Questions about relapse

[MCC]

I'm sure you're familiar with options that are okay to use during pregnancy (e.g. Imuran (aka azathioprine)). Although I'm hoping to reach remission and be medication-free, I know that there are options that are more tolerable as maintenance drugs long term which could allow for healthy pregnancies and keep me from flaring. I would like to have a child but I'm waiting to go in remission first (generally better outcomes).

Imuran I was told was one not to use in pregnancy and the leaflet online backs it up "

• You should avoid becoming pregnant while you are taking azathioprine. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner."

[lag713]

Would you mind sharing your source about Imuran? I'm still considering my future options as I would like to have a child so it would be helpful to know.

I've read a number of scientific journal articles and the main takeaway I get it "it depends". Ideally, we would prefer to not take any medications especially during pregnancy. However, we often need to go on medication to deal with the symptoms and keep ourselves healthy and safe. It is essential to have pre-pregnancy counseling with your physicians to find the right plan for you.

As of right now, the best medications for use during pregnancy are prednisone, azathioprine (Imuran), cyclosporine, and IV immunoglobulin. If you're familiar with any research that recommends other medications or treatments then I would love it if you would share. Cyclophosphamide (except possibly in late pregnancy) and methotrexate should be avoided if pregnant, trying to become pregnant, or breast feeding.

I discussed the issue of pregnancy and GPA here: http://www.wegeners-granulomatosis.c...-i-let-go.html

[MCC]

from here: Azathioprine (Imuran) | Medicine | Patient.co.uk

I was told by my doctor to wait at least a year after coming off it.

[lag713]

That's surprising to me. My rheumatologist told me that I should go off methotrexate for 3 months prior to trying to conceive. Unlike azathioprine, mtx is strongly contraindicated for pregnancy.