Table 2 Medications used in the treatment of inflammatory bowel disease.
| Drug | FDA category | Recommendations for pregnancy | Breastfeeding62 |
|---|---|---|---|
| Adalimumab | B | Limited human data: low risk | No human data: probably compatible |
| Alendronate | C | Limited human data: animal data suggest risk. | No human data: probably compatible |
| Azathioprine/ 6‐ mercaptopurine | D | Data in IBD, transplant literature suggest low risk | No human data: potential toxicity |
| Balsalazide | B | Low risk | No human data: potential diarrhoea |
| Budesonide | C | Data with inhaled drug low risk. No human data for oral drug | No human data |
| Ciprofloxacin | C | Avoid: potential toxicity to cartilage | Limited human data: probably compatible |
| Corticosteroids | C | Low risk: possible small risk of cleft palate, adrenal insufficiency, premature rupture of membranes | Compatible |
| Ciclosporin | C | Low risk | Limited human data: potential toxicity |
| Fish oil supplements | – | Safe. Possibly beneficial | No human data |
| Infliximab | B | Low risk: limited human data | Limited human data: probably compatible |
| Mesalamine | B | Low risk | Limited human data: potential diarrhoea |
| Methotrexate | X | Contraindicated: teratogenic | Contraindicated |
| Metronidazole | B | Given limited efficacy in IBD, would avoid in first trimester | Limited human data: potential toxicity |
| Olsalazine | C | Low risk | Limited human data: potential diarrhoea |
| Risedronate | C | Limited human data. | Safety unknown |
| Rifaximin | C | Animal teratogen. No human data | Safety unknown |
| Sulfasalazine | B | Low risk. Give folate 2 mg daily | Limited human data: potential diarrhoea |
| Tacrolimus | C | Low risk | Limited human data: potential toxicity |
| Thalidomide | X | Contraindicated: teratogenic | No human data: potential toxicity |
Low risk is defined as “the human pregnancy data does not suggest a significant risk of embryo or fetal harm”.
IBD, inflammatory bowel disease.