Azathioprine and Pregnancy?

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Miss_sterious

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Is it better to be on or off azathioprine during pregnancy?
My specialist seemed torn as the benefits/risks are similar severity.
 
MS - A recent medical journal review article I posted at http://www.crohnsforum.com/showthread.php?t=12220 has a fair bit of info on AZA in pregnancy. Although the drug can cause birth defects in lab animals (rats, mice), the picture in humans appears less clear, with conflicting evidence. There seems to be some indication the risk to the fetus may be low, apparently in part because the fetal liver appears unable to convert AZA to the active 6MP.

Apparently, AZA is generally considered safe during breast feeding.

The article in the link has some of the best, up to date general info on pregnancy + IBD that I've seen. I can email you a PDF of it to show to your doctor, if you like.
 
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There's debate about pregnancy and breast feeding with all of the medications for IBD. It's a tough call but if it were me, I'd stop all meds during pregnancy (unless there was a risk of my death) and resume meds after I gave birth and would most likely bottle feed with formula (unless I was healthy enough to breast feed without meds for a little while).
 
Hi....per my pharmacology software app (Epocrates), Imuran has been shown to have "positive evidence of human fetal risk; maternal benefit may outweigh fetal risk in serious or life-threatening situations."

Dr. S
 
During both my pregnancies I stopped taking my meds. My doctor and I felt it was best at the time considering they were class 3 drugs. But with my experience, even off my meds I didn't have any trouble or flare ups during my pregnancies.
 
It is not supposed to be taken during pregnancy or while breast feeding. I had to stop my Imuran before I got pregnant, but started getting symptoms and then was given a Remicade infusion and got pregnant several weeks later. I barely could tell I even had Crohn's while pregnant. I could eat Oreo's with milk again! I fed my child for six weeks after birth until I started getting sick again, so I had to start up my Imuran again and my little man had to go on formula. He is now a very vibrant five year old and is about the same height as my eight year old niece and nephew!
 
Hi

Just realised this was an old post. How did you get on with your pregnancy? I was on imuran/azathioprine all the way through my pregnacy as my Dr's felt the risk to my health would be too great to come off it. I had a great pregnancy and my Crohn's was better than it's ever been. Jack was born a few weeks early and is now a strapping 10 month old. I did come off my meds a month before he was born so that I could breastfeed him and managed to do that for 5 months before I started to feel the onset of a flare up. Anyway, back on my meds now and planning to do it all again!! ish me luck!!

xJulie
 
Hello all.

I too am in the same predicament. I am 6 weeks pregnant and have been taking Azathioprine for a year and a half now. My IBD nurse has told me to stay on the Aza as it would be more harmful to myself and the baby to come off it. Because if I were to have a flare up the baby would not survive. It is so worrying as all you read is premature birth/ still birth etc! Not good when your main focus is to remain calm!

Any advice would be greatly welcome.

Good luck to everyone x
 
I'm now 4 1/2 months pregnant and opted to go against my doctors advice and have been feeling fine! Bella, you should probably take the advice of your Doctor. However, if you have been in remission awhile and feeling good, you'd probably be fine off it too.
 
Kris, so sorry to hear that. How heartbreaking. We never know why some babies get taken early, it could have had nothing to do with the pentasa. I hope you conceive again and carry a healthy baby.
 
Hi I am also 7 weeks and 5 days pregnant and i am so nervouse and scared!! I am on prednisone right now and i was supose to start humaria but when i found out that i am pregnant i want to double check with my doctor to make sure it is ok. I would reallly love to go drug free during the pregnancy! Has anyone on here gone drug free while pregnant? i dont know if i am in remission or not becasuse i am on prednisone so i feel fine but i know that im stil inflammed because my poop is skinny and weird looking.. does that mean that i am still active? i really dont want to miscarry or have a still birth!
Does anyone have any advice? what my diet should and should not consist of.
 
I am now 5 weeks pregnant. I flared up with my first pregnancy (which I didn't know I had crohn's), and had a healthy baby girl, she's 18 months now. She was 5 weeks early and I had an emergency c-section. I am hoping that I can do this pregnancy drug free again, but without the flare! I'd like to know what everyone else is doing during their pregnancies :)
 
I didnt know i had crohns with my first son.. i had a flare up aswell but just thought it was something that i ate or the flu.. this one tho the doctor wants me to go on azathioprine becasue i am on prednisone and he wants me to get off that.. i really dont know what to do all the research i am doing is telling me knot to go on it... should i just chance a flare up?
 
JoleneZ said:
I didnt know i had crohns with my first son.. i had a flare up aswell but just thought it was something that i ate or the flu.. this one tho the doctor wants me to go on azathioprine becasue i am on prednisone and he wants me to get off that.. i really dont know what to do all the research i am doing is telling me knot to go on it... should i just chance a flare up?
Click to expand...

Flaring while pregnant is also risky, probably more risky than the azathioprine IMO.
 
I found out that I was pregnant in 09. I took my self of the medicine against my GI advice. I already was having flare-ups before my pregnancy. When I turned 20 weeks I started flaring-up real bad. I kept going back and fourth to the emergency room. I was finally admitted around 22 weeks into my pregnancy and then the next day I went into labor. My baby was born. but it passed away shortly. Now I am 9 weeks pregnant now and I decided to stay on the medicine. I am have been labeled high risk. I pray and hope everything this time goes well. So far everything is fine. The Crohn's are okay. So its really up to you to decide whats best for you. I tried without the medicine first and had a bad outcome.I feel my chances are better with the medicine.
 
Hey there,

Rob and I were just through this....when he was last admitted, we were trying to see if he could wean off his Imuran because we were not sure if the medication would mess around with his baby making ability. We got so many articles from the pharmacists and the docs who said it was ok for him (or me if I had colitis) to be on the meds while pregnant. I hope this helps!

Amber
 

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