Pharmacotherapy for heartburn during pregnancy: Safety of reserve drugs


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Abstract

Trials conducted in foreign countries have indicated that histamine H2 blockers (H2B) and proton pump inhibitors (PPIs) are used rarely in pregnancy, even if indicated. Objective. To determine how frequently physicians prescribe H2B and PPIs to pregnant women in the Russian Federation (RF). To analyze regulatory documents for the use of drugs in this group in the RF and to make a systems analysis of the data available in the current literature on their safety during pregnancy. Subjects and methods. 332 therapists and 734 obstetricians/gynecologists were interrogated; the information contained in the Russian clinical guidelines, current manuals for obstetricians/gynecologists, Order No. 572н issued by the Ministry of Health of Russia, and medical use instructions were analyzed. Foreign and Russian articles published in the past decade and found in Pubmed on this topic were reviewed. Results. In heartburn, antacids, PPIs, and H2B are prescribed by 75.4, 6.7, and 6.2%, of physicians, respectively. Russian guidelines draw little attention to the safety of reserve drugs used to treat heartburn. The analysis of the instructions has shown that some manufacturers do not allow use of the drugs of this group during pregnancy. Conclusion. The results of recent trials enable one to consider H2B and PPIs to be rather safe agents during pregnancy; however, their clinical application in the RF is limited by the lack of clear clinical recommendations and inconsistency available in different manufacturers’ instructions.

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About the authors

Natalia A. Chukhareva

Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health Russia

Email: 0330348@gmail.com
Junior Researcher of the Therapeutic Department

Varvara S. Kartseva

Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health Russia

Email: extralab@mail.ru
Junior Researcher of the Therapeutic Department

Roza M. Esayan

Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health Russia

Email: rozaes@mail.ru
PhD, head of the Therapeutic Department

Elena A. Ushkalova

Peoples’ Friendship University of Russia

Email: eushk@yandex.ru
MD, Professor of the department of Basic and Clinical Pharmacology

Olga N. Tkacheva

N.I. Pirogov Russian National Research Medical University

Email: ontkacheva@gmail.com
MD, Professor, Director of Stand-alone structural unit of Russian Gerontology Research and Clinical Center

Alina Yu. Bevz

N.I. Pirogov Russian National Research Medical University

PhD, Researcher, Stand-alone structural unit of Russian Gerontology Research and Clinical Center

Sergey V. Povetkin

Kursk State Medical University

Email: clinfarm@kursknet.ru
MD, Professor, Head of the department of Clinical Pharmacology

Galina V. Chizhova

Institute for Postgraduate Education in Public Health, Ministry of the Health of the Khabarovsk Territory

Email: rec@ipksz.khv.ru
MD, Professor, Rector

Irina A. Panova

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood

Email: ia_panova@mail.ru
MD, head of the Department of obstetrics and gynecology

Roman A. Bontsevich

Belgorod State National Research University

Email: bonts@mail.ru
MD, PhD, assistant professor, Pharmacology department

Nadezhda G. Vinogradova

Nizhny Novgorod State Medical Academy

Email: vinogradovang@yandex.ru
PhD, Assistant, Department of internal diseases

Olga V. Pribytkova

South Ural State Medical University

Email: ovpribytkova@gmail.com
MD, PhD

Yulia V. Feoktistova

Pasific State Medical University

Email: feoktistovauv@gmail.com
MD, PhD, Assistant of Basic and Clinical Pharmacology Chair

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