Kim Kardashian Advertising Morning-Sickness Pill

Why should we care?

In July 2015, Kim Kardashian faced some backlash after promoting a drug called Diclegis on her Instagram account. Kim, who was pregnant with Kanye West's second child, claims that the drug helps with her morning sickness and is perfectly safe, posing no risk to the fetus.

To be fair, Diclegis--the prescription drug previously sold as Bendectin--is safe and effective; it's pregnancy category A which is the safest rating conferred to drugs.

Lots of pregnant women are prescribed the drug every day and have healthy babies. But in the 1970s, Bendectin was done in by baseless lawsuits and bad PR.

Bendectin and the 1970s Lawsuits

In the 1970s. a mother taking Bendectin had a baby with a heart defect. She sued, and the case was settled out of court. Other mothers who took Bendectin and had babies with birth defects followed suit (pun intended) and also sued the makers Bendectin. Consequently, Bendectin was pulled from the market.

In reality, studies showed that the prevalence of birth defects in children born to mothers who took Bendectin was no greater than the prevalence of birth defects among all children. Of note, after Bendectin was pulled from the market, the number of hospitalizations due to nausea and vomiting doubled.

Diclegis Hits the Market in 2013

In 2013, a Canadian company received FDA approval for Diclegis, an extended-release tablet which, like Bendectin, is composed of pyridoxine and doxylamine.

The FDA cited studies showing that Diclegis was safe and posed no risk to the fetus.

Other than allergy to either pyridoxine or doxylamine, the only other big reason a woman should avoid taking Diclegis is if she's recently been taking monoamine oxidase inhibitors (MAOIs). MAOIs are a type of psychiatric medication used to treat atypical depression and anxiety disorders.

As could probably be expected due to its antihistamine properties, the only adverse effect of Diclegis is sleepiness. Therefore, Diclegis should be taken before you sleep. You shouldn't drive or operate heavy machinery after taking Diclegis.

Diclegis is the only drug approved by the FDA for the treatment of morning sickness. This drug should be prescribed after lifestyle modification fails to relieve first-trimester morning sickness.

Lifestyle Modifications for Morning Sickness

Of note, here are some lifestyle modifications which may reduce the nausea and vomiting of morning sickness:

  • Eating several small meals a day
  • Eating bland food
  • Eating foods low in fat
  • Avoiding foods with strong smells that trigger nausea

Morning sickness typically abates on its own after the first trimester of pregnancy. Thus, after the first trimester of pregnancy, your physician should reevaluate whether you still need Diclegis.

Final Thoughts

Okay, so Diclegis is safe. But even if Kim Kardashian were somehow wrong in plugging the drug, why should we care?

I have nothing against Kardashian, and she's free to advertise, express her opinion or whatever, but why would anyone put stock in her medical advice? She isn't a physician, nurse, or other health care professional with specialized knowledge ... she's a celebrity famous for being a celebrity.

Trusting Kardashian's medical advice reminds me of a Dave Chappelle stand-up routine in which he cautions us to "stop worshipping celebrities so much ... just don't pay attention." He also wondered why the rapper Ja Rule was interviewed by MTV about 9/11.

"I don't want to dance," quipped Chappelle, "I'm scared to death. I want some answers that Ja Rule might not have right now."

If you're interested in linking to the stand-up routine, click here. Be warned, however, this content contains salty language and is NSFW.

Selected Sources

Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Teratology, Teratogens, and Fetotoxic Agents. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. eds. Williams Obstetrics, Twenty-Fourth Edition. New York, NY: McGraw-Hill; 2013. Accessed July 23, 2015.

Krause RS, Janicke DM, Cydulka RK. Chapter 101. Ectopic Pregnancy and Emergencies in the First 20 Weeks of Pregnancy. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011. Accessed July 23, 2015.

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