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Which of the lupus drugs are safe in pregnancy?

Prednisolone
Prednisolone is metabolised (destroyed) by the placenta to a great extent & hence only a minimal amount reaches the unborn baby. In order to keep the fetal exposure minimal, the dose is kept at a minimum required dose.
Non steroidal anti inflammatory drugs
Non steroidal anti inflammatory drugs are better avoided during pregnancy due to the effect on the fetal heart (ductus atreriosus). Paracetamol is a relatively safe option.
Hydroxychloroquine
It is transferred across the placenta. However, it is continued during pregnancy as its discontinuation may lead to lupus flare. It fares well if the risk benefit ratio is taken into consideration.
Azathioprine
It can cause suppression of the immunity in the newborn. However, many papers stating its safety in pregnancy have been published recently.
Mycophenolate mofetil
Is avoided during pregnancy.
Cyclophosphamide
Is avoided during pregnancy.
Cyclosporine
Is avoided during pregnancy.

Ref: Michelle Petri, The Hopkins Lupus Pregnancy Center: Ten Key Issues in Management Rheum Disease Clinics of  North America 33 (2007) 227–235.


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Created on: April 2007
Last updated on: Feb 2015
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