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To the Editor In the study on the use of metoclopramide during pregnancy and the risk of congenital malformations and fetal death,1 explicit details as to the dosage of metoclopramide were not reported. The only stratification made was women receiving 1 prescription vs 2 or more.
Specifically, information was lacking on the dose and the total amount of metoclopramide to which the fetuses were exposed, along with the duration of exposure and the form of administration. Because these factors can affect the molar concentration and the bioavailability of the drug,2 provision of this information is important to evaluate the actual exposure of the fetuses.
Vrachnis N, Zygouris D, Iliodromiti Z. Fetal Outcomes Associated With Metoclopramide Use in Pregnancy. JAMA. 2014;311(6):623-624. doi:10.1001/jama.2013.285286