Table 3.

How to use specific available medication during preconception period.

Medication	Pre-Conception	References
Hydroxychloroquine	Recommended to all patients	[5,15,46]
Oral glucocorticoids	Accepted if needed at lowest effective dose, but less than 20 mg/day equivalent Prednisone	[5,15,46]
Azathioprine	Accepted if needed	[5,15,46]
Cyclosporin A and tacrolimus	Accepted if needed, caution if high blood pressure	[5,15,46]
Nonsteroidal antiinflamatory drugs	Accepted if needed, discontinue if there is problem with conceiving, cyclooxygenase 2 not indicated	[5,15,46]
Methotrexate	Stop 1–3 months prior to conception	[5,15,46]
Leflunomide	Stop if planning a pregnancy, washout with cholestyramine until no longer detected	[5,15,46]
Mycophenolate Mofetil and Mycophenolic Acid	Stop at least 6 weeks before conception to observe flare after discontinuation	[5,15,46]
Cyclophosphamide	Stop 3 months prior to conception	[5,15,46]
Available biologics (Belimumab, Rituximab)	Discontinue at conception	[15]
Recently approved biologic (Anifrolumab)	Not yet included in EULAR and ACR recommendations, no available data related to safety during pregnancy

EULAR—European Alliance of Associations for Rheumatology; ACR—American College of Rheumatology.