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

What are omeprazole and esomeprazole? 

These two medications contain the same active ingredient and act in the body in a similar way. Both omeprazole and esomeprazole belong to a group of medications called proton pump inhibitors (PPIs). PPIs that lower the amount of acid released by the stomach. 

Omeprazole is a medication that has been used to treat heartburn, stomach ulcers, and acid reflux (also known as GERD, or gastroesophageal reflux disease). A common brand for omeprazole is Prilosec®. Omeprazole is combined with sodium bicarbonate in the medication Zegerid®.  

Esomeprazole is a medication that has been used to treat heartburn, stomach ulcers, acid reflux (also known as GERD, or gastroesophageal reflux disease), and Zollinger-Ellison syndrome. A common brand for esomeprazole is Nexium®.  

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.

I take omeprazole or esomeprazole. Can it make it harder for me to get pregnant? 

It is not known if taking omeprazole or esomeprazole can make it harder to get pregnant. Information from animal studies does not suggest that omeprazole or esomeprazole affects female fertility (ability to get pregnant). 

Does taking omeprazole or esomeprazole increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Information from limited studies suggest that taking omeprazole or esomeprazole during pregnancy is not expected to increase the chance of miscarriage.  

Does taking omeprazole or esomeprazole 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 omeprazole and esomeprazole, might increase the chance of birth defects in a pregnancy.  

Omeprazole (which has the same active medication as esomeprazole) is the best studied of the PPIs. Available information does not suggest an increased chance of birth defects when omeprazole or esomeprazole is used in pregnancy.   

Does taking omeprazole or esomeprazole in pregnancy increase the chance of other pregnancy-related problems? 

Information from limited studies suggests that taking omeprazole or esomeprazole is not likely to cause 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).  

Esomeprazole is being studied as a treatment in pregnancy to prevent preeclampsia (high blood pressure and problems with organs, such as the kidneys), which can lead to seizures (called eclampsia). 

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

It is not known if omeprazole or esomeprazole use in a pregnancy can cause behavior or learning issues for the child.  

Breastfeeding while taking omeprazole or esomeprazole: 

Limited data suggest that doses of 20mg of omeprazole or 10mg or esomeprazole daily result in low levels of these medications in breastmilk. The amounts of omeprazole or esomeprazole in breastmilk are not expected to be harmful to a nursing infant. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

One study found that when PPIs were used for any period between 6 and 12 months, the sperm count was decreased. However, a more recent study looking at the effects of PPI use on male fertility (ability to make healthy sperm) did not link PPI use with negative impacts on sperm count or quality. 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. 

This sheet is about exposure to zolpidem 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 providers. 

What is zolpidem? 

Zolpidem is a sedative-hypnotic medication (causes calm and sleep) that has been used to treat insomnia (not being able to fall asleep or stay asleep). It belongs to a group of medications called hypnotic benzodiazepine receptor agonists, or HBRAs (sometimes called z-hypnotics or z-drugs). HBRAs are not benzodiazepines, but they work in a similar way. Some brand names of zolpidem are Ambien®, Edluar®, and Intermezzo®. 

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. Some people who stop taking zolpidem suddenly might experience withdrawal symptoms like fatigue, nausea, vomiting, flushing, lightheadedness, crying, and nervousness. Your healthcare providers can talk with you about the benefits of treating insomnia, and the risks of untreated insomnia during pregnancy.  

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

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

Does taking zolpidem increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if zolpidem can increase the chance of miscarriage. 

Does taking zolpidem 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 zolpidem, can increase the chance of birth defects in a pregnancy. Several studies have reported no increased chance of birth defects with the use of zolpidem during pregnancy. 

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

Several studies have found that using zolpidem during pregnancy does not greatly 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). Other studies have found that women who took zolpidem during pregnancy were slightly more likely to deliver early or have smaller babies compared with women who did not take these medications during pregnancy. These studies did not consider other factors, such as the use of other medications, smoking, alcohol or drug use, or the underlying medical condition that the medication was used to treat. This makes it hard to know if the medication, illnesses being treated, or other factors are the reason for the reported issues.    

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

It is not known if zolpidem can increase the chance of behavior or learning issues for the child. 

Breastfeeding while taking zolpidem: 

Zolpidem passes into breast milk in small amounts. One small study and a case report found that 6 women who took zolpidem during the days after delivery had small amounts of the medication in their breast milk three hours after taking it. No problems were reported in their babies. If you suspect the baby has any symptoms (being very sleepy, trouble gaining weight, low muscle tone or floppiness, or slow breathing), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Studies have not been done to see if zolpidem could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In general, men’s exposures are unlikely to increase risks to a pregnancy. For more general 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 azathioprine / 6-mercaptopurine (6-MP) in pregnancy and while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare providers.

What is azathioprine and 6-MP?

Azathioprine and 6-MP are medications that lower the body’s immune system. These medications are closely related to each other. In the body, azathioprine breaks down into 6-MP. The brand name of azathioprine is Imuran®. The brand name of 6-MP is Purinethol®.

Azathioprine and 6-MP have been used to treat autoimmune conditions like lupus and rheumatoid arthritis. It has also been used to treat inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. MotherToBaby has facts sheet on lupus https://mothertobaby.org/fact-sheets/lupus-pregnancy/, rheumatoid arthritis https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/, and inflammatory bowel disease https://mothertobaby.org/fact-sheets/inflammatory-bowel-disease-pregnancy/.

Azathioprine is also used to help prevent the body from rejecting an organ transplant. 6-MP is used to treat some cancers.

Sometimes when people 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.

I take azathioprine / 6MP. Can it make it harder for me to get pregnant?

It is not known if taking azathioprine or 6MP can make it harder to become pregnant.

Does taking azathioprine / 6MP increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Taking azathioprine or 6MP is not expected to increase the chance of miscarriage.

Does taking azathioprine / 6MP 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 a certain exposure, like azathioprine / 6-MP, might increase the chance of birth defects or other problems in a pregnancy.

Azathioprine and 6-MP have been studied in over 1,700 pregnancies. Most studies found no increased chance of birth defects. Some studies have found an overall increase in birth defects; however, these increases were usually no different from those in groups of people with similar health conditions. This makes it hard to know if the medication, the medical condition, or other factors were the cause. There was also no consistent pattern of birth defects, which means they could have been caused by chance or other reasons.

Does taking azathioprine / 6-MP in pregnancy increase the change of other pregnancy related problems?

Some studies on azathioprine and 6-MP have reported higher rates of babies being born early (birth before week 37) or with low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). The illnesses these medications are used to treat can also increase the chance of these outcomes. This means it is not clear if the outcomes are due to the medical condition being treated, the medication, or other factors.

Use of azathioprine or 6-MP near delivery has been associated with temporary problems with the immune system and low blood counts in the newborn. This seems more likely with higher doses, such as those used to treat cancer and organ transplantation. It might be more likely when the person who is pregnant has low white blood cells themselves.

Does taking azathioprine / 6-MP affect future behavior or learning for the baby?

It is not known if azathioprine / 6-MP can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking azathioprine or 6-MP:

Small amounts of azathioprine and 6-MP have been found to enter breast milk in people whose bodies are able to break down these medications as expected. The highest amount of 6-MP has been found in the breast milk around 1-2 hours after the person’s last dose. About 4 hours after the last dose, the amount of medication in breast milk is very small. Most babies exposed to these medications through breastmilk have been found to have normal blood counts and do not have higher rates of infection. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a male takes azathioprine / 6-MP, could it affect fertility or increase the chance of birth defects?

No effects on male fertility (ability to get partner pregnant) have been reported with the use of azathioprine / 6-MP. Studies that have looked at pregnancy outcomes after male use of these medications before or during conception have not found an increase 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 tralokinumab 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 tralokinumab?

Tralokinumab (Adbry®) is a medication in the form of a shot (injection) that has been used to treat moderate to severe atopic dermatitis (eczema) that is hard to treat with topical therapies (used on the skin). It has also been used to treat atopic dermatitis in people who cannot use topical therapies. MotherToBaby has a fact sheet on atopic dermatitis here https://mothertobaby.org/fact-sheets/atopic-dermatitis/.  

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. 

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

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

Does taking tralokinumab 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 tralokinumab can increase the chance of miscarriage. 

Does taking tralokinumab 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 tralokinumab, might increase the chance of birth defects in a pregnancy. Human studies have not been done to see if tralokinumab can increase the chance of birth defects. An animal study did not find an increased chance of birth defects when tralokinumab was used in pregnancy.  

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

Studies have not been done to see if tralokinumab 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 tralokinumab in pregnancy affect future behavior or learning for the child?  

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

Can my baby receive live vaccines before one year of age if I take tralokinumab while pregnant?

Since tralokinumab might suppress the immune system of the person taking it, there is a theoretical concern that the same thing could happen to the baby if they are exposed during pregnancy. If someone has a weakened immune system, they might be more likely to develop an infection from a live vaccine. Live vaccines contain a small amount of live virus. Inactivated vaccines do not contain live virus, so they cannot cause the disease they protect against. In the United States, rotavirus is the only live vaccine routinely given in the first year of life. Most people can get inactivated vaccines in the first year of life.  

Talk with your child’s healthcare provider about your exposure to tralokinumab during pregnancy. They can talk with you about the vaccines your child should receive and the best time for your child to receive them. 

Breastfeeding while taking tralokinumab:

Tralokinumab has not been studied for use in humans while breastfeeding. Based on the size of the tralokinumab molecules, it is thought that the chance it enters the breastmilk is low. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Studies have not been done to see if tralokinumab 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/.  

MotherToBaby is currently conducting a study looking at tralokinumab-ldrm and other medications used to treat atopic dermatitis in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-study/.

Please click here to view references.

This sheet is about exposure to chlordiazepoxide 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 providers. 

What is chlordiazepoxide?

Chlordiazepoxide is a medication that has been used to treat anxiety and symptoms of alcohol withdrawal syndrome (such as anxiety and agitation). MotherToBaby has a fact sheet on anxiety here https://mothertobaby.org/fact-sheets/anxiety-fact/. Chlordiazepoxide is in a class of medications called benzodiazepines. A brand name for chlordiazepoxide is Librium®.  

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.  

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

It is not known if chlordiazepoxide can make it harder to get pregnant. 

Does taking chlordiazepoxide 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 chlordiazepoxide can increase the chance of miscarriage. 

Does taking chlordiazepoxide 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 chlordiazepoxide, might increase the chance of birth defects in a pregnancy. 

Most reports did not find a higher chance for birth defects with first trimester use of chlordiazepoxide. While there have been some reports of birth defects with first trimester use, no clear pattern of birth defects has been associated with this medication. 

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

Chlordiazepoxide has not been well studied for use during pregnancy. One study found a higher chance for low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) when chlordiazepoxide was taken during pregnancy. It is not known if chlordiazepoxide might increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37).  

I need to take chlordiazepoxide throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth? 

The use of chlordiazepoxide during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms might include tremors, irritability, or other issues. Not all babies exposed to chlordiazepoxide will have symptoms. It is important that your healthcare providers know you are taking chlordiazepoxide so that if symptoms occur your baby can get the care that is best for them. 

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

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

Breastfeeding while taking chlordiazepoxide:

Chlordiazepoxide has not been studied for use while breastfeeding. Chlordiazepoxide stays in the body for a long time and might pass into breast milk. If you suspect the baby has any symptoms (poor feeding, poor weight gain, or sleepiness) contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if chlordiazepoxide 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.