Drugs in IBD safe in Pregnancy

Ciprofloxacin and Augmentin safe

Metronidazole controversial and should be avoided in first trimester
Rifaximin should be avoided
5 Amino salicylic acid is safe
Steroids should be avoided as planned maintenance therapy
MTX absolute contraindication
Thiopurines (Azathioprine, 6- MP, thioguanine) are safe but not to be initiated first
in pregnancy
Cyclosporine can be used for acute severe Ulcerative colitis but can cause
increased gestational diabetes, maternal HT, preeclampsia, preterm birth, small for
gestational age and LBW babies and so used when critically required
Tacrolimus data limited. Increased risk of malformations positive
Tofacitinib (Janus Kinase Inhibitor Class JAK inhibitor) incompletely studied -used
when MTX fails
Anti TNF factor agent safe (1. Monoclonal Antibodies Infliximab, Adalimumab,
Certolizumab, golimumab: 2. Circulating receptor fusion protein -Etanercept)
Vedolizumab (antibody binds to Integrin alpha 4 beta 7 integrin producing gut
selective anti-inflammatory activity) and Ustekinumab (antibody to IL-12 and IL-
23) require further study