By marjy33405 | 1 post, last post over a year ago. Azathioprine is normally converted to the active metabolite 6-mercaptopurine. Revisiting the immunomodulators tacrolimus, methotrexate, and mycophenolate mofetil: their mechanisms of action … Dr. Heidi Fowler answered. Azathioprine is commonly used in Crohn’s disease. 72 In a prospective observational study in 189 pregnant … Has anyone experienced taking Azathioprine whilst pregnant? marjy33405 over a year ago. Currently, infants born to mothers taking azathioprine in pregnancy do not routinely have their haemoglobin level measured. A retrospective analysis of the outcome of 16 pregnancies in 14 women receiving azathioprine … The objective of this study was to evaluate the risk of adverse fetal outcome in systemic lupus erythematosus (SLE) women exposed to azathioprine during pregnancy … However, pancytopenia and severe combined immune deficiency-like disease have been reported in infants whose mothers received azathioprine throughout pregnancy. Azathioprine should be used during pregnancy only if the potential benefit justifies the potential risk. Older data available for pregnancy use of azathioprine in systemic lupus erythematosus and renal transplantation suggested that it is safe during pregnancy (Erkman & Blythe, 1972; Price et al, 1976), and this is supported by a consensus paper (Provan et al, 2010). Alstead EM, Ritchie JK, Lennard-Jones JE, et al. Azathioprine has a good safety profile in pregnancy. This is because the evidence for safety is not absolutely watertight. For these reasons, before you start taking azathioprine it is important that your doctor or pharmacist knows: If you are pregnant, trying for a baby or breastfeeding. Azathioprine (Imuran) in Pregnancy/Lactation I have been taking this drug for 4 years to control Crohn's Disease related problems. Imuran (azathioprine): Imuran (azathioprine) is FDA pregnancy category D (Positive evidence of risk) 2 doctors agree. 6-MP is further metabolized by hypoxanthine-guanine phosphoribosyltransferase (HGPRT) into 6 … A retrospective cohort study of 476 women taking azathioprine early in pregnancy reported an increased risk of ventricular and atrial septal defects, as well as … INTRODUCTION: The use of azathioprine (AZA) in the treatment of autoimmune diseases during pregnancy are believed to be relatively safe, particularly taking into account the potential risks for mother and fetus should the underlying disease become active due to withdrawal of this thiopurine. Azathioprine should not be started de novo in pregnant women; its long latency to therapeutic effect would make this an illogical choice for immunosuppression in this setting. It has been administered to many pregnant women over many years without significant side effects. Immunomodulators, such as Azathioprine (Imuran®), 6-mercaptopurine (6-MP, Purinethol®), and cyclosporine A (Sandimmune®, Neoral®), appear low risk during pregnancy in standard I’m 10 weeks gone now and I did stop taking my medication but my consultant is adamant that it won’t cause the baby any harm. Unlike mercaptopurine,' , =, 3 a closely related analogue, azathioprine has been found to have no teratogenic activity in the rat .4 However, the present study, previously reported in part,' has demonstrated a profound effect of the drug on pregnancy in … Current guidelines say that azathioprine can be taken if trying for a baby and even when pregnant or breastfeeding. However, there have been reports of premature birth and low birth-weight following exposure to azathioprine, particularly in combination with corticosteroids. However, in some serious situations, the benefit of using this medication may be greater than the risk of harm to the baby. While azathioprine is probably safe in all of these situations, you must always discuss azathioprine use with your doctor before planning a pregnancy. Spontaneous abortion has been reported following maternal or … Therefore, azathioprine would be best avoided unless there is no alternative treatment. Angrybird Moderator. Azathioprine has been classed as FDA category D – positive evidence of risk. Overall, azathioprine concentration in breast milk is very low and mothers taking azathioprine may breast feed; any detectable concentration of azathioprine … It is important that you tell us if you are pregnant or planning on getting pregnant so that we can review all of your medicines and monitor you more closely. However, in pregnancy the placenta can metabolize azathioprine to thiouric acid, an inactive metabolite. 0. Although azathioprine has been reported to be safe during pregnancy in renal transplant recipients and patients with systemic lupus erythematosus, opinions vary whether it should be continued in pregnancy in inflammatory bowel disease. Azathioprine crosses the placenta, but drug and metabolite concentrations are lower in the fetal circulation, suggesting placental metabolism. New Reply Follow New Topic. The immunosuppressive agent azathioprine is considered a pregnancy category D drug, with some evidence of increased risk of fetal abnormalities in human studies. 6, 9-11 Furthermore, supported by animal and human data (on renal transplant recipients only), the use of azathioprine in pregnancy may be related to intrauterine growth … 0items $0.00. Whenever possible, use of azathioprine in pregnant patients … We reviewed the medical records of SLE pregnant women followed from January 2005 to April 2013. View 2 more answers. If you become pregnant while taking this drug, call your doctor right away. In addition the fetal liver does not have inosinatopyrophosphorylase which therefore largely protects the fetus from … azathioprine in pregnancy . Also known as AZA, AZTP, Imuran (tn) A purine analogue with cytotoxic and immunosuppressive activity. Is azathioprine safe in pregnancy and breastfeeding? There are no controlled data in human pregnancy. However, you should always discuss azathioprine use with your doctor in advance of planning any pregnancy. Women diagnosed with IBD and with prescriptions for azathioprine and/or corticosteroids, have an increased risk of LBW, pre-t … I was diagnosed with Crohn's disease 15 years age. Use of azathioprine and corticosteroids was often reduced or discontinued before or during early pregnancy followed by an increased use of corticosteroids later in pregnancy. The most important thing is that your AIH is as controlled as well as possible during pregnancy. Feb 20, 2012 #2 Hi there, my GI is fully aware that I want to start trying for a baby in the next few months and has said it is still fine … Our findings are comparable with other studies which have similarly examined the use of AZA/6-MP in IBD women during pregnancy. 0 thank. A 40-year-old member asked: do you need a prescription for imuran (azathioprine)? Azathioprine teratogenicity has been demonstrated in animals (malformations such as cleft palate, hydrocephalus, skeletal defects and ocular anomalies). best sellers. I was taking 75mg to begin with then I found out that I was pregnant about 2-3 months after starting the treatment (4weeks until due date now) and my rheumatologist then lowered my dose to 50mg as I was nervous about carrying on taking medication whilst being pregnant … Medscape - Indication-specific dosing for Azasan, Imuran (azathioprine), frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information. 0. Azathioprine is probably safe in all of these situations. If the benefits of treatment with azathioprine (for instance, to maintain remission during pregnancy) outweigh the risks, this drug may be continued during pregnancy… Therefore, azathioprine would be best avoided unless there is no alternative treatment. Key clinical point: Monotherapy with azathioprine and anti-TNF agents can be continued in pregnancy with IBD to maintain remission.Major finding: Congenital anomalies were not higher in children with exposure to azathioprine, anti-TNF agents, or combination therapy, compared with no drug exposure (1 Azathioprine falls into category D. It has been shown that use of azathioprine in pregnant women caused some babies to be born with problems. This is because the evidence for safety is not absolutely watertight. This seems to have worked, but I have recently found out that I am pregnant and am concerned about the effects on the baby. Gastroenterology 1990; 99:443. van Dieren JM, Kuipers EJ, Samsom JN, et al. Does taking Azathioprine affect pregnancy? The azathioprine was supplied by Burroughs-Wellcome and Company. Men are also fine to continue taking it when trying for a baby. In animal studies, the drug increased the risk of certain birth defects. Immunomodulators. Ever since, I was on some medications in order to control my disease. I was taking 75mg but he said I … Azathioprine. Send thanks to the doctor. Does it affect the baby. Transplant patients immunosuppressed with azathioprine should not discontinue it on becoming pregnant. The objective of this study was to evaluate the risk of adverse fetal outcome in systemic lupus erythematosus (SLE) women exposed to azathioprine during pregnancy. Do you have to come off the tablets before becoming pregnant? Location Hertfordshire. home. 6, 13, 14 In a retrospective cohort study by Francella et al. 6, there was no reported increase in prematurity, spontaneous abortion, congenital anomalies, or neonatal and childhood infections in patients who were exposed to 6-MP prior to and during pregnancy … Azathioprine use in pregnancy has been studied predominantly in women with inflammatory bowel disease, and in those with prior renal transplantation. Do not take double or extra doses.This medicine may also interact with the following medications:This list may not describe all possible interactions. We reviewed the medical records of SLE pregnant women followed from January 2005 to April 2013. Safety of azathioprine in pregnancy in inflammatory bowel disease. If you’re planning a family or become pregnant while taking azathioprine, you should discuss this with your doctor as soon as possible. Despite conflicting data, general expert opinion suggests that azathioprine may be considered for use during pregnancy in certain situations (where the potential benefits outweigh potential risks). The U.S. Food and Drug Administration (FDA) uses a category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. 41,71 Data relating to rheumatologic diseases are limited, and although azathioprine is being used during pregnancy, it is better avoided during pregnancy and lactation if possible. I have been taking Azathioprine for nearly a year now. In a pregnant woman with a history of severe Crohns disease in clinical remission after 1 year on azathioprine, 89% of experts usually continue azathioprine until delivery and 9% of physicians never administrate azathioprine during pregnancy. 0 comment. Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. Imuran ® (azathioprine) may not be safe for use in pregnant women. The patients were evaluated at least … Before taking azathioprine. The objective of this study was to evaluate the risk of adverse fetal outcome in systemic lupus erythematosus (SLE) women exposed to azathioprine during pregnancy. Azathioprine is a prodrug that is converted by hepatic xanthine oxidase to its active metabolite 6-mercaptopurine (6-MP). The patients were evaluated at least onc … Treatment with azathioprine is therefore continued during pregnancy to prevent disease relapse and/or transplant rejection.