This sheet is about exposure to finasteride 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 finasteride?

Finasteride is a medication that has been used to treat male pattern hair loss and benign prostatic hyperplasia (enlarged prostate). Oral finasteride (a pill taken by mouth) has been approved by the U.S. Food and Drug Administration (FDA) for use in men. Finasteride is not approved for use in woman but has been used “off-label” in women to treat hair loss and hirsutism (extra hair growth on areas of the body such as the face, chest, and back). Some brand names for finasteride are Propecia® and Proscar®.

Topical finasteride (used on the skin) has not been approved by the U.S. FDA, but has been used to treat male and female pattern hair loss. This fact sheet will focus on the use of oral finasteride. Finasteride, in any form, is not recommended for use during pregnancy.

I am taking finasteride, 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 2 days, on average, for most of the finasteride to be gone from the body.

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

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

I just found out I am pregnant. Should I stop taking finasteride?

Finasteride is not recommended for use during pregnancy. If you are taking finasteride and find out that you are pregnant, contact your healthcare provider to talk about your exposure.

Does taking finasteride 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 taking finasteride could increase the chance of miscarriage.

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

Animal studies have suggested that exposure to large doses of finasteride when the fetal sex organs are developing (8 to 12 weeks of pregnancy) could increase the chance for some birth defects of the sex organs in a male fetus. Animal studies have reported hypospadias (when the opening of the penis is on the underside of the penis instead of at the tip), a shorter distance from the anus to the genitals (anogenital distance), and lower weight of the prostate and seminal vesicles (glands that help make semen).

If I touch or handle finasteride tablets during pregnancy, is there an increased chance of birth defects?

Pregnant women are told not to handle finasteride tablets that are crushed or broken as a precaution. The coating on uncrushed or unbroken tablets should prevent contact with finasteride during typical handling. If you touch or handle crushed or broken finasteride tablets, wash your hands. It is unlikely that enough of the medication would get through the skin and increase risks to a pregnancy.

People who are required to work with finasteride as part of their job should wear gloves, clean surface areas where pills are handled, and wash their hands. Workers should discuss proper handling and storage with their occupational safety officers. For more information about workplace exposures, see the MotherToBaby fact sheet here: https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/.

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

Studies have not been done in humans to see if finasteride 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).

Experimental animal studies suggest that finasteride exposure in pregnancy might increase the chance of preterm delivery and might affect the ability of the testicles to move down into the proper position in the scrotum (the bag of skin hanging below the penis). This process is called testicular descent and usually happens on its own in most males soon after birth.

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

Studies have not been done in humans to see if finasteride can increase the chance of behavior or learning issues for the child. An animal study reported use of finasteride in pregnancy might affect memory in some exposed offspring.

Breastfeeding while taking finasteride:

Finasteride use while breastfeeding has not been studied. No information is available on its transfer into human milk. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man is taking finasteride, should they stop taking finasteride before trying to get a woman pregnant?

Men taking finasteride should go over the benefits and limitations of taking the medication with their healthcare provider, especially before deciding to stop treatment.

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

Problems with sexual function have been reported in man taking finasteride. Low sperm counts have been reported in men who take finasteride. Sperm levels improved when the medication was stopped.

A study in rats did not show an increased chance of birth defects in the offspring of female rats who had mated with male rats given finasteride.

There has been concerns about an increased chance of birth defects involving the sex organs of male babies if a man and a woman had unprotected sex during the critical time in pregnancy when the sex organs are developing (8 to 12 weeks of pregnancy). However, the amount of finasteride found in semen is small. If fetal exposure to the drug is only through semen with vaginal sex, the amount of finasteride in semen is not expected to be enough to cause a problem for the developing fetus. There are case reports of pregnancies with documented paternal exposure to finasteride either before or during pregnancy that resulted in the birth of full-term infants without reported 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 siponimod 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 siponimod?

Siponimod (Mayzent®) is a medication approved to treat relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. To learn more about multiple sclerosis, please see our fact sheet at: https://mothertobaby.org/fact-sheets/multiple-sclerosis/.

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 this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I am taking siponimod, 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 8 to 10 days, on average, for most of siponimod to be gone from the body.

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

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

Does taking siponimod increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. According to the product label, experimental animal studies reported an increase in pregnancy loss. Studies have not been done in human pregnancy to see if siponimod increases the chance for miscarriage.

Does taking siponimod increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. According to the product label, experimental animal studies reported an increased chance for birth defects. Studies have not been done in human pregnancy to see if siponimod increases the chance for birth defects above the background risk.

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

According to the product label, experimental animal studies reported a chance of low birth weight. Studies have not been done in human pregnancy to see if siponimod increases the chance for 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 siponimod in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if siponimod can cause behavior or learning issues for the child.

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects. Ultrasounds can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.

Breastfeeding while taking siponimod:

Siponimod has not been studied for use while breastfeeding. It is possible that small amounts of this medication might get into the breastmilk. However, these amounts can be potentially toxic for a breastfed infant. If you are taking siponimod while breastfeeding and you suspect the baby has any symptoms, such as vomiting, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Studies have not been done to see if siponimod 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/.

MotherToBaby is currently conducting a study looking at multiple sclerosis and medications used to treat it in pregnancy. If you would like to learn more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

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This sheet is about exposure to adalimumab 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 adalimumab? 

Adalimumab is a medication used to treat autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, and inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease. Adalimumab is a tumor necrosis factor (TNF) inhibitor, meaning it blocks TNF, a substance that causes inflammation in the joints, spine, and skin. Adalimumab is sold under the brand name Humira®. 

MotherToBaby has fact sheets on the following medical conditions:   

Ankylosing spondylitis: https://mothertobaby.org/fact-sheets/ankylosing-spondylitis
Inflammatory bowel disease (IBD): https://mothertobaby.org/fact-sheets/inflammatory-bowel-disease-pregnancy
Psoriasis and psoriatic arthritis: https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy
Rheumatoid arthritis: https://mothertobaby.org/fact-sheets/rheumatoid-arthritis 

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. Autoimmune diseases in pregnancy, especially when not well treated, could increase the risk of pregnancy-related problems. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I am taking adalimumab, 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 (process) medication is not the same for everyone. In healthy non-pregnant adults, it takes up to 12 weeks (3 months), on average, for most of the adalimumab to be gone from the body. One case report described a woman who stopped adalimumab at 16 weeks of pregnancy. At delivery, 21 weeks later, the medication was still found in her blood and in the baby’s umbilical cord blood. 

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

It is not known if adalimumab can make it harder to get pregnant. Studies are ongoing to see whether adalimumab might improve some fertility treatment outcomes. 

Does taking adalimumab increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Most available studies on adalimumab do not suggest an increased chance of miscarriage. 

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

One study of 495 women taking a TNF inhibitor (147 on adalimumab) suggested a slightly higher chance of birth defects compared to women without autoimmune disease. It is unclear whether this was due to the medication or the underlying disease. Other studies of nearly 700 pregnancies exposed to adalimumab found no increased chance of birth defects. 

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

Adalimumab may pass through the placenta more in the third trimester than in the first. Studies of women who continued TNF inhibitors, including adalimumab, into the third trimester did not show a higher chance of preterm birth (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). You and your healthcare provider can decide whether to use adalimumab later in pregnancy, depending on your condition and symptoms. 

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

One study that looked at infants exposed to TNF inhibitors (including adalimumab) in pregnancy throughout their first year of life did not find an increased chance of behavior or learning problems.   

Can my baby receive live vaccines before one year of age if I take adalimumab later in pregnancy? 

Some TNF inhibitors, like adalimumab, may affect the immune system. This raised a theoretical concern (not proven) that babies exposed during pregnancy could also have weaker immunity. 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.  

For adalimumab, studies have shown no increase in infection rates in children after delivery, and up to 12 months of age. Talk with your child’s healthcare provider about vaccines and the best timing for your child after your exposure to adalimumab during pregnancy. 

Breastfeeding while taking adalimumab: 

The amount of adalimumab that passes into breastmilk is low. Also, adalimumab is usually not well absorbed by the gut, so the amount of the medication absorbed by the baby from breastmilk is expected to be low. There are a small number of reports of healthy newborns who were exposed to adalimumab through breastmilk. If you think the baby has symptoms (vomiting, frequent infections), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Two small studies suggest TNF inhibitors might affect sperm function, but most studies have not shown an effect on fertility (ability to make healthy sperm). Studies have not been done to see if adalimumab could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase the 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 flurazepam 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 flurazepam? 

Flurazepam is a medication that has been used to treat insomnia (having a hard time falling asleep or staying asleep). Flurazepam is in a class of medications called benzodiazepines. A brand name for flurazepam is Dalmane®. 

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. 

Stopping flurazepam suddenly could cause withdrawal symptoms. It is not known if or how withdrawal might affect a pregnancy. It has been suggested that any reduction in flurazepam be done slowly, and under the direction of your healthcare provider.  

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

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

Does taking flurazepam 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 flurazepam can increase the chance of miscarriage. 

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

Studies have not been done in humans to see if flurazepam can increase the chance of birth defects. Animal studies did not find a higher chance of birth defects with exposure to flurazepam.  

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

Studies have not been done to see if flurazepam 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). 

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

The use of flurazepam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. If flurazepam is used at the end of pregnancy, the baby can be monitored for “floppy infant syndrome” (poor muscle tone) and trouble feeding. Not all babies exposed to flurazepam will have symptoms. It is important that your healthcare providers know you are taking flurazepam so that if symptoms occur your baby can get the care that is best for them. 

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

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

Breastfeeding while taking flurazepam:

Flurazepam has not been studied for use while breastfeeding. There is a report of drowsiness (being very sleepy) in an infant who was exposed to flurazepam and 3 other medications through breastmilk. It is not known if the flurazepam, another medication, the combination of medications, or other factors caused the baby to be too sleepy.  

The product label for flurazepam recommends people who are breastfeeding not use this medication. However, the benefit of using flurazepam might outweigh possible risks. If you take flurazepam while breastfeeding and suspect the baby has any symptoms (such as drowsiness, poor feeding, or poor weight gain), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if flurazepam could affect men’s fertility (ability to get a partner 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 temazepam 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 temazepam? 

Temazepam is a medication that has been used to treat insomnia (having a hard time falling asleep or staying asleep). Temazepam is in a class of medications called benzodiazepines. It is sold under the brand name Restoril®. 

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. 

If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping all at once. Stopping this medication suddenly can cause some people to have withdrawal symptoms. It is not known what effects, if any, withdrawal could have on a pregnancy. 

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

It is not known if using temazepam could make it harder to get pregnant.  

Does taking temazepam increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. One study suggested that temazepam might increase the chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage. 

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

A study of 379 children exposed to temazepam in the first trimester of pregnancy did not find a higher chance of birth defects. 

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

Studies have not been done to see if temazepam 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).  

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

The use of benzodiazepines during pregnancy near the time of delivery could cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms can include irritability, crying, sleep disturbances, tremors, jitteriness, trouble breathing, or muscle weakness. Not all babies exposed to benzodiazepines will have these symptoms. It is not known if the use of temazepam in pregnancy can cause these symptoms in a newborn. It is important that your healthcare providers know you are taking temazepam so that if symptoms occur your baby can get the care that is best for them. 

Can I take my benzodiazepine with diphenhydramine?

A single human report and animal data have suggested that the combination of temazepam and diphenhydramine (Benadryl®) might increase the chance for stillbirth or for infant death shortly after birth. People taking temazepam should talk with their healthcare provider before taking diphenhydramine during their pregnancy. MotherToBaby has a fact sheet on diphenhydramine here: https://mothertobaby.org/fact-sheets/diphenhydramine-pregnancy/.  

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

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

Breastfeeding while taking temazepam:

Temazepam has not been well studied for use while breastfeeding. Only small amounts of temazepam get into breast milk. No side effects were reported in approximately 10 infants who were exposed to temazepam through breast milk. Children exposed to temazepam through breastfeeding should be watched for excessive drowsiness (being too sleepy). If you suspect the baby has any symptoms (such as being very sleepy, poor weight gain, low muscle tone [floppiness], or slowed breathing), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Studies have not been done to see if temazepam could affect men’s fertility (ability to get a partner 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.