Posted by: sandra | 2005/06/28



Here is my question to the on line doctor.

Is azzapress a harmful drug? I have been on this drug for 4 and a 1/2 weeks after conceiving my baby. Will this harm the fetus? I am now almost 12 weeks pregnant.
I was taking this medications from 22 April until 25 May. Found out I was pregnant on 8 June & have not been taking Azzapress since but am on predisone. I have SLE. I under went a renal biopsy in early April & was put on a course of azzapress.

I look forward to your response.

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Our expert says:
Expert ImageGynaeDoc

It appears that there are some risks associated with azapress use in preganncy, but these are not clearcut. I enclose further information.
' Many studies found an increased risk of fetal growth retardation, lymphopenia, decreased thymus size and prematurity (Bermas and Hill, 1995, Connell and Miller, 1999 and Witter et al., 1981). The malformation rate was 3.9%, which is close to the general population rate. The association between azathioprine and IUGR appears to be the highest when used in combination with a corticosteroid such as prednisone. Thus the direct role of azathioprine in infants with IUGR is difficult to determine as other medications (corticosteroids have been associated with IUGR).

A potential risk for chromosome anomalies has been raised following a case report of a woman with lupus who took the drug during two different pregnancies. She delivered two infants with separate de novo translocations. Due to these being isolated cases it is unlikely a true association. However, further investigation is required to determine if this is a true risk from gestational exposure to azathioprine (Bermas and Hill, 1995, Connell and Miller 1999, Reprotox #1459, 1980 and Witter et al., 1981).
There is one study of azathioprine use in pregnant patients with inflammatory bowel disease. This study did not find an increased risk for congenital abnormalities or subsequent health problems (Connell and Miller, 1999 and Connell and Sandborn 1999). Still, due to the potential risks, azathioprine and mercaptopurine are usually not prescribed in pregnancy unless the disease is severe (Connell and Sandborn 1999).

Best wishes

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