Is It Safe to Take Abstral While Pregnant?

Abstral is a brand-name medication that contains the powerful and often addictive painkiller fentanyl. Abstral is available as a sublingual tablet and classified as an opioid or a narcotic. Abstral is meant to be taken only in very specific circumstances, and it is prescribed for breakthrough pain in opioid tolerant patients who have been receiving continuous opioid therapy for managing pain. For a patient to be considered opioid tolerant, they would need to have been taking at least 60 mg of morphine daily for a week. For someone who isn’t opioid-tolerant or who takes Abstral outside of prescribing guidelines, it can be dangerous and deadly. Abstral, similarly to other opioids, slows the central nervous system and the respiratory system. Breathing can slow to the point that someone overdoses or dies as a result.

While Abstral has rigid prescribing guidelines, as with other opioids, it is sometimes diverted from medical use and sold on the black market. Abstral and other drugs containing fentanyl are in high-demand because of the opioid epidemic. Since fentanyl is so potent, people seek it out. It’s also included in other drugs sold on the black market. If people do not realize they’re taking it, they may die. Abstral is a Schedule II controlled substance in the U.S. It’s available only through a program from the Food and Drug Administration called a Risk Evaluation and Mitigation Strategy (REMS). In this program, healthcare professionals who prescribe medicines to outpatients and pharmacies must enroll.

Is it safe to take Abstral while pregnant? The answer is no. The FDA’s data sheet on Abstral warns that it can cause fetal harm and it’s not recommended to be taken by women who are breastfeeding, either. There are two different scenarios where a person may wonder if it’s safe to take Abstral while pregnant. The first would be if they were misusing opioids and became pregnant. The second scenario is during labor and delivery. If a woman is treated with epidural or intravenous fentanyl during labor and delivery, then the management of the medication is up to the treating physicians. In terms of someone who is misusing or addicted to Abstral or fentanyl and becomes pregnant, it’s not safe, and the woman should speak with her physician openly and honestly to try and determine what options may be available.

If you find yourself in this situation, you can also reach out to us at The Recovery Village. We have inpatient and outpatient treatment programs designed to help you overcome your addiction.

How Does Abstral Affect a Fetus?

Since Abstral is an opioid, it can affect a fetus in a way similar to other drugs in this class. Other opioids include prescription pain medicines like hydrocodone and oxycodone, as well as heroin. Abstral can increase the risk of miscarriage and preterm labor and premature birth. Taking opioids during pregnancy is associated with an increased risk of birth defects like spina bifida and heart defects as well as low birthweight and fetal growth restriction.

However, if a woman is dependent on Abstral or another opioid when she becomes pregnant, stopping suddenly can also be dangerous. Abruptly stopping opioids while pregnant can increase the risk of preterm labor, premature birth or placental abruption. Placental abruption can cause heavy bleeding that can be deadly for a woman and the child. Also possible is a stillbirth, which is the death of a baby in the womb anytime after the 20th week of pregnancy. Instead of trying to stop treatment on your own, it’s important to speak with your healthcare provider about the safest route to take.

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Babies Born Addicted to Abstral

When a mother takes Abstral or another opioid during pregnancy, her baby may be born addicted to it. When a baby is exposed to a drug in the womb and goes through withdrawal following birth, it’s called neonatal abstinence syndrome or NAS. The baby may experience breathing problems, tremors, seizures, twitching or rigid muscles. Also possible is excessive crying or irritation, poor feeding, fever, sweating or sleep problems. Complications related to NAS include low birth weight, the development of jaundice and the need to stay in the newborn intensive care unit (NICU) after birth.

When a baby is born with NAS, doctors will usually provide medications to treat the symptoms and stabilize the baby. Medicines like morphine and buprenorphine may be used in cases of severe neonatal withdrawal. A baby will also be given fluids to avoid dehydration, and high-calorie baby formula may be used as well. NAS symptoms typically start to subside within 5 to 30 days.

Alternatives to Taking Abstral While Pregnant

If someone is taking Abstral, any fentanyl product or any opioid and becomes pregnant, they should first and foremost speak to their healthcare provider, whether it’s prescribed to them or not. A healthcare provider can help a pregnant woman find ways to possibly stop using opioids, but not to do so abruptly. Sometimes medication-assisted treatments like methadone or buprenorphine are used for pregnant women. Depending on the reasons a woman may be using opioids, her healthcare provider might be able to find another medication to treat pain. Again, regardless of the situation, it’s important not to suddenly stop opioids during pregnancy because it can be more harmful than beneficial.

To learn more about opioids and addiction treatment and recovery, reach out to us. At The Recovery Village, we’re here to help, and we believe in recovery for you or your loved one.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.