Key:
| |||
Medication | Pre-conception | During pregnancy | Breastfeeding |
Conventional medications | |||
Hydroxychloroquine | ++ | ++ | ++ |
Sulfasalazine | ++ | ++ | ++ |
Colchicine | ++ | ++ | ++ |
Azathioprine, 6-mercaptopurine | ++ | ++ | + Low transfer |
Prednisone | + Taper to <20 mg/day by adding pregnancy-compatible immunosuppressants | + Taper to <20 mg/day by adding pregnancy-compatible immunosuppressants | + After a dose of >20 mg, delay breastfeeding for 4 hours |
Cyclosporine, tacrolimus | + Monitor blood pressure | + Monitor blood pressure | + Low transfer |
Nonsteroidal antiinflammatory drugs (cyclooxygenase 2 inhibitors not preferred) | + Discontinue if the woman is having difficulty conceiving | + Continue in first and second trimesters; discontinue in third trimester | + Ibuprofen preferred |
Tumor necrosis factor inhibitors (tumor necrosis factor inhibitors are considered compatible with pregnancy) | |||
Certolizumab | ++ | ++ | ++ |
Infliximab, etanercept, adalimumab, golimumab | + Continue through conception | + Continue in first and second trimesters; discontinue in third trimester several half-lives prior to delivery | ++ |
Rituximab | + Discontinue at conception | + Life-/organ-threatening disease | ++ |
Other biologics (limited safety data; limited transfer in early pregnancy but high transfer in second half of pregnancy) | |||
Anakinra, belimumab, abatacept, tocilizumab, secukinumab, ustekinumab | + Discontinue at conception | × Discontinue during pregnancy | + Expect minimal transfer due to large molecular size, but no available data |
Not compatible with pregnancy | |||
Methotrexate | ×× Stop 1-3 months prior to conception | ×× Stop and give folic acid 5 mg/day | × Limited data suggest low transfer |
Leflunomide | ×× Cholestyramine washout if detectable levels | ×× Stop and give cholestyramine washout | ×× |
Mycophenolate mofetil and mycophenolic acid | ×× Stop >6 weeks prior to conception to assess disease stability | ×× | ×× |
Cyclophosphamide | ×× Stop 3 months prior to conception | + Life-/organ-threatening disease in second and third trimesters | ×× |
Thalidomide | ×× Stop 1-3 months prior to conception | ×× | ×× |
Tofacitinib, apremilast, baricitinib | Unable to determine due to lack of data; small molecular size suggests transfer across the placenta and into breast milk |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟