Pregnancy and Medications

Pregnancy, whether planned or a pleasant surprise, brings with it important concerns about prescription and over the counter medications. Not every medication poses a risk to your unborn baby; however, some do. It is important to talk to your doctor.

Safe in Pregnancy

The following medications are considered safe in pregnancy:

  • Prednisone
  • Hydroxychloroquine (Plaquenil)
  • Sulfasalazine (Salazopyrin) & Folic Acid 5 mg/day
  • Azathioprine (Imuran) at less than 2 mg/kg/day
  • Cyclosporine/Tacrolimus (widely used in transplant patients)
  • Intravenous Immune Globulin (IVIG)
  • Cimzia (certolizumab) (does not cross the placenta)

With Prednisone, take care to watch for diabetes during pregnancy. Prednisone may also increase the risk of infection, and high-doses increase the risk of premature birth.

Use with Caution in Pregnancy

The following medications can be used with caution in pregnancy or must be stopped at a certain point in time:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Infliximab - Remicade, Renflexis, Inflectra
  • Adalimumab - Humira, Abrilada, Amgevita, Hadlima, Hyrimoz, Idacio, Simlandi, Yuflyma
  • Etanercept - Enbrel, Erelzi, Brenzys
  • Golimumab - Simponi

There are many types of Non-Steroidal Anti-Inflammatory Drugs including Naproxen, Ibuprofen, Diclofenac, Celecoxib, Indomethacin, and Meloxicam. Non-Steroidal Anti-Inflammatory Drugs should be stopped before week 28.

Please discuss these medications with your doctor.

AVOID in Pregnancy

The following medications are UNSAFE in pregnancy. Women taking these medication should be using reliable contraception such as the birth control pill.

  • Methotrexate
  • Leflunomide (Arava)
  • Cyclophosphamide (Cytoxan)
  • Rituximab - Rituxan, Ruxience, Rixmyo, Truxima
  • Mycophenolate

There is limited safety data available for

  • Actemra (tocilizumab)
  • Benlysta (belimumab)
  • Bimzelx (bimekizumab)
  • Cosentyx (secukinumab)
  • Kineret (anakinra)
  • Olumiant (baricitinib)
  • Orencia (abatacept)
  • Rinvoq (upadacitinib)
  • Stelara (ustekinumab)
  • Taltz (ixekizumab)
  • Xeljanz (tofacitinib)

If you become pregnant while taking any of these medications, stop immediately and contact your doctor.

If you are considering becoming pregnant, talk to your medication about switching medications before you try to conceive.

Methotrexate should be stopped 3 months prior to trying to conceive. Use during pregnancy may cause birth defects and increases the risk of miscarriage.

Arava (leflunomide) may cause birth defects. A Cholestyramine washout can help flush this medication out of the body.

Cytoxan (cyclophosphamide) is known to reduce fertility in both men and women. It may cause birth defects and miscarriage. It should be stopped 3-6 months before trying to conceive.

Mycophenolate may cause birth defects and increase the risk of miscarriage. It should be stopped 3 months before trying to conceive.

Pregnancy and Medications Quick Reference Guide