Metoclopramide pretreatment attenuates emergency contraceptive-associated nausea

Objective: The study was undertaken to determine whether metoclopramide pretreatment attenuates side effects associated with high-dose estrogen/progestin emergency contraception in at-risk patients. Study design: This was a randomized, prospective, double-blind, placebo-controlled study at the University of Kansas. Patients (141) requesting emergency contraception and lacking contraindications were offered entry in the study. Both the treatment (metoclopramide 10 mg) and placebo groups received active emergency contraception. Participants evaluated symptom severity with a 12-question survey tool developed for this study. Results: Metoclopramide pretreatment provided protection against nausea and cramping associated with estrogen/progestin emergency contraception. The average scores on a 10-point scale for the treatment group and placebo group were as follows: nausea 3.2 versus 4.8 (P= .01) and cramping 0.9 versus 2.2 (P< .01), indicating less severe nausea and cramping in the treatment group. Conclusion: Metoclopramide pretreatment attenuates the nausea and cramping associated with Yuzpe emergency contraceptive treatment. (Am J Obstet Gynecol 2003;188:330-3.)