Can I use nicotine replacement products or quitting medications during pregnancy? Quitting medications. Quitting smoking during pregnancy: Compare your options. Nicotine transdermal (OTC) Brand and Other Names: Nicoderm CQ, Nicotrol. Classes: Smoking Cessation Aids. Dosing & Uses; Adverse Effects; Warnings. Other side effects may be withdrawal effects related. It is sensible to limit use of medication during pregnancy. No one knows exactly how many women use nicotine replacement therapy during pregnancy. The prescription medicines bupropion (Zyban) and varenciline (Champix) are not approved for use during pregnancy. Nicotine replacement products. If a women is pregnant or breastfeeding, it is recommended that she first try to quit without the use of nicotine replacement products (nicotine gum, inhalator, lozenges, mouth spray and patch). However, if she is unable to quit without medication, she may use these products to help her quit, after discussing it with the doctor overseeing her pregnancy. Use of nicotine replacement products during pregnancy is not contraindicated, however it is also not free from risk. However, there is little research on the safety of nicotine replacement products during pregnancy, so its real- life effects have not yet been established. Nicotine gum and patches cause increases in the mother's blood pressure and heart rate, and a smaller increase in foetal heart rate, but other nicotine replacement products produce a smaller effect than smoking. Nicotine (from cigarettes or by itself) changes hormone patterns, affecting the endocrine profile of the infant. It affects the structure and functioning of the oviduct (fallopian tube) in ways that may impair fertility and complicate the pregnancy. Nicotine impairs the transport of essential nutrients across the placenta. Study on nicotine patches in pregnancy Share : Save: Subscribe. If women who are trying to quit during pregnancy can achieve this without nicotine.Nicotine can alter embryonic movements that are important in the early development of the organs. It may interfere with foetal brain and lung development, although the long- term effects are not clear. Although nicotine is a toxin, pregnant women already expose their unborn child to nicotine if they continue to smoke. There is no evidence that using nicotine replacement products in pregnancy results in higher blood levels of nicotine than smoking. The argument for allowing use of nicotine replacement in pregnancy, despite potential risks, is that if it increases the chances of pregnant women quitting smoking, then withholding it would be harmful. Overall, nicotine replacement prodcuts are considered to be safer than continuing to smoke as cigarette smoke contains other chemicals known to be toxic to the foetus as well as nicotine. Effectiveness of nicotine replacement among pregnant women. Few trials of the use of nicotine replacement products in pregnancy have been conducted, and the percentage of pregnant women who actually used them as the researchers intended varied considerably. The current evidence suggests that nicotine replacement in pregnant women does not work as well as it does in the general population, and that it has no significant advantage over counselling and behavioural support. However, in these studies many women were reluctant to use nicotine replacement, and either used a low dose (of the nicotine gum) or only used it for a short time. This could have affected the results. In the largest trial, women using a nicotine patch had a higher quit rate after four weeks, but had a similar quit rate to those who had used a placebo (a patch without nicotine) by the end of their pregnancy. More research is needed. Compared with use of a placebo, use of a nicotine replacement product by smokers trying to quit improves the birth weight of the babies and may improve birth outcomes (i. The safety of nicotine replacment in terms of foetal development and birth outcomes (compared to successfully quitting without it) remains unclear. Use of nicotine replacement products in pregnancy. A pregnant woman considering using a nicotine replacement product to help her quit should first discuss the risks and benefits with her doctor or pharmacist, and also the doctor supervising her pregnancy. Nicotine replacement should be used as early on in the pregnancy as possible (after quitting without it proves unsuccessful), with the aim of quitting and discontinuing use as soon as possible. Intermittent forms of nicotine replacement - the gum, lozenge, inhaler or tablet - are recommended, as these products usually provide a lower overall daily dose than the patch. However, if the woman cannot tolerate these forms of nicotine replacement, for example, she suffers from nausea, the day only patch may be used. The patch must be removed before going to bed, as the effect of continual exposure to nicotine is unknown. Nicotine replacement products work best for addicted smokers who want to quit. Women with cravings associated with people, places, routines, or emotions may benefit from counselling and behavioural support. Nicotine replacement works better when triggers for cravings are also reduced. Having a spouse who is a non- smoker or quits smoking is an advantage. Women who can make their home smokefree and get rid of all cigarettes in their home and car will have a better chance of success. Use of nicotine replacement products while breastfeeding. Breastfeeding is recommended even if a mother smokes or uses a nicotine replacement product. Babies of smokers are more prone to chest illnesses, but breastfeeding helps prevent these infections. Breastfeeding also has several other advantages over bottle- feeding, reducing the risk of illness and death for the baby. Women who are breastfeeding may use the gum, lozenge, inhaler or tablet to help them quit. The patch is not recommended. Nicotine from cigarettes and nicotine replacement products is found in breast milk. However, the amount of nicotine from nicotine replacement products is less than that from cigarettes, and less dangerous to her child than secondhand smoke. Women should breastfeed just before using nicotine replacement. This ensures that the longest possible time between use of nicotine replacement and breastfeeding, so the child is exposed to less nicotine. Nicotine Side Effects in Detail. In Summary. Commonly reported side effects of nicotine include: nasal mucosa irritation. Other side effects include: arthralgia, nausea and vomiting, and mild headache. Major Side Effects. If any of the following side effects occur while taking nicotine, check with your doctor immediately: Less common: Blurred visiondizzinessheadachenervousnesspounding in the ears. Rare. Fast or irregular heartbeathives, itching, rash, redness, or swelling of the skin. If any of the following symptoms of overdose occur while taking nicotine, get emergency help immediately: Symptoms of overdose Dizzinessfast heartbeatnausea or vomitingweakness. Minor Side Effects. Some nicotine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them: More common: Mouth sores, blisters, or irritationnausea or vomitingsore throat. Less common: Acid or sour stomachbelchingdiarrheadizzinessheartburnhiccupsmouth, tooth, jaw, or neck painproblems with teethunusual tiredness or weakness. For Healthcare Professionals. Applies to nicotine: compounding powder, inhalation device, nasal spray, oral transmucosal gum, oral transmucosal lozenge, transdermal film extended release. Cardiovascular. Cardiovascular effects have included increases in heart rate and blood pressure. Rennard S, Daughton D, Cheney R, Thompson A, Miles R, Windle J, Repsher L, Clifford DP, Schones W, Fortmann SP, Killen JD, Pe . Warner JG, Little WC . Dale LC, Hurt RD, Offord KP, Lawson GM, Croghan IT, Schroeder DR . Sandborn WJ, Tremaine WJ, Offord KP, Lawson GM, Petersen BT, Batts KP, Croghan IT, Dale LC, Schroeder DR, Hurt RD . Joseph AM, Norman SM, Feerry LH, et al. Khosla S, Laddu A, Ehrenpreis S, Somberg JC . Nicorette (nicotine). Nicotrol NS (nicotine). Jessen AB, Toubro S, Astrup A . Tang JL, Law M, Wald N . Hilleman DE, Mohiuddin SM, Delcore MG . Jorenby DE, Smith SS, Fiore MC, Hurt RD, Offord KP, Croghan IT, Hays JT, Lewis SF, Baker TB . Fiore MC, Kenford SL, Jorenby DE, Wetter DW, Smith SS, Baker TB . Shiffman S, Dresler CM, Hajek P, Gilburt SJ, Targett DA, Strahs KR . Einarson TR, Einarson A . Hjalmarson A, Nilsson F, Sjostrom L, Wikland O . Kadakia SC, Delabaume HR, Shaffer RT . Silagy C, Mant D, Fowler G, Lodge M . Pullen RD, Rhodes J, Ganesh S, et al. Riche G, Nighoghossian N, Trouillas P . Mundal HH, Hjemdahl P, Gjesdal K . Eliasson B, Taskinen MR, Smith U . Finch CK, Andrus MR, Curry WA . These can be reported to the FDA here. Always consult a healthcare professional for medical advice. More about nicotine Consumer resources Professional resources Related treatment guides. Disclaimer: Every effort has been made to ensure that the information provided 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 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 safety, effectiveness, or appropriateness for any given patient. Drugs. com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.
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