Bupropion

(Date: January 2023. Version: 4)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

Quick read

Bupropion is not recommended in pregnancy. Other treatments are available which are safer to use.

What is it?

Bupropion (Zyban®) can help some people stop smoking.

What are the benefits of using bupropion in pregnancy?

It is important to try not to smoke in pregnancy as it can harm the baby. However, bupropion is not usually recommended in pregnancy as there are other methods to stop smoking that are thought to be safer for the baby.

What are the risks of using bupropion in pregnancy?

There is no evidence that use of bupropion in pregnancy causes miscarriage, stillbirth, preterm birth, or low infant birth weight. Although some studies suggest a link with birth defects, others do not agree, and ongoing data collection is therefore required. One study found that children who were exposed to bupropion in pregnancy (particularly during the second trimester) were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) by the age of 5. Further research is required to confirm this link.

Bupropion may cause short-term withdrawal symptoms in the newborn baby if taken in the weeks before delivery. For this reason, a baby may be monitored for some time after birth to check for symptoms such as jitteriness, difficulty sleeping and breathing problems.

Medicines that work in a similar way to bupropion have been linked in rare cases to a lung problem in newborn babies called persistent pulmonary hypertension of the newborn (PPHN). There is no good information on whether bupropion use around the time of delivery increases the chance of PPHN. As a precaution, a baby exposed in late pregnancy would be checked for breathing problems by a midwife or paediatrician.

Are there any alternatives to using bupropion in pregnancy?

Yes. Other products to stop smoking are preferred in pregnancy. These include nicotine gums, patches, sprays, and e-cigarettes.

Ideally, a woman who smokes and is pregnant or planning a pregnancy should speak to her GP or midwife who will offer support to stop or cut down smoking.

What if I prefer not to use products to help stop smoking during pregnancy?

It is important to try and stop smoking in pregnancy, or cut down as much as possible, to reduce the chance of miscarriage, stillbirth, some birth defects, preterm birth, and low birthweight in the baby. Use of nicotine gums, patches, sprays, or e-cigarettes are safer for the baby than continuing to smoke in pregnancy.

Will I or my baby need extra monitoring?

All pregnant women in the UK should be offered a detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following use of bupropion or products to help stop smoking in pregnancy.

Are there any risks to my baby if the father has used bupropion?

We would not expect any increased risk to the baby if the father took bupropion before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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