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Pregnancy with Rheumatoid Arthritis

Which of the anti-arthritis drugs are safe during pregnancy?
Anti arthritis medicines may be divided into two categories–
Drugs absolutely unsafe in pregnancy–
Methotrexate, Leflunomide, Mycophenolate mofetil. If you have taken any of these during pregnancy, you should speak to your Rheumatologist immediately.
Drugs that are considered safe in pregnancy–
Steroids—one of the drugs used commonly if a pregnant woman has a flare of Rheumatoid Arthritis activity. They are considered relatively safe when used in low doses (< 20 mg of prednisone). Among the steroids, prednisone is used as it is converted in the placenta into inactive forms. Only about 10% of the maternal dose reaches the baby. Dexamethasone, Betamethasone are not used since they are not inactivated by the placenta. However, steroids in general may increase the risk of diabetes (gestational), edema, blood pressure in the mother & premature rupture of the membranes. There is also a small risk of cleft palate in the baby with the use of steroids in the 1st trimester (1st three months). Cleft palate occurs at a rate of 1 in 1000 newborns in the population, prednisone would increase this risk to about 3 in 1000. This risk would be weighed against the risk of active disease by your Rheumatologist.

Sulphasalazine—the risk of harming the unborn baby with Sulphasalazine is considered to be very low & most experts advise continuation of Sulphasalazine throughout pregnancy to control the RA activity. Folic acid supplements are recommended with sulphasalazine during pregnancy.

Hydroxychloroquine—Most studies with Hydroxychloroquine have found it safe during pregnancy.

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Also Read:
Pregnancy with Rheumatoid Arthritis
Which of the anti–arthrtis drugs are safe while breast feeding the baby?
Do anti–arhritis drugs affect fertility?

Created on: April 2007
Last updated on: Feb 2015
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