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Nicotine Pregnancy and Breastfeeding Warnings

Nicotine is also known as: Commit, Habitrol, Leader Nicotine Polacrilex, Nicoderm CQ, Nicorelief, Nicorette, Nicorette DS, Nicotrol Inhaler, Nicotrol NS, Nicotrol TD, ProStep

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.

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