Try antacids, sucralfate first for gastroesophageal reflux disease. (Few Gerd Drugs Tested in Pregnancy).

LAS VEGAS -- If drug therapy is required in pregnant patients with gastroesophageal reflux disease, first-line treatment should consist of non-systemically absorbed medications like antacids and sucralfate, Dr. Joel Richter said at the annual meeting of the American College of Gastroenterology.

Hardly any of the drugs used to treat gastroesophageal reflux disease (GERD) have been tested in pregnancy, said Dr. Richter, chairman and professor of gastroenterology at the Cleveland Clinic Foundation.

Systemic therapy with [H.sub.2] antagonists or prokinetic drugs like metoclopramide or cisapride should be reserved for patients with severe symptoms. "Metoclopramide does cross the placenta and is excreted in breast milk," he noted. "But there are no teratogenetic effects in animals or in humans. It may be a drug you want to use in the pregnant patient [who presents] with nausea and vomiting."

Ranitidine is one of the few drugs that has been documented to be effective in pregnancy, especially at dosages of 150 mg b.i.d. ...