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Dublin: 4 °C Thursday 24 January, 2019
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Concerns raised over morning sickness medication being sold to women online

There have been calls for the drug, which can cost up to €3,000, to be made available to women with a medical card.

Image: Shutterstock/SpeedKingz

THE HEALTH MINISTER has been called on to urgently consider extending the availability of a morning sickness drug to those with a medical card. 

Fianna Fáil Seanad Spokesperson on Justice, Children and Youth Affairs, Senator Lorraine Clifford-Lee said Cariban, a drug prescribed for Hyperemesis Gravidarum, a condition that causes extreme morning sickness in some women during pregnancy, should be available under HSE schemes in Ireland.

With the drug costing between €1,500 and €3,000, the senator said she is also extremely worried about seeing the medication being sold online. 

Between one in every 100 and one in 200 women suffers from severe vomiting, known as Hyperemesis Gravidarum or HG, which can profoundly debilitate women.

The condition got a lot of attention when Kate Middleton was expecting her first child. Her condition was so severe it resulted in her hospitalisation.

While many women suffer from regular morning sickness (which can actually occur at any time of the day) HG is a lot more serious.

Hyperemesis gravidarum 

If you’re suffering from HG, you’ll probably find you struggle to keep anything down.

The HSE states the symptoms of hyperemesis gravidarum include:

  • prolonged and severe nausea and vomiting
  • dehydration
  • ketosis - a serious condition that is caused by a raised number of ketones in the blood; ketones are toxic (poisonous) acidic chemicals
  • body weight loss
  • low blood pressure (hypotension) when standing up

In addition, the symptoms can have a significant effect on a woman’s life and may lead to further complications, such as depression.

Senator Clifford-Lee said pregnancy is not always a pleasant time for women, adding that is can be debilitating for many – particularly where there is a diagnoses of HG. 

“Cariban is an effective drug prescribed to counter the desperate symptoms caused by the condition but unfortunately it is unavailable to women under any scheme in Ireland – general medical services, the drugs payment scheme or the long-term illness scheme,” said the senator. 

Cost of Cariban

She added that those without the means or health insurance are being forced to pay full price for the drug, which can range from between €1,500 to €3,000.

“The cost of the drug itself combined with potential hospital admissions to receive IV fluids is substantial, particularly while trying to save for the arrival of a newborn,” she said, adding that she has come across the drug being sold online. 

“Such is the expense of this drug, I have previously come across an online advert on a well-known Irish website attempting to sell two boxes of the medication for a knocked down price. Expecting women to turn to online advertisements to be able afford essential medication while suffering is downright unacceptable,” she said. 

The senator pointed out that the HSE’s own clinical practice guidelines for treatment of HG states that if there are no improvements following a number of recommended treatments or therapies, then Cariban should be prescribed.

“This drug may not be suitable to relieve the symptoms for every woman in pregnancy but surely it’s a game changer for those it does work on,” she said, adding: 

Despite our own national Health Service Executive acknowledging the importance of this drug, the Minister confirmed this month that Cariban is not licensed as a medicine in Ireland.
While I’m aware that some consultant obstetricians and maternity hospitals do dispense this medication to patients suffering HG in pregnancy, surely if it’s recommended by the HSE it should be covered under the Drugs Payment Scheme.

Getting sick up to 20 times a day 

A number of women previously told TheJournal.ie about their experiences dealing with HG, and how Cariban was the only treatment to work. 

A number of women spoke about the lack of understanding among the medical profession about HG, with many women stating they felt “unsupported, extremely sick and quite down”.

One woman described how she was admitted and readmitted to hospital, getting sick up to 20 times a day, while another said when she presented to hospital she was sent home with no help. 

Another said her doctor told her to eat cold milk and Rice Krispies during her pregnancy. Later, when she presented to Holles Street Maternity Hospital emergency room, they prescribed Cariban to the woman. 

“It’s an expensive drug, but worth every penny. I took it for many weeks and then tried to come off it thinking I was through it, but as soon as I did the sickness and nausea came back. I went back on the drug and within days was perfect. The drug for me was effective and saved my sanity. I returned to work and got my life back,” she told TheJournal.ie.

Cariban is available in the Coombe, Rotunda and Holles Street maternity hospitals and has been for the four years.

The use of Cariban to treat women 

Dr Mary Higgins from the National Maternity Hospital in Dublin previously told this website that having done training in Canada, she observed that nearly every woman suffering from this condition was on the medicine. 

She explained Cariban, a vitamin B6 antihistamine, was first developed in the 1970s.

However, due to a class-action suit taken in the US in relation to a small number of babies being born with anomalies, and due to the concern at the time in relation to thalidomide scandal, it was taken off the market. She said when this happened, there was a huge rise in the number of women presenting to be admitted.

The practice then was to just admit women and give them IV fluids. However, since the 1980s, there has been a large amount of research carried out on the drug.

“It is the most studied pregnancy drug,” said Dr Higgins, adding that studies have been carried out on more than 200,000 women.

She said one published paper on the medicine goes so far as to say that it is now “unethical not to give it to women”, adding that there still is a certain amount of a “put up with it” attitude out there.

“This condition can really make people miserable – it really comes down to quality of life while you are pregnant and some women simply don’t have that when they have this condition.”

The issue of the drug’s availability has been raised in the Dáil previously by Fianna Fáil’s Stephen Donnelly, Billy Kelleher and John Brassil, who called on the government to  remove all costs associated with pregnancy in their totality.

Senator Clifford-Lee said that given this country’s poor record historically in supporting women in pregnancy, it’s both timely and appropriate to make sure that greater resources are provided to support women’s health.  

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