This sheet is about exposure to guselkumab 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 guselkumab? 

Guselkumab is a medication that has been used to treat moderate to severe plaque psoriasis and psoriatic arthritis in adults. It is given by injection under the skin and is sold under the brand name Tremfya®. For more information about psoriasis, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy/.     

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 guselkumab. Can it make it harder for me to get pregnant? 

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

Does taking guselkumab increase the chance of miscarriage?   

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

Does taking guselkumab 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. In studies including more than 200 pregnancies exposed to guselkumab, there has not been a reported increase of birth defects. In manufacturer follow-up data on 178 exposed pregnancies, no birth defects were reported.  

Very little guselkumab is expected to cross the placenta and reach the developing pregnancy during the first trimester (when many of the fetal organs and body structures are forming). More of the medication can cross the placenta starting in the second trimester. 

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

Available studies have not found an increased chance of stillbirth or preterm delivery (birth before 37 weeks of pregnancy) with guselkumab use during pregnancy. Studies have not been done to see if guselkumab can increase the chance of other pregnancy-related problems such as low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

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

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

Breastfeeding while taking guselkumab: 

Guselkumab is a large protein, and little of the medication is expected to pass into breast milk. Guselkumab is not well absorbed from the intestines (gut) when swallowed, so any medication that would get into breast milk is unlikely to enter the baby’s bloodstream. If you suspect the baby has any symptoms (such as fever or 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 guselkumab, could it affect his fertility or increase the chance of birth defects? 

In clinical trial data, 12 pregnancies were reported in partners of men taking guselkumab. No increased chance of birth defects or other pregnancy complications has been reported with paternal use of guselkumab. Studies have not been done to see if guselkumab could affect men’s fertility (ability to make healthy sperm). 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 guselkumab and other medications used to treat psoriasis, ulcerative colitis, and Crohn’s disease in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or or sign up at https://mothertobaby.org/join-study/.

Please click here for references.

This sheet is about exposure to lorazepam 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 lorazepam? 

Lorazepam is a medication that has been used to treat anxiety and insomnia (trouble falling and/or staying asleep). It has also been used to treat seizures and alcohol withdrawal syndrome. Some brand names for lorazepam are Alzapam®, Ativan®, Loram®, Loraz®, and Loreev®. Lorazepam belongs to the class of medication called benzodiazepines.  

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. Studies have shown that when anxiety is left untreated during pregnancy, there can be a higher chance for pregnancy complications such as preterm delivery and/or low birth weight. MotherToBaby has a fact sheet on anxiety at https://mothertobaby.org/fact-sheets/anxiety-fact/. 

Some women have physical symptoms (called withdrawal) when they suddenly stop taking lorazepam. It is not known if or how withdrawal might affect a pregnancy. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

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

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

Does taking lorazepam increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if lorazepam could increase the chance of miscarriage. Some studies looking at benzodiazepines as a group suggest an increased chance of miscarriage. Because miscarriage can happen for many reasons, it is hard to know if a medication, the medical condition being treated, other health factors or age are the cause.  

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

It is unlikely that lorazepam significantly increases the chance of birth defects. One study found a possible association with anal atresia (bottom of the intestinal tract is closed off), and another study found an increased chance of pulmonary valve stenosis (abnormal development of the baby’s heart). However, other studies did not find an increased chance of birth defects with the use of lorazepam.  

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

Some studies have suggested a higher chance of preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) in infants that were exposed to lorazepam in the second half of pregnancy. However, not all studies found a higher chance for these pregnancy-related complications. It is possible that other factors, not lorazepam, caused these complications.  

I need to take lorazepam during my pregnancy. Will it cause withdrawal symptoms in my baby after birth? 

The use of lorazepam during pregnancy can 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 lorazepam will have these symptoms. If symptoms develop, they usually go away within a few weeks and are not known to have any long-term effects for the baby. It is important that your healthcare providers know you are taking lorazepam so that if symptoms occur, your baby can get the care that is best for them.  

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

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

Breastfeeding while taking lorazepam:  

Lorazepam gets into breast milk in small amounts. No side effects were found in studies of children exposed through breast milk. If you suspect the baby has any symptoms (being too sleepy, slower breathing rate, 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 lorazepam, can it affect his fertility or increase the chance of birth defects? 

When a male takes lorazepam, it is not expected to affect fertility (ability to make healthy sperm) or increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.

This sheet is about exposure to mepolizumab 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 mepolizumab? 

Mepolizumab is a medication used with other medications to treat a severe type of asthma called eosinophilic asthma, and to treat eosinophilic granulomatosis with polyangiitis (Churg-Strauss Syndrome). A brand name of mepolizumab is Nucala®. 

Mepolizumab belongs to a class of medications called monoclonal antibodies. Drugs in this class are very large proteins, and it is thought that they do not cross the placenta to the fetus very well in the 1st trimester; but likely do cross later in pregnancy.   

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 or poorly controlled asthma during pregnancy increases the chance of complications for both the woman who is pregnant and the baby. 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 asthma, please see the MotherToBaby fact sheet at: https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.  

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

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

Does taking mepolizumab 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 mepolizumab can increase the chance of miscarriage. 

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

Studies have not been done in humans to see if mepolizumab increases the chance of birth defects. Studies in laboratory animals did not find an increased chance for birth defects. There are 3 published case reports of health pregnancies with mepolizumab use.  

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

Studies have not been done to see if mepolizumab can increase 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). No adverse effects on fetal growth were seen when monkeys were given mepolizumab while pregnant.  

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

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

Breastfeeding while taking mepolizumab: 

Mepolizumab has not been studied for use during breastfeeding. Mepolizumab is a very large protein, so it is thought to be unlikely that much of the medication would get into the breast milk. In addition, this medication is not well absorbed when taken orally, so if a baby swallowed small amounts in the milk, it would be unlikely to be absorbed. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if mepolizumab could affect male fertility (ability to make healthy sperm) 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 promethazine 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 promethazine?  

Promethazine is a medication that has been used to treat nausea and vomiting, motion sickness, and allergies. It has also been used for sedation (to help sleep) and for treating vertigo (a feeling of motion or spinning). Promethazine is sold under brand names such as Phenergan®, Promethegan®, and Phenadoz®.   

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 nausea and vomiting during pregnancy, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/.  

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

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

Does taking promethazine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. One small study did not report an increased chance of miscarriage after taking promethazine. 

Does taking promethazine 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 promethazine, might increase the chance of birth defects in a pregnancy. Taking promethazine during pregnancy is not expected to increase the chance of birth defects.  

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

It is not known if promethazine 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).  

Some reports have suggested that taking promethazine late in pregnancy might increase the chance of slowed breathing (respiratory depression) in newborns. It is important that your healthcare providers know you are taking promethazine so that if respiratory depression happens, your baby can get the care that is best for them. 

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

It is not known if promethazine can increase the chance of behavior or learning issues. One study looked at children exposed during pregnancy to promethazine or a similar medication, ondansetron, and did not find meaningful behavior or development problems. Babies were checked at 1 week old, and children were evaluated again between the ages of about 1½ years to 5½ years old. The results grouped both medicines together, so they did not look at each drug separately.  

Breastfeeding while taking promethazine: 

Studies have not been done to see if promethazine can get into breastmilk. Promethazine can cause sleepiness in adults and might have the same effect in a nursing baby. If you suspect the baby has any symptoms (sleepiness or lack of energy), contact the child’s healthcare provider.  

It is possible that promethazine could reduce how much milk the body makes, especially at the start of breastfeeding. If you are having trouble producing milk, talk with your healthcare provider or a lactation specialist. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Studies have not been done to see if promethazine could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. 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 elagolix 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 elagolix? 

Elagolix is a gonadotropin-releasing hormone antagonist medication. It has been used to treat pain associated with endometriosis (a condition where tissue, that is like the inner lining of the uterus, grows outside the uterus). A brand name for elagolix is Orlissa®. Elagolix is also sold as a combination medication with estradiol and norethisterone. This medication is called Oriahnn®.  

Sometimes when women find out they are pregnant, they consider changing how they take their medication or stopping it 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. 

The product label for elagolix recommends that this medication not be used in pregnancy due to possible concerns with miscarriage. It also suggests caution when using this medication during breastfeeding. However, the benefit of using elagolix may outweigh possible risks. Your healthcare provider can talk with you about using elagolix and what treatment is best for you. 

I am taking elagolix, 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 36 hours, on average, for most of the elagolix to be gone from the body. 

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

Elagolix can lower the body’s levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are important for ovulation (when an ovary releases an egg. This can make it harder to get pregnant. 

Does taking elagolix increase the chance of miscarriage?  

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

Animal studies with very high doses of elagolix reported more pregnancy losses. However, animal studies do not always predict what will happen in humans, especially when animals are given much higher doses than those given to humans. A clinical trial looking at 453 human pregnancies exposed to elagolix, estradiol, and norethisterone did not report an increased chance of miscarriage.  

The product label for this medication reported miscarriages when elagolix during pregnancy. However, the number of miscarriages was not higher than what would be expected in the general population. Also, some health conditions, such as endometriosis, can increase the chance of miscarriage.  

Does taking elagolix 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 exposure, like elagolix, might increase the chance of birth defects in a pregnancy. 

It is not known if elagolix can increase the chance of birth defects. Clinical trial data on 49 pregnancies exposed to elagolix reported no increased chance of birth defects.  

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

It is not known if elagolix 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). Clinical trial data on 49 pregnancies exposed to elagolix reported no changes in birth weight. Studies have not been done to look at the chance of other pregnancy complications after elagolix use.  

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

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

Breastfeeding while taking elagolix: 

There is no information available on the use of elagolix while breastfeeding. It is not known if elagolix passes into breast milk, or what side effects, if any, a child might have when exposed to elagolix through breast milk. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Typically, elagolix is not prescribed to men. Studies have not been done to see if elagolix could affect male fertility (ability to make healthy sperm) 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.