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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.

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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    Mute Frank Dubogovik
    Favourite Frank Dubogovik
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    Oct 6th 2018, 7:33 AM

    anyone else suffering from ” brexit fatigue”…its been non stop in the media for nigh on 2years. every day there’s a new ” angle”…a new “scare” story. The world isn’t going to stop turning in March 2019- deal or no deal.I wonder what’s the media going to be so obsessed with after brexit

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    Mute FartyTowels
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    Oct 6th 2018, 8:24 AM

    @Frank Dubogovik: completely agree. However I want to know will brexit mean that we will once again be able to buy duty free on ferries between Ireland and the UK? Up yours high duty on my beloved vino

    33
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    Mute JustOneScoop
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    Oct 6th 2018, 9:22 AM

    @Frank Dubogovik: no not really.just because your a bot programmed to disperse apathy doesn’t change the fact that brexit is an immensely serious problem for this island. Disperse your apathy elsewhere

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    Mute Frank Dubogovik
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    Oct 6th 2018, 9:59 AM

    @JustOneScoop: ??? whatever morphine or cocaine or whatever you’re on there lad you need to check the doses. I’m a “bot”…wtf is that that supposed to mean??

    9
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    Mute Tweed Cap
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    Oct 6th 2018, 7:25 AM

    The product will still be there. It just might (or not) be subject to a customs check, like 100% of all other non EU goods that come through Irish & European Ports.
    The way some people are going on you’d swear the Brits were intent on rolling up their country like a carpet and moving it to the Southern Hemisphere.
    After next March, they’ll still be right next door, doing fine and getting on with life. And all the disappointed drama junkies will find something else to fret about. Somebody rightly compared all this hysterical carry on to the millennium bug nonsense.

    54
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    Mute Greg Blake
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    Oct 6th 2018, 9:21 AM

    @Tweed Cap: of course it’ll be there. The very reason the world will not come to a grinding halt is that these things are being put out there, now, by organisations such as this. So their concern is that it will be business as usual for most of them providing the bureaucrats do their thing in the background. ‘It’ll be alright on the night‘ requires the backstage staff to be on the ball.

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    Mute JustOneScoop
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    Oct 6th 2018, 9:22 AM

    @Tweed Cap: bot alert . Incoming

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    Mute John Horan
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    Oct 6th 2018, 10:47 AM

    @Tweed Cap: Incorrect. You cannot import whatever you like from the rest of the world into the EU. There are restrictions on certain items coming into the EU but if they are produced in the EU they circulate freely. Additionally the items that get imported to the EU are subject to duties and taxes that make them more expensive. Remember that bit where the customs check your luggage to see what you bought on your shopping trip to NY and if you have certain stuff you get a big bill? Like that but worse

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    Mute wattsed
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    Oct 6th 2018, 11:39 AM

    @Tweed Cap: Agreed. You would think there will be folks watching Sky News at midnight on the night waiting for the country to disappear into a large sinkhole or at best for the UK to be plunged into darkness and wiped out with the plague.

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    Mute eastsmer
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    Oct 6th 2018, 7:04 AM

    Another thing that a United Ireland will solve

    43
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    Mute Michael Kavanagh
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    Oct 6th 2018, 7:09 AM

    @eastsmer: Relactification!

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    Mute Helen O'Neill
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    Oct 6th 2018, 7:55 PM

    Hopefully won’t become an issue as they do incredible work in the milk bank! Such an amazing thing to do m, if you can. I donated almost 6L about2.5 years ago and it’s so lovely to hear back how many babies got your milk and a little broach as a keepsake. Amazing work up there!!

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    Mute Johnny Mason
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    Oct 6th 2018, 8:02 AM

    We survived before without it I am sure we can do it again !

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    Mute AnneMarie Roche
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    Oct 6th 2018, 8:54 AM

    @Johnny Mason: The point is that vulnerable premature babies don’t survive without breast milk. Options of feeding this population is mothers breast milk, donated milk, TPN (nutrition delivered via its veins)-in that order. Mothers supply is often affected by the stressful situation she finds herself in and donated milk is required.

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    Mute Johnny Mason
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    Oct 6th 2018, 12:59 PM

    @AnneMarie Roche: Yes but we don’t need to make a Industry about it and worry ourselves to death !

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    Mute AnneMarie Roche
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    Oct 6th 2018, 10:24 PM

    @Johnny Mason: Tell that to the parents of a premmie born at 24weeks. Just because it doesn’t affect you directly doesn’t make it unimportant. And the Republic could do with “making an industry ” of it, we spend alot of money buying it from the north.

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