Medication for Ankylosing Spondylitis During Pregnancy: What You Need to Know

Medications for Ankylosing Spondylitis during Pregnancy

I would like to ask the doctor, I have been diagnosed with ankylosing spondylitis and have been taking hydroxychloroquine for 4 months.
My inflammatory markers in blood tests are normal, and the doctor advised taking one pill a day when there is no pain, and two pills a day when there is pain.
Since I previously underwent in vitro fertilization and have frozen embryos planned for implantation, I am unsure if this medication is safe to take during pregnancy or if there are alternative medications available.
The immunologist suggested I consult with an obstetrician, but the obstetrician prescribed a 3-month supply of the medication while expressing concerns about its potential impact on the embryo.
I would appreciate your guidance on this matter.
Thank you.

Xiao Ru, 40~49 year old female. Ask Date: 2020/01/02

Dr. Wang Shouji reply Orthopedics

Hello, according to the literature, CELECOR may lead to premature closure of the ductus arteriosus in the fetus.
Therefore, pregnant patients, especially those in the later stages of pregnancy (after 30 weeks), should avoid its use.
It is recommended to consult the prescribing physician regarding the necessity of the medication.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2020/01/02

More Info

When considering medication for Ankylosing Spondylitis (AS) during pregnancy, it is crucial to weigh the benefits and risks associated with the use of specific drugs, particularly in the context of fertility treatments and embryo implantation. In your case, you have been taking Hydroxychloroquine (often referred to as "希克寧" in Chinese) for four months, and you are preparing for embryo implantation after undergoing in vitro fertilization (IVF).

Hydroxychloroquine is an antimalarial drug that is also used to treat autoimmune diseases, including lupus and rheumatoid arthritis. It has anti-inflammatory properties and is generally considered safe for use during pregnancy. Studies have shown that Hydroxychloroquine does not significantly increase the risk of congenital malformations or adverse pregnancy outcomes. However, it is essential to consult with your healthcare provider regarding its use, especially since you are in the process of embryo implantation.

The concerns raised by your obstetrician regarding the potential impact of medications on the embryo are valid. While Hydroxychloroquine is generally deemed safe, the decision to continue its use during pregnancy should be made collaboratively with your rheumatologist and obstetrician, considering your specific health needs and the stability of your AS symptoms. If your inflammatory markers are normal and you are experiencing minimal pain, your healthcare team may consider tapering the medication or switching to alternatives that are also safe during pregnancy.

Alternatives to Hydroxychloroquine may include non-steroidal anti-inflammatory drugs (NSAIDs), but these are typically not recommended during the third trimester due to risks such as premature closure of the ductus arteriosus in the fetus. Acetaminophen (Tylenol) is often suggested for pain relief during pregnancy, as it is considered safe when used at recommended doses.

It is also important to monitor your condition closely during pregnancy. If your AS symptoms worsen, your healthcare provider may need to reassess your treatment plan. In some cases, physical therapy, exercise, and other non-pharmacological interventions can be beneficial in managing symptoms without the need for medication.

In summary, while Hydroxychloroquine is generally considered safe during pregnancy, the decision to continue its use should be made in consultation with your healthcare providers. They will take into account your current health status, the stability of your AS, and the potential risks to your pregnancy. Always prioritize open communication with your medical team, and do not hesitate to seek a second opinion if you feel uncertain about the recommendations provided. Your health and the health of your future child are of utmost importance, and a tailored approach to your treatment will help ensure the best possible outcomes.

Similar Q&A

Concerns About Medication Effects on Pregnancy with Ankylosing Spondylitis

Hello Doctor, I have been diagnosed with ankylosing spondylitis and am currently on a regular medication regimen. My doctor has prescribed Meloxicam 7.5 mg, to be taken once in the morning and once in the evening. I would like to inquire whether this medication will affect my fut...

Dr. Zeng Guosen reply Internal Medicine
Hello, the medication Meilokang is classified as an anti-inflammatory and analgesic, and it will not affect future chances of pregnancy. There is no need to stop taking the medication in preparation for pregnancy. However, once pregnancy is confirmed, it is important to discuss a...

Understanding Ankylosing Spondylitis: Symptoms, Treatment, and Concerns

Hello LYC, this is Joann. You might remember me a little. I apologize for losing your email address and hope to connect with you through the internet! A week ago, I went to the Tri-Service General Hospital for a diagnosis, and the doctor prescribed me medication to take for a wee...

Dr. Lin Yijun reply Orthopedics
Remember that your HLA-B27 test at National Taiwan University was negative, and your inflammatory markers were normal. Clinically, diagnosing ankylosing spondylitis in HLA-B27 negative patients requires caution. Due to anatomical factors, early sacroiliitis is often difficult to ...

Understanding Ankylosing Spondylitis: Symptoms, Treatment, and Pregnancy Concerns

Hello, doctor. My husband is 31 years old. Since early October last year, he has been waking up in the middle of the night due to lower back pain. He has seen many doctors, and each one has given a different opinion. Today, we visited the Tri-Service General Hospital in Taipei, w...

Dr. Shi Qiming reply Orthopedics
Hello: Ankylosing spondylitis currently has no curative treatment; the available therapies primarily aim to slow its progression and prevent severe deterioration. However, it does not significantly affect life expectancy. Due to the difference in incidence rates between genders (...

Managing Childbirth Challenges in Women with Ankylosing Spondylitis

Hello, Doctor. I started experiencing severe joint swelling and pain around the age of 13, and now at 31, the locations and timing of the pain have changed with age. I only began seeking medical attention in adulthood, and the doctor diagnosed me with ankylosing spondylitis and r...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your question. Here are my responses: 1) Due to the frequent pain during flare-ups, which can make movement difficult, is it possible to have a smooth delivery if the condition flares up during natural childbirth? --> In principle, flare-ups of ankylosin...