Pharmacotherapy for heartburn during pregnancy: Safety of reserve drugs

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. © Bionika Media Ltd.