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IBD medications during pregnancy and lactation
Ole Haagen Nielsen1, Cynthia Maxwell2, Jakob Hendel1
1Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
Nature Reviews. Gastroenterology & Hepatology
|July 31, 2013
Summary
This review examines the safety of inflammatory bowel disease (IBD) medications during pregnancy and breastfeeding. Many common IBD treatments, including 5-aminosalicylic acid, glucocorticoids, thiopurines, and TNF inhibitors, are safe for use.
Area of Science:
- Gastroenterology and Hepatology
- Pharmacology
- Reproductive Medicine
Background:
- Inflammatory Bowel Disease (IBD) frequently impacts individuals during their reproductive years.
- Long-term medication is often required for IBD management, necessitating safety assessments during pregnancy and lactation.
- Understanding drug safety is crucial for clinical practice in managing IBD patients of childbearing potential.
Purpose of the Study:
- To review current data on the safety of IBD medications during pregnancy and breastfeeding.
- To assess the impact of IBD therapies on fertility.
- To provide guidance on medication choices for IBD patients who are pregnant or breastfeeding.
Main Methods:
- Comprehensive literature review of studies on IBD drug safety in pregnancy and lactation.
- Analysis of contraindications and recommendations for specific IBD medications.
- Evaluation of evidence regarding the effects of IBD treatments on fertility.
Main Results:
- Thalidomide and methotrexate are contraindicated during pregnancy and breastfeeding.
- Alternatives to ciprofloxacin, natalizumab, and sodium phosphate are recommended for pregnant women.
- Ciclosporin, metronidazole, and ciprofloxacin use during breastfeeding is discouraged.
- 5-aminosalicylic acid preparations, glucocorticoids, thiopurines, and TNF inhibitors are considered safe during pregnancy and lactation.
Conclusions:
- Informed patient-physician discussions are vital for optimizing outcomes in pregnant IBD patients.
- Therapeutic decisions for IBD during pregnancy and lactation should prioritize maternal and infant safety.
- Continued research and updated guidelines are essential for managing IBD in women of reproductive age.
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