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Pregnancy Planning in Rheumatic Disease
Medication and risk planning before conception.
Video lesson
Key points
Aim for at least 3 to 6 months of quiescent disease. Check antiphospholipid antibodies and SSA/SSB in lupus and connective tissue disease.
Practical approach
Stop methotrexate 1 to 3 months and mycophenolate at least 6 weeks before conception. Leflunomide needs cholestyramine washout. Continue hydroxychloroquine, sulfasalazine, azathioprine, tacrolimus and TNF inhibitors as appropriate. Low-dose aspirin from 12 weeks for lupus and APS.
Pearls
Paternal methotrexate does not need to be stopped according to current ACR guidance.
At a glance
Category
Patient counseling
Reviewed by Farhan Tahir, MD, FACR
Questions about your own care?
Book an in-person or telehealth consultation with Dr. Tahir.
For education only. Don’t start, stop or change a medicine without talking to your care team.