I am due to start sulfasalazine any day and i have found out today that i am pregnant!!! Do i go ahead and start the medication? PLease help me. I have had RA for the last 2-3 years and have coped with paracetamol, dixclofenic and codeine phosphate ( which i know already i cannot take). How much damage will sulfasalzine cause to the baby?
[QUOTE=alexi]I am due to start sulfasalazine any day and i have found out today that i am pregnant!!! Do i go ahead and start the medication? PLease help me. I have had RA for the last 2-3 years and have coped with paracetamol, dixclofenic and codeine phosphate ( which i know already i cannot take). How much damage will sulfasalzine cause to the baby?
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You should definitely check with your pharmacist, OBGYN and rheumatologist. Sulfasalazine is FDA pregnancy category B, which means that there doesn't appear to be much risk from taking it during pregnancy:
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Reproduction studies have been performed in rats and rabbits at doses up to 6 times the human dose and have revealed no evidence of impaired female fertility or harm to the fetus due to Sulfasalazine. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
A national survey evaluated the outcome of pregnancies associated with inflammatory bowel disease (IBD). In a group of 186 women treated with Sulfasalazine alone or Sulfasalazine and concomitant steroid therapy, the incidence of fetal morbidity and mortality was comparable to that for 245 untreated IBD pregnancies as well as to pregnancies in the general population.1 A study of 1,455 pregnancies associated with exposure to sulfonamides indicated that this group of drugs, including Sulfasalazine, did not appear to be associated with fetal malformation. 2 A review of the medical literature covering 1,155 pregnancies in women with ulcerative colitis suggested that the outcome was similar to that expected in the general population.3
No clinical studies have been performed to evaluate the effect of Sulfasalazine on the growth development and functional maturation of children whose mothers received the drug during pregnancy.
Nonteratogenic EffectsSulfasalazine and sulfapyridine pass the placental barrier. Although sulfapyridine has been shown to have a poor bilirubin-displacing capacity, the potential for kernicterus in newborns should be kept in mind.
A case of agranulocytosis has been reported in an infant whose mother was taking both Sulfasalazine and prednisone throughout pregnancy.
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http://www.drugs.com/pro/sulfasalazine.html
paracetamol is OK to take during pregnancy, and many OBGYNs consider codeine and other opiates safe to take OCCASIONALLY during pregnancy, but if you take it right before the kid is born it can cause breathing problems and lethargy in the baby. Luckily many women experience pregnancy-induced remission from RA.
Again, talk to your doctors, and also your pharmacist.
Reproduction studies have been performed in rats and rabbits at doses up to 6 times the human dose and have revealed no evidence of impaired female fertility or harm to the fetus due to Sulfasalazine. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
A national survey evaluated the outcome of pregnancies associated with inflammatory bowel disease (IBD). In 186 pregnancies in women treated with Sulfasalazine alone or Sulfasalazine and concomitant steroid therapy, the incidence of fetal morbidity and mortality was comparable both to that of 245 untreated IBD pregnancies, and to pregnancies in the general population. Thanks for your advice. I will go and see my GP and see what he says. thank you Welcome and congrats on your baby news! Check with your doctor and I wish all the best to you!Welcome! What wonderful news about the baby. I don't think I'd take it. Check with your doctor. You're symptoms my be far less while preg. Your doctor maybe able to give you predisone if you have too much trouble. If you've gone this long without it I'd say 9 more month would be fine....why take the risk.