What Is the Teratogenic Risk of Mycophenolate?

Kylat, Ranjit I

doi:10.1055/s-0036-1597933

Cited by 14 publications

(10 citation statements)

References 16 publications

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“…It is recommended that pregnancy be avoided by women taking MPA [42]. Women being considered for treatment with MPA should always have a negative pregnancy test and should employ at least two methods of contraception during its use [43,44]. A retrospective cohort study investigated the association between the discontinuation of MPA and pregnancy after kidney transplantation in 382 cases.…”

Section: Nucleotide Synthesis Inhibitorsmentioning

confidence: 99%

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Ponticelli

Moroni

2018

JCM

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Women affected by autoimmune diseases, organ transplantation, or neoplasia need to continue immunosuppressive treatment during pregnancy. In this setting, not only a careful planning of pregnancy, but also the choice of drugs is critical to preventing maternal complications and minimizing the fetal risks. Some immunosuppressive drugs are teratogenic and should be replaced even before the pregnancy, while other drugs need to be managed with caution to prevent fetal risks, including miscarriage, intrauterine growth restriction, prematurity, and low birth weight. In particular, the increasing use of biologic agents raises the question of their compatibility with reproduction. In this review we present data on the indication and safety in pregnancy of the most frequently used immunosuppressive drugs.

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Section: Nucleotide Synthesis Inhibitorsmentioning

confidence: 99%

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Ponticelli

Moroni

2018

JCM

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“…As has been seen in other studies of HCQ use in pregnancy, women reporting HCQ also took other immunomodulatory agents, biologic agents, and corticosteroids for their rheumatic conditions (Bermas et al, 2018 ; Desai et al, 2016 ). Some HCQ‐exposed women in our analysis reported medications thought to be teratogenic: four took methotrexate (three cases, one control) and one reported mycophenolate mofetil (one case; Götestam Skorpen et al, 2016 ; Kylat, 2017 ; Milunsky, Graef, & Gaynor Jr., 1968 ).…”

Section: Discussionmentioning

confidence: 89%

Maternal exposure to hydroxychloroquine and birth defects

Howley

Werler

Fisher

et al. 2021

Birth Defects Research

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Background Hydroxychloroquine is a treatment for rheumatic disease and considered safe during pregnancy. Interest in hydroxychloroquine has increased as it is being examined as a potential treatment and prophylaxis for coronavirus disease 2019. Data on the risks of specific birth defects associated with hydroxychloroquine use are sparse. Methods Using data from two case–control studies (National Birth Defects Prevention Study and Slone Epidemiology Center Birth Defects Study), we described women who reported hydroxychloroquine use in pregnancy and the presence of specific major birth defects in their offspring. Cases had at least one major birth defect and controls were live‐born healthy infants. Women self‐reported medication use information in the few months before pregnancy through delivery. Results In total, 0.06% (19/31,468) of case and 0.04% (5/11,614) of control mothers in National Birth Defects Prevention Study, and 0.04% (11/29,838) of case and 0.05% (7/12,868) of control mothers in Birth Defects Study reported hydroxychloroquine use. Hydroxychloroquine users had complicated medical histories and frequent medication use for a variety of conditions. The observed birth defects among women taking hydroxychloroquine were varied and included nine oral cleft cases; the elevated observed:expected ratios for specific oral cleft phenotypes and for oral clefts overall had 95% confidence intervals that included 1.0. Conclusion While teratogens typically produce a specific pattern of birth defects, the observed birth defects among the hydroxychloroquine‐exposed women did not present a clear pattern, suggesting no meaningful evidence for the risk of specific birth defects. The number of exposed cases is small; results should be interpreted cautiously.

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“…Considering the safe use of (over the counter) medicinal products, herbs and supplements, there are several free accessible databases with scientific information on safe preconception drug use for males and females mainly for antiepileptic ' s, folate antimetabolites, warfarin and related anticoagulants, retinoic acid derivatives and ACE-inhibitors [6-12]. Mycophenolate mofetil is taken by many patients with rare inflammatory diseases and because of its teratogenic properties [10] it can best be switched before conception to another treatment [13]. Adherence to medication and diet for rare disease patients is very important in this period to keep levels (eg.…”

Section: Safe Medicines Before Pregnancymentioning

confidence: 99%

Preconception Pharmaceutical Care & Rare Diseases

Dooms¹

2019

J Rare Disord Diagn Ther

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The objective of this paper is to demonstrate how both individual family physicians and pharmacists, as well as larger primary care organisations can contribute to the implementation of preconception care delivery i.e. to establish the service, to reach the target population and to add sustainably and effectively to the primary goals of preconception care i.e. to modify the risks to the health of future children and more specifically with respect to rare diseases. This paper comprises a short introduction into the contents of preconception care and a structured debate in which implementation options are will be explored such as; seizing opportunities in daily practice, integration in contraception counselling and/or sexual and reproductive health programmes; selection of and outreach to, high risk subgroups defined for example by genetic predisposition, social economic deprivation, chronic diseases etc. The readers are expected to understand options to improve preconception pharmaceutical care applicable in their own healthcare system. Community pharmacists are in a privileged position to implement pharmaceutical care to prevent rare diseases wherever possible by dispensing safe medicines and advising healthy life-style and genetic counselling before conception as well as occasionally referring to the possibility of assisted reproductive technology.

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What Is the Teratogenic Risk of Mycophenolate?

Cited by 14 publications

References 16 publications

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Maternal exposure to hydroxychloroquine and birth defects

Preconception Pharmaceutical Care & Rare Diseases

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