This sheet is about exposure to propylthiouracil (PTU) in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is propylthiouracil?

Propylthiouracil (PTU) is a medication that has been used to treat hyperthyroidism (when the thyroid gland makes too much thyroid hormone) and Graves’ disease (a common cause of hyperthyroidism). It lowers the amount of thyroid hormone that the thyroid gland makes. One brand name for PTU is Propycil ®. 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Untreated hyperthyroidism can increase the chance of poor outcomes for a pregnancy, including thyroid storm (life-threatening overactive thyroid), maternal congestive heart failure, and other complications. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take PTU. Can it make it harder for me to get pregnant?

It is not known if PTU can make it harder to get pregnant. Untreated thyroid disorders might make it harder to get pregnant. 

Does taking PTU increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Three studies did not find a higher chance of miscarriage when using PTU during pregnancy. Hyperthyroidism has been associated with an increased chance of miscarriage. 

Does taking PTU increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at published data to try to understand if an exposure, like PTU, might increase the chance of birth defects in a pregnancy. 

It is not known if taking PTU can increase the chance of birth defects. Several studies suggest there could be a small increased chance of birth defects when taking PTU, while other studies do not. There has not been a confirmed pattern of birth defects linked to PTU exposure alone.  

The U.S. Food and Drug Administration (FDA) and The American College of Obstetricians and Gynecologists (ACOG) have noted that PTU might be the preferred treatment for hyperthyroidism during the first trimester of pregnancy.  

Does taking PTU in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if PTU can increase the chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Hyperthyroidism has been found to increase the chance of pregnancy complications like preterm delivery and low birth weight.  

Antithyroid medications, like PTU, or having Graves’ disease, can lead to too low or too high thyroid levels in a baby. If you take PTU, or if you have Graves’ disease, your baby’s thyroid level should be checked after delivery. 

The FDA has reported that PTU can cause serious liver damage in people who take this medication, including pregnant women. There is limited data on whether PTU use during pregnancy can cause liver damage in the baby. Talk to your healthcare team to decide what treatment is best for your situation. 

Does taking PTU in pregnancy affect future behavior or learning for the child?   

Two studies looking at 44 children (from preschool to adult ages) exposed to PTU during pregnancy found no difference in intelligence scores compared to their unexposed siblings. Untreated hyperthyroidism in pregnancy can increase the chance of learning problems in children. 

Breastfeeding while taking PTU:

PTU gets into breastmilk in small amounts, and the amounts ingested by the infant are small. The American Thyroid Association has suggested that doses of PTU should be limited to 450 mg per day while breastfeeding due to the lack of research on the chance of liver damage in the breastfed infant. No side effects have been reported in babies who were exposed to PTU through breastmilk. Studies show that PTU does not significantly affect the breastfed infants’ thyroid function. If you suspect the baby has any symptoms, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes PTU, could it affect fertility or increase the chance of birth defects?  

Studies have not been done to see if PTU could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references

This sheet is about exposure to evolocumab in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is evolocumab?

Evolocumab is a prescription medication that has been used to lower the levels of low-density lipoprotein (LDL) cholesterol. It has been used to treat a type of inherited high cholesterol called familial hypercholesterolemia (FH) and a type of heart disease called atherosclerotic cardiovascular disease (ASCVD). Evolocumab is made up of an antibody (blood protein), so it is called a biologic medication. It is sold under the brand name Repatha®.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. For more information about high cholesterol in pregnancy, please see our fact sheet at https://mothertobaby.org/fact-sheets/high-cholesterol/.

I am taking evolocumab, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

People eliminate medication at different rates. In healthy non-pregnant adults, it takes up to 102 days (or about 14 and a ½ weeks), on average, for most of the evolocumab to be gone from the body.

I take evolocumab. Can it make it harder for me to get pregnant?

Studies have not been done in humans to see if evolocumab can make it harder to get pregnant. Information from animal studies does not suggest that taking evolocumab in pregnancy can make it harder to get pregnant.

Does taking evolocumab increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if evolocumab can increase the chance of miscarriage.

Does taking evolocumab increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like evolocumab, might increase the chance of birth defects in a pregnancy.

Studies have not been done in humans to see if evolocumab can increase the chance of birth defects. Information from animal studies done by the manufacturer does not suggest that taking evolocumab in pregnancy increases the chance of birth defects. Based on what is known about other antibody medications, very little of the medication would be expected to reach the developing fetus in the first trimester.

Does taking evolocumab in pregnancy increase the chance of other pregnancy-related problems?

Studies have not been done to see if evolocumab can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking evolocumab in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if evolocumab can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking evolocumab:

Evolocumab has not been studied for use during breastfeeding. This medication is a very large protein, so it is not likely that much of the medication passes into breast milk. Evolocumab is not well absorbed by the stomach, so any medication that passes into breast milk would be unlikely to enter the baby’s blood.

Due to the lack of studies, it has been suggested that evolocumab be used with caution while breastfeeding, especially with a newborn or an infant born preterm. However, the benefit of using evolocumab, along with the benefits of breastfeeding your child, may outweigh possible risks. Your healthcare providers can talk with you about using evolocumab and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes evolocumab, could it affect fertility or increase the chance of birth defects?

Studies have not been done in humans to see if evolocumab could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. Information from animal studies done by the manufacturer does not suggest that taking evolocumab would affect male fertility. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

MotherToBaby is currently conducting a study looking at evolocumab in pregnancy. If you are interested in learning more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

This sheet is about exposure to teriflunomide in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is teriflunomide?

Teriflunomide is a prescription medication that has been used to treat multiple sclerosis (MS). It is marketed under the brand name Aubagio®. There is another medication, called leflunomide, which turns into teriflunomide in the body. For more information on this similar medication, please see the fact sheet leflunomide at https://mothertobaby.org/fact-sheets/leflunomide-pregnancy/.  

The product label for teriflunomide recommends women should not take teriflunomide if they are trying to get pregnant, if they are not actively using birth control to prevent a pregnancy or, if they are already pregnant. However, you should not stop taking any medications without first talking with your healthcare provider. Your healthcare providers can talk with you about using teriflunomide and what treatment is best for you.  

The drug label also states that after stopping teriflunomide, all women of childbearing potential should receive a treatment to help eliminate the drug faster from the body (called a “washout”). Women planning pregnancy are also recommended to stop teriflunomide and receive a treatment to eliminate the drug from the body faster. After receiving treatment to wash out the medication, the drug label states that women should not try and get pregnant until levels of teriflunomide in blood are less than 0.02 mg/L (0.02 mcg/mL). 

I take teriflunomide. Can it make it harder for me to get pregnant?

It is not known if teriflunomide can make it harder to get pregnant. It is recommended that women who are trying to get pregnant not take teriflunomide. If you are trying to get pregnant and are on teriflunomide it is important for you to talk with your healthcare providers. 

I am taking teriflunomide, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

The time it takes the body to metabolize (to process) medication is not the same for everyone. In healthy non-pregnant adults, it takes up to four months after stopping teriflunomide for most of the medication to be gone from the body. It could take up to 2 years for some people to clear this medication from their body. There are treatments to help the body clear this medication faster. Talk with your healthcare provider if there is a concern for you.  

Does taking teriflunomide increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if teriflunomide can increase the chance of miscarriage. No increase in miscarriage was reported in 150 pregnancies with teriflunomide exposure early in the 1st trimester and use of the rapid washout procedure. 

Does taking teriflunomide increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at published data to try to understand if an exposure, like teriflunomide, might increase the chance of birth defects in a pregnancy. 

It is unknown if taking teriflunomide in pregnancy can increase the chance of birth defects. Reports looking at a total of over 250 pregnancies with exposure to teriflunomide did not find an increased chance of birth defects. It has been recommended to avoid teriflunomide during pregnancy. If teriflunomide is taken during pregnancy, talk with your healthcare provider about rapid washout of the medication. 

Does taking teriflunomide increase the chance of other pregnancy-related problems?

Studies have not been done to see if teriflunomide can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

Does taking teriflunomide in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if teriflunomide can affect future behavior or learning for the child.  

Breastfeeding while taking teriflunomide:  

There are no studies looking at the use of teriflunomide in breastfeeding. It is unknown how much of the medication can get into breast milk. The product label for teriflunomide recommends women who are breastfeeding not use this medication. Your healthcare providers can talk with you about using teriflunomide and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes teriflunomide, could it affect fertility or increase the chance of birth defects?  

It is not known if taking teriflunomide can affect men’s fertility (ability to get a woman pregnant). One study looked at 18 males who received teriflunomide an average of 198 days leading up to conception in their partner. All pregnancies resulted in live births, with only one report of a birth defect (plagiocephaly). The manufacturer recommends that men and their partners use reliable contraception while taking this medication. Men who are planning to conceive should talk with their healthcare provides about the rapid washout or waiting to try to get a woman pregnant until after his blood levels of teriflunomide are low. For general information on exposures that men might have, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

MotherToBaby is currently conducting a study looking at multiple sclerosis and the medications used to treat MS in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

Please click here for references.     

This sheet is about having hidradenitis suppurativa (HS) in pregnancy or while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is hidradenitis suppurativa (HS)? 

Hidradenitis suppurativa is a condition that causes small, painful lumps to form under the skin. The lumps usually develop in areas where skin rubs against skin, such as the armpits, groin, buttocks and breasts. The lumps tend to heal slowly. They also tend to keep coming back (recur). This can lead to tunnels under the skin and scarring. Hidradenitis suppurativa is sometimes called HS. HS has also been called acne inversa. 

HS symptoms might stay the same, become better, or become worse during pregnancy. Following pregnancy, some women with HS have reported that their symptoms can be worse in the postpartum period (up to 8 weeks after childbirth). 

I have HS. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk with your healthcare team (including your obstetrician and dermatologist) about plans for treating HS before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. Things to talk about with your healthcare team include: 

• Ways to monitor your pregnancy and your HS symptoms

• Any medications you should take during pregnancy

• Any other questions or concerns you have

I have HS. Can it make it harder for me to get pregnant? 

This has not been well studied. It is not known if having HS can make it harder to get pregnant. One study has suggested that HS might be linked to infertility in females.  

Does having HS increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if HS can increase the chance of miscarriage. Some studies have not found an association between HS and miscarriage. Other studies have suggested that there might be a higher chance of miscarriage among women with HS. Since there can be many causes of miscarriage, it is hard to know if a medication, the medical condition, or other factors (age, health, other exposures) were the cause of a miscarriage in these studies. 

Does having HS increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like HS, might increase the chance of birth defects in a pregnancy. It is not known if HS can increase the chance of birth defects because this has not been well studied.  

Would having HS increase the chance of other pregnancy related problems? 

HS has been linked to a greater chance of preterm delivery (birth before week 37) in some studies. One study has also suggested a possible increased chance of stillbirth.  

Studies have reported that people with HS have a greater chance of developing high blood pressure. This could also affect a pregnancy for women with HS, as high blood pressure and preeclampsia (a pregnancy related condition that can include high blood pressure and problems with the kidneys) have been reported.  

Gestational diabetes and bleeding after delivery (post-partum hemorrhage) have also been reported to be more common among women with HS. One article reported a higher chance for postpartum sepsis (infection that happens after childbirth that can lead to organ failure).  

It is hard to know from the way these studies were done if these findings could also be related to a medication, a different medical condition, or other exposures (such as age, smoking, or obesity). 

Does having HS in pregnancy affect future behavior or learning for the child?    

Studies have not been done to see if HS can increase the chance of behavior or learning issues for the child. 

Breastfeeding with HS: 

Most women with HS can breastfeed if they desire. Some females with HS might have a harder time with lactation if their HS is affecting the breast glands that secrete breastmilk, or if an HS flare affects their nipple/areola area of the breast.  

If you have questions about medications used to treat HS, please reach out to MotherToBaby with your specific treatment. Be sure to talk to your healthcare providers about all your breastfeeding questions.  

If a man has HS, can it affect his fertility or increase the chance of birth defects?   

It is not known if HS can affect male fertility. One study did not report a lower chance of fertility, while another study suggested a higher chance of erectile dysfunction, which could make it harder to get a partner pregnant. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

MotherToBaby is currently conducting a study looking at medications used to treat hidradenitis suppurativa (HS) in pregnancy. If you are interested in learning more, please call 1-877-311-8972 or visit our study page at:  https://mothertobaby.org/join-study/. 

Please click here for references.

This sheet is about exposure to amlodipine in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is amlodipine?

Amlodipine is a medication that has been used to treat high blood pressure (hypertension). It is in a class of medications called calcium channel blockers. A brand name for amlodipine is Norvasc®.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

Women who are pregnant and have high blood pressure have a greater chance of developing pre-eclampsia (high blood pressure and problems with organs, such as the kidneys) that can lead to seizures (called eclampsia). High blood pressure can increase the chance for medical complications for the woman who is pregnant and for the pregnancy.

I take amlodipine. Can it make it harder for me to get pregnant?

Studies have not been done to see if amlodipine can make it harder to get pregnant.

Does taking amlodipine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if amlodipine can increase the chance of miscarriage. One study looking at 78 women who took calcium channel blockers did not find a higher chance of miscarriage.

Does taking amlodipine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. Information on the use of amlodipine in pregnancy is very limited. Most available information on the use of calcium channel blockers as a group in human pregnancy does not suggest an increased chance of birth defects.

Does taking amlodipine in pregnancy increase the chance of other pregnancy-related problems?

One study comparing amlodipine to nifedipine (a similar medication) found no difference in the chance of other pregnancy related problems, including need for a c-section section, preterm delivery (birth before week 37), placental abruption (when the placenta pulls away from the wall of the uterus before labor starts), or growth restriction (babies that are smaller than usual). Available data on the use of calcium channel blockers as a group does not suggest an increased chance of pregnancy complications.

Uncontrolled high blood pressure during pregnancy has been associated with growth restriction and a higher chance of preterm delivery.

Does taking amlodipine in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if amlodipine can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking amlodipine:

Information on the use of amlodipine in breastfeeding is limited. The amount of amlodipine in milk is usually low and side effects in breastfed infants have not been reported.

The product label for amlodipine recommends women who are breastfeeding not use this medication. But the benefits of using amlodipine and the benefits of breastfeeding your baby might outweigh possible risks. Your healthcare providers can talk with you about using amlodipine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes amlodipine, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if amlodipine could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.