title: IBD medications during pregnancy and lactation.
abstract: IBD often affects patients during their peak reproductive years. Several drugs are available for the treatment of IBD and new drugs are continuously in the pipeline. As long-term administration of medications is often necessary, the safety of drug therapy during pregnancy and breast-feeding needs to be considered in daily clinical practice. The aim of this Review is to summarize the latest information concerning the safety of medications used to treat IBD during pregnancy and lactation, as well as their effect on fertility. Although only thalidomide and methotrexate are absolutely contraindicated during pregnancy and breast-feeding, alternatives to ciprofloxacin, natalizumab and sodium phosphate should also be considered for pregnant women. Breast-feeding is also discouraged while on treatment with ciclosporin, metronidazole and ciprofloxacin. However, therapy with 5-aminosalicylic acid preparations, glucocorticoids, thiopurines and TNF inhibitors are acceptable during pregnancy and lactation. Pregnant women who have symptomatic IBD or who require therapy should have the opportunity to discuss any associated risks to their pregnancy and infant with the appropriate consultants. By ensuring that the patient and her family are informed, the clinical outcome might be optimized.
authors.affiliation: Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
authors.forename: Ole Haagen
authors.initials: OH
authors.lastname: Nielsen
authors.affiliation: Department of Obstetrics and Gynaecology, Maternal Fetal Medicine Division, Mount Sinai Hospital, University of Toronto, OPG-3, 600 University Avenue, Toronto, ON M5G 1X5, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Maxwell
authors.affiliation: Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Hendel
mesh_terms: D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D007774:Lactation / Q000502:physiology*; D019804:Mesalamine / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000517:prevention & control*; D018570:Risk Assessment
chemical_list: D005938:Glucocorticoids; D019804:Mesalamine; D002939:Ciprofloxacin