Buprenorphine and Pregnancy -- What You Need to Know

This patient handout sheet explains concerns and risks for buprenorphine treatment of patients who are or wish to become pregnant.

Buprenorphine and Pregnancy -- What You Need to Know

Abusing heroin or prescription painkillers while you are pregnant is very dangerous --both for your own health and for the health of the baby you are carrying. The best action you can take is to get into treatment and stop using drugs.

What happens if you are pregnant (or want to become pregnant) and want to start taking buprenorphine?

Methadone maintenance treatment and buprenorphine monotherapy are both appropriate choices for pregnant women with opioid use disorder.

Drug-free treatments, naltrexone treatment, or "detox" are also good choices if you are just planning a pregnancy, but they are a bad idea if you are already pregnant --these treatments will force you to go into withdrawal, which could cause a miscarriage.

Your provider can advise you about other treatments and help you choose one that it right for you.

What happens if you are already using buprenorphine and want to get pregnant?

If you want to get pregnant, the safest thing to do is switch to another treatment that is safe to use during pregnancy -- methadone, naltrexone, or a drug-free treatment.

Let your provider know in advance if you want to become pregnant so you can work together to plan your change in treatment. Also, use birth control to reduce the chance of having an unplanned pregnancy.

But what happens if you are taking buprenorphine and get pregnant unexpectedly?

In this situation, you have 2 things to consider:
 There is a small chance that buprenorphine will hurt your child, but

If you switch from buprenorphine to any other kind of treatment (except for the buprenorphine only form --see below), you will probably go into withdrawal --and withdrawal could cause a miscarriage.

Miscarriage from withdrawal is the greater of these 2 risks. So, if you are already on buprenorphine and you become pregnant, you should not switch to another treatment.

There is only one change you should make --your provider will probably switch you from buprenorphine/naloxone combination to buprenorphine only form (monotherapy). Monotherapy has the same active ingredient as the buprenorphine/naloxone combination formulation and is used in the same way, but it doesn't have another ingredient (naloxone) which could be dangerous to take during pregnancy.

Remember to talk to your provider if you wish to become pregnant or suspect you are pregnant at any time while taking buprenorphine.