NP myself, sometimes I have ZERO clue what will happen to the patients after I see them. Will they truly follow up with OB?  I have seen MANY MANY women go in for "verification" and then never get any more pre-natal care.  This NP could have just been doing everything for you, JUST IN CASE you couldn't get in with your OB right away and had awful nausea/vomiting, or, just plain decided never to seek any more pre-natal care.  She could just be looking out for you. I DON'T KNOW, but I'm trying to see it from her perspective. Also, Zofran is a category B, which means it is just as safe as Tylenol (acetaminophen) in pregnancy.  So, anyone with Zofran prescriptions, don't feel bad/guilty taking it.  It's a good drug and it works. Usually.

[wholenewworld]

May 17, 2015 19:16:35 GMT -5 itsmeally said:

May 17, 2015 19:06:54 GMT -5 valie said:

This. I have started taking my Diclectin. If my MS is as bad as last time I'm going to need Zofran eventually, but my HCP and I agree that it comes after a max dose of Diclectin (B6 and doxylamine) isn't enough.

Just wanted to say I agree with you guys as zofran not being first line for MILD pregnancy induced nausea/vomiting. BUT, (I'm just playing devil's advocate), she said this lady was NOT her OB.  Sounds like she went to her PCP first so she could be referred to an OB.  As an NP myself, sometimes I have ZERO clue what will happen to the patients after I see them. Will they truly follow up with OB?  I have seen MANY MANY women go in for "verification" and then never get any more pre-natal care.  This NP could have just been doing everything for you, JUST IN CASE you couldn't get in with your OB right away and had awful nausea/vomiting, or, just plain decided never to seek any more pre-natal care.  She could just be looking out for you. I DON'T KNOW, but I'm trying to see it from her perspective. Also, Zofran is a category B, which means it is just as safe as Tylenol (acetaminophen) in pregnancy.  So, anyone with Zofran prescriptions, don't feel bad/guilty taking it.  It's a good drug and it works. Usually.

Thanks for that perspective! That is a sad truth that some women do not end up with prenatal care for whatever reason.
Not anti-zofran, but as with any drugs the risks vs benefits must be weighed. I just don't like blanket prescribing in a woman not even experiencing symptoms, especially when non-pharmacological or first line alternatives have not been discussed or tried first.