Which nicotine replacement product is categorized as pregnancy category D?

The nicotine patch is categorized as pregnancy category D due to the evidence that suggests potential risks to the developing fetus from nicotine exposure. Category D indicates that there is positive evidence of human fetal risk, but the potential benefits of use may warrant use of the drug in pregnant women despite the risks.

Nicotine replacement therapy (NRT) is generally considered a safer alternative to continued smoking during pregnancy, but the patch delivers a steady dose of nicotine through the skin, which can lead to higher plasma nicotine levels compared to other forms like gum or lozenges. This continuous exposure raises concerns regarding fetal development, particularly with respect to birth weight and potential neurodevelopmental issues.

While other nicotine replacement products such as gum, lozenges, and inhalers also contain nicotine, they have not been assigned a category D rating, indicating that their risk profile during pregnancy is regarded as potentially lower or less well-defined compared to the patch. This makes the nicotine patch the most noteworthy when discussing risk during pregnancy among nicotine replacement products.