Nicotine Pregnancy and Breastfeeding Warnings
Nicotine Pregnancy Warnings
Nicotine replacement products have been assigned to pregnancy category C (nicotine gum) and category D (transdermal patches, inhalers, and spray nicotine products) by the FDA. Cigarette smoking is known to cause spontaneous abortion, low birth weight, and increased perinatal mortality, probably due to nicotine and carbon monoxide. Nicotine has been shown to cause adverse fetal outcome in animals when administered in high doses. The use of nicotine replacement products is only recommended for use during pregnancy when the benefit outweighs risk, noting the possibility the patient may continue to smoke while using a replacement product.
According to the manufacturers of Nicorette gum, one to two pieces of 2- or 4-mg gum had less ability than one to two cigarettes to increase fetal blood flow and heart rate and decrease uterine blood flow and fetal breathing movements. One study of 29 pregnant women showed the short-term use of nicotine gum delivered less nicotine than usual cigarette smoking. The manufacturers of Nicoderm transdermal patch state that spontaneous abortion has been reported during use of a nicotine patch.
Nicotine Breastfeeding Warnings
Nicotine is excreted into breast milk with a milk to plasma ratio of 2.9. Nicotine and cotinine have been detected in the serum and urine of nursing infants. The effects in the nursing infant are unknown. The manufacturer recommends that caution be used when administering nicotine to nursing women.
Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Wolters Kluwer Health and Drugs.com is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2008 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.