How safe are anti-rheumatic drugs during pregnancy?

Curr Opin Pharmacol. 2013 Jun;13(3):470-5. doi: 10.1016/j.coph.2013.03.004. Epub 2013 Mar 20.


Rheumatic diseases may be active during pregnancy necessitating drug treatment in order to control maternal disease activity and ensure a successful pregnancy outcome. The present literature survey of the last 2 years does not profoundly change the recommendations given in recent reviews: the teratogenic drugs cyclophosphamide, methotrexate, mycophenolate mofetil, and biologics without or with few pregnancy data must be withdrawn before a planned pregnancy. Leflunomide has up to date not shown to be a human teratogen. Drugs that can be used throughout pregnancy include corticosteroids, sulfasalazine, antimalarials, cyclosporine, tacrolimus and azathioprine. Among biological drugs extended pregnancy experience exists only for TNF-inhibitors. The effect of immunosuppressive drugs and biologics on male reproductive function is only partly known.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use*
  • Antirheumatic Agents / therapeutic use*
  • Contraindications
  • Female
  • Humans
  • Pregnancy
  • Rheumatic Diseases / drug therapy*


  • Antibodies, Monoclonal
  • Antirheumatic Agents