From: Anti-inflammatory and immunosuppressive drugs and reproduction
Drug | FDA riska | Transplacental passage | Human teratogenicity | Fetal/neonatal adverse effects | Long-term effects in offspring | Impairment of fertility |
---|---|---|---|---|---|---|
Chloroquine/hydroxychloroquine | C/C | Yes | No | Not at recommended doses | No impairment of vision or hearing | Not studied |
Sulphasalazine | B | Fetal like maternal serum concentration | No | Case reports of aplastic anaemia and neutropenia at >2 g maternal dose | Not studied | In men: oligospermia, decreased sperm motility, abnormal forms |
Leflunomide | X | No data | Data not conclusive | None published | Not studied | Not studied |
Azathioprine Mercaptopurine | Db | Yes | No | Sporadic congenital anomalies. Transient immune alterations in newborn infants | Normal immune responses in childhood. One case report of late development of autoimmunity. | No |
Methotrexate | X | Methotrexate + polyglutamates | Yes | Cytopenia | None reported | Oligospermia at high doses |
Cyclophosphamide | D | Yes – animal data | Yes | Chromosomal abnormalities. Cytopenia | Anecdotal | In males and females |
Cyclosporine | C | 10–50% of maternal plasma concentration | No | Transient immune alterations | None reported | No |
Tacrolimus | C | Yes | Not reported | Hyperkalaemia, renal impairment | Not studied | Not studied |
Mycophenolate mofetil | C | Yes | 3 reports of congenital abnormalities | Not reported | Not studied | Not studied |
Intravenous immunoglobulin | C | Yes | No | No fetal effects reported | Not studied | Not studied |
Etanercept | B | Yes | Not reported | Not reported | Not studied | Not studied |
Infliximab | B | Not reported | Not reported | Not reported | Not studied | Data not conclusive |