Immunosuppression safety in pregnancy and breast feeding
| Periconception | T1 | T2/T3 | Breast feeding | Paternal exposure | |
| Prednisolone36 | Yes | Yes | Yes | Yes | Yes |
| Intravenous MP36 | Yes | Yes | Yes | Yes | Yes |
| AZA38 | Yes | Yes | Yes | Yes | Yes |
| MTX≤25 mg/week38 39 | Stop 1 month in advance | No | No | No | Yes |
| MMF38 | Stop 6 weeks in advance | No | No | No | See text |
| CYC38 | No | No* | No* | No | No |
| Intravenous Ig37 38 | Yes | Yes | Yes | Yes | Yes† |
| Rituximab7 38 | Consider stopping at conception‡ | Severe disease if no alternatives‡ | Severe disease if no alternatives§ | Yes† | Yes† |
*Only consider in severe life or organ-threatening maternal disease.
†Limited data available.
‡Can consider in severe maternal disease if no pregnancy-compatible alternatives available.
§If used in third trimester, avoid live vaccinations in infant until 6 months of age.
AZA, azathioprine; CYC, cyclophosphamide; Ig, immunoglobulin; MMF, mycophenolate mofetil; MP, methylprednisolone; MTX, methotrexate.