II. Evaluation
- Avoid diagnostic testing in pregnancy
III. Management: First Line Agents
- First: Antacids (may interfere with iron absorption)
- Aluminum hydroxide - Magnesium Hydroxide (Maalox)
- Calcium Carbonate (Tums)
- Next: Gastric mucosa protection or skip to H2 Blocker
- Sucralfate 1 gram PO tid
- Next: H2 Blocking Agents (Avoid Axid or Nizatidine)
- Cimetidine (Tagamet) 400 mg PO bid or qhs
- Ranitidine (Zantac) 150 mg PO bid
- Less known about Ranitidine in pregnancy
IV. Management: Refractory cases
- Metoclopramide (Reglan)
- Avoid Proton Pump Inhibitors (e.g. Prilosec)
- Class C Medication
- Unknown longterm safety
