6-MP and Pregnancy

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UCRookie
New Member


Date Joined Jan 2008
Total Posts : 2
   Posted 6/18/2008 9:39 PM (GMT -6)   
Hi All! I have been flaring since first being diagnosed back in August.  After a really rough winter and part of the spring I am starting to feel better, however do still have some symptoms. I think the 6-MP has helped tremendously, but seemed to take about 5 months to work.  I'm at the stage in my life where I'm considering to have a child.  I haven't heard alot about the pregnancy risks of taking 6-MP, do you guys have any thoughts? I haven't talked to my GI about this, but definitely plan to.   
Diagnosted with UC August 2007.  Horrible reactions to Pentasa and Asacol, currently on 75 mg of 6-MP.  Also on iron supplements, Calcium and Vitamin D, and Digestive Advantage Chrons and Colitis Therapy. 


princesscolon
Veteran Member


Date Joined Apr 2006
Total Posts : 733
   Posted 6/18/2008 9:44 PM (GMT -6)   
Hi UCRookie. All I know is that I am on Humira and my GI perscribed me 6MP recently. When he was giving me the presciption he asked me if I was sure I would not get pregnant because it is not safe in pregnancy.
Diagnosed with Left-sided UC in 1995 at age 15, Prednisone, Rowasa & Hydrocort. Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Aloe Juice, Canasa, Enotcort, Colazol, Anamantle, Remicade, etc... had 1 inch deep rectal ulcer 2004, put on Remicade, August 2007:Increased Remicade dosage-700mg every 6 weeks,diagnosed w/ Psoriatic Arthritis & Fibromyalgia Current meds: Clorazepate, Lomotil,  Tylenol pm, Lyrica started 1/17/08,  Humira started 4/4/08


murf28
Regular Member


Date Joined Jan 2003
Total Posts : 78
   Posted 6/18/2008 10:18 PM (GMT -6)   
I was very ill during my pregnancy with my third child. My GI would not start 6-MP until after I had delivered, and I was unable to nurse her. I don't think that it is recommended.

murf

tooth fairy
Regular Member


Date Joined Jan 2008
Total Posts : 98
   Posted 6/18/2008 10:45 PM (GMT -6)   
I am taking imuran, a different immunosupressant, and have been given the doc's blessing to try to conceive. My GI, a high-risk OB-GYN, and my regular GYN all concur. I am not sure about the risks with 6MP. I do know that imuran has been used w/ transplant patients for over 40 years and that the pregnancy risks are negligible. Your best bet for good answers is a high-risk OB-GYN. My regular OB said "no way" at first, and my GI said pregnancy was ok but not until my UC was in a solid remission. The high-risk doc was really nonchelant about everything and said she that pregnancies on imuran are quite common and the outcomes are overwhelmingly good. She actually started her email, "Unfortunately, you have been getting information from somebody who is not well-versed in pregnancy and IBD. You should feel very comfortable heading into another pregnancy, provided you understand the small risk that exists for UC patients."

Wish I had more info for you about the 6MP! I do know both drugs are immunosupressants-so perhaps you could switch to imuran when you are ready for a pregnancy.

Best! -E
Erica, 31
Pancolitis, diagnosed July 2006, at age 29
Imuran, Asacol, Rowasa*(new!)
Experimenting with diet, live culture yogurt and probiotics


AngelTT
Regular Member


Date Joined Jun 2005
Total Posts : 213
   Posted 6/19/2008 10:16 AM (GMT -6)   
When I started trying to get pregnant my doc told me absolutely not until I was off 6MP.

34 year old female, Diagnosed 5 years ago
Current Meds: Remicade every 6 weeks, Prednisone 10mg (tapering), Prevacid, Sustenex, Lialda, Lexapro (anxiety), Synthroid, Iron, vitamins, Fish Oil
Expecting first child 12/08 via gestational surrogate!!!!


kb5
Veteran Member


Date Joined Jan 2007
Total Posts : 1015
   Posted 6/19/2008 10:25 AM (GMT -6)   
Doctors are very torn on this issue. Some say it's ok, some say no way. My GI said yes, my OB no.

The gov't classifies imuran and 6mp as class D unsafe unless absolutely neccessary. Though as others have said there have been many many many safe, healthy pregnancies on these drugs.

Though all agree that breastfeeding is a no.

I"m on remicade and will be when my husband and I start trying next year. It's classified as B, safe for pregnancy. I wish i were able to breast feed as well but they say no with remicade as well.
Kelly, 30

Left sided UC diagnosed 1/98 age 19, Pan colitis diagnosed 1/07
Currently on 4x3 Asacol, no more pred after two years!!!! Off imuran as remicade is working!
Prontonix once daily for acid reflux, zofran 8mg every six hours for nausea
Remicade started 3/1/08...just had 4th infusion


31fan
Regular Member


Date Joined Feb 2007
Total Posts : 34
   Posted 6/19/2008 10:36 AM (GMT -6)   
There are potential risks to being on any medication during pregnancy -- I think 6-MP and Imuran are considered riskier than most -- but ultimately you have to weigh the risks and benefits for you personally.  If you need to be on 6-MP to be healthy, it might well be worth it to you since I think most doctors would agree that flaring during pregnancy is a more risky scenario.  Doctors deal in evaluating the risks neutrally, and it is often in their interest to give conservative advice, but the decision to have a baby is obviously a personal one and not a strictly rational one. 
Diagnosed with UC in transverse and descending colon in Feb. 2007
Doing well so far on Asacol 800 mg. 2x a day
Also take 25 mg. Paxil, 100 mg. Wellbutrin, 1 probiotic pearl per day
Currently off other meds because I'm newly PG, due next July


shannon1
Regular Member


Date Joined Feb 2005
Total Posts : 369
   Posted 6/19/2008 11:10 AM (GMT -6)   
I took 6mp through out the trying to concieve stage and through most of my pregnancy (including the development stages) There is not much research, as, who wants to do research on a pregnant woman (what my ob said)....

I was followed by a OB, a high risk OB (perinatologist), GI and fertility doctor. They all agreed that i should stay on 6mp. None of the other meds had worked for me and i achieved remission on 6mp, so they did not want to risk going off it. I was told there were risks to a devloping baby, and had alot of ultrasounds and 3 or4 level 2 ultrasounds, and one 3D when i was on pred to check for cleft lip/palete (flared right when i got pg)

My daughter is perfect!

My perinatologist told me that the risk of flaring in pregnancy was worse than the low risk of problems associeated w/ the meds. If you want actual staticts, you should see a peri, who will take all ur meds/illnesses, and give u percentages on how it should affect u or baby. This should be the first order of business when you decided it's time to start your family. GL
2003, dx moderate UC
2000, dx selective IGA deficiency w/ anti IGA antibodies
2000, dx Antipholipid Antibody Syndrome
1999-current, chronic hemmoragic ovarian cysts, w/ partial ovary removal
1977, complete reconstruction of foot after lawnmower accident (chronic pain)
 
Meds
6mp 75mg, prednisone 40mg (just starting meds again)
percocet 5mg 3x day
potassium 3x day
 


Gymdaisy
New Member


Date Joined Feb 2007
Total Posts : 3
   Posted 6/19/2008 4:44 PM (GMT -6)   

I just wanted to say that I was on Imuran and Remicade for my entire pregnancy, and I have, and will continue to nurse my healthy baby.

I have been a patient at the Mayo clinic in Rochester, MN  due to the severity of my disease. All of the doctors that I have seen there have said that pregnancy is fine with these two drugs and the benefits of nursing far out way the VERY small amount the baby could possibly get.

 I also contacted the Research institute in Texas which is currently studying the effects of these drugs in pregnant woman taking them for Ruehmatiod arthritis. They were very helpful and answered all of my questions. Nothing worth noting has been found I was told. The only thing was a possible higher risk of pre-term labor, which could possibly be attributed to the disease not the medication. The research institute also called me after I delivered and asked me again if they could answer more questions.

I hope this info helps a little


LWW1993
Regular Member


Date Joined Oct 2006
Total Posts : 90
   Posted 6/19/2008 4:53 PM (GMT -6)   
My GI has also said the same things as Shannon's and Toothfairy's doctors. That you are better off being healthy and in remission and stay on 6mp while pregnant that to go off it, flare, and potentially risk the development of the fetus. I'm on 6mp right now and am patiently waiting for my GI's "permission" to ttc sometime this summer. He is waiting for me to fully be off prednisone to ensure that 6mp and 6mp alone is working for me. Additionally, he wants to do a scope and visually see that my colon looks good before I get pregnant. I was lucky with my first pregnancy to have no UC symptoms, so I'm hopeful that if I'm in remission when I get pregnant that I will stay in remission and have another healthy baby.
Diagnosed UC - 1993
32 year old female

Current Meds:
Prednisone - 10 Mgs
6-MP - 75 Mgs
Colazal (3 pills three times a day)
Folic Acid


shannon1
Regular Member


Date Joined Feb 2005
Total Posts : 369
   Posted 6/19/2008 6:42 PM (GMT -6)   
Also wanted to add that it is stress by the "research" that you NOT breastfeed on 6mp. It is suspected that little crosses the placenta vs. going right through the breast milk.

I delivered my first premature and it was very important for me to breastfeed, so i called LLL to see if they had any info on it and they called me back and said that the info they had, that it was better to not breastfeed.

In the end, i went into preterm labor at 25wks,and chose to stop my 6mp so that if i delivred early i could breast feed. I delivered at 34wks and felt comfortable enough to do it then. So far, my daughter shows no ill side effects as a result.

GL
2003, dx moderate UC
2000, dx selective IGA deficiency w/ anti IGA antibodies
2000, dx Antipholipid Antibody Syndrome
1999-current, chronic hemmoragic ovarian cysts, w/ partial ovary removal
1977, complete reconstruction of foot after lawnmower accident (chronic pain)
 
Meds
6mp 75mg, prednisone 40mg (just starting meds again)
percocet 5mg 3x day
potassium 3x day
 


UCRookie
New Member


Date Joined Jan 2008
Total Posts : 2
   Posted 6/19/2008 9:17 PM (GMT -6)   
Thank all of you for the comments.  Sounds like I definitely need to discuss with my GI.  But it sounds like there is hope for me to have a healthy child in the future.
Diagnosted with UC August 2007.  Horrible reactions to Pentasa and Asacol, currently on 75 mg of 6-MP.  Also on iron supplements, Calcium and Vitamin D, and Digestive Advantage Chrons and Colitis Therapy. 


epeters
Regular Member


Date Joined Feb 2004
Total Posts : 28
   Posted 7/7/2008 2:51 AM (GMT -6)   
I was on 6mp throughout my entire pregnancy with my son with no complications. The doctors told me they hadn't had bad results with pregnancy and 6mp, they just didn't have very many. My son is beautiful and a wonderfully healthy and welcome headache for me now that he's in his twos. I did have to go off of it to breastfeed him, but I've been off of it for 2 years and am now pregnant with my second child.

Good luck with yours.

angel15w
New Member


Date Joined Jun 2008
Total Posts : 2
   Posted 7/24/2008 9:28 AM (GMT -6)   
I found out I was pregnant in May and had a flare up as soon as the pregnancy started.  I have always been on asacol, but apparently it stopped working.  It was the worst flare I've had since I was diagnosed, so my doctor put me on Prednisone because a lot of the literature shows that active disease is more of a risk to the baby than meds.  So many people have delivered healthy babies while on Pred/6mp...so anyway I was put on Prednisone I was on it for 4 weeks, everything seemed to have cleared up, and then when I went for my 12 week ultrasound we found out that the baby had stopped growing at about 8 weeks.  My white cell count was up to 30,000 so it was clear that my body was attacking the fetus.  I am now going on 6MP to control my immune system and we are going to try again.  I am confident in my doctor's choice to control the illness to prevent another miscarriage, hope this helps.
Age 28
diagnosed 1997-started as sigmoiditis, now pancolitis

9 Asacol
20mg Prednisone 2x/day
prenatal vitamin


MissKitty
New Member


Date Joined Feb 2007
Total Posts : 13
   Posted 7/28/2008 9:46 AM (GMT -6)   
I don't know if 6MP is anything like Imuran, but I took aza all throughout my pregnancy and breastfead for a little bit (I had complications with my c-section incision and had to stop due to all the other meds) My baby was born perfectly healthy and continues to be so.

My GI did say he would prefer me to be on no meds, but that it was better for me to be healthy to have a healthy baby. All other Drs agreed that it was pretty well safe to take and that it was better for me to have no flares than to stop and maybe get really sick again.
No day but today... Defy gravity... Measure in love...
 
25 year old female from Ontario, Canada.
 
*Told I have UC in Jan '07. Found out it was of the whole colon while in the hospital being treated for a flare (March 6/07 to March 16/07)
*Hospitalized again May/June '08 for 9 days after c-section for infection of incision and small flare
*Taking Azathioprine (Imuran)... 150mg (3 50mg pills) at bedtime
*Liquid multi-vitamin mineral shot in the morning
 
Mommy to Lliam (born May 16th 2008)
 


kstate95
New Member


Date Joined Sep 2008
Total Posts : 1
   Posted 9/27/2008 9:35 AM (GMT -6)   
I was diagnosed with Crohn's Disease back in 1997.  I was on Pentasa with my first
child and she is now 4.  I had a flare up about 2 years ago and had to go on 6mp.  I have been doing well and now I just recently found out I was pregnant.  I have talked to my gastro dr and he said that I would be worse off getting off the meds than staying on them.  I have done research and there is not alot out there to tell me different.  I was curious if anyone was currently on 6mp and pregnant and if there are any problems or issues that you are going through.  My OB wants me to see a high risk prenatal dr, which I plan on doing.  I just would kiek some more feedback from anyone.
 
Thanks!

jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 9/27/2008 10:02 AM (GMT -6)   

The whole confusion over 6-MP and Aza during pregnancy is based on the fact that studies have shown it produced birth defects in rats. However, the rats were given doses hundreds of times higher than what we take for IBD, and rats metabolize these immunosuppressant drugs differently than humans. Humans lack an enzyme that creates the teratogenic (defect-producing) feature during metabolism.

Large studies of actual human patients have shown no increase in the rate of birth defects or miscarriage over those of mothers who are on no immunosuppressants. So in practice, it appears to be safe during pregnancy. Many times OB's will recommend against any drug they are not familiar with, but may not be aware of the possible consequences to the mother of stopping the drug. The chances of having a miscarriage are increased more by being in a bad flare than by taking the medications, based on studies of actual pregnancies.


Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 9/27/2008 10:16 AM (GMT -6)   
kstate95,
You might want to visit the crohns board as well.
A fellow Wildcat crohnie
 


Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


jenjim
Regular Member


Date Joined Apr 2008
Total Posts : 55
   Posted 9/27/2008 10:05 PM (GMT -6)   
I took Imuran and Pred throughout my pregnancy, and I breastfed my son. I was followed by a perinatologist & a GI Dr. My son was 5 weeks premature (water broke- who knows why) but the Pred made his lungs mature, so they say, and he didn't have to be in the NICU.
The thing to keep in mind when looking at "pregnancy categories" is that a "D" may mean that they just don't have enough info to know how it will affect a baby. Not enough human studies have been done in a controlled setting to make Imuran anything other than a category D.
You need to be as healthy as possible when trying to get pregnant & pregnant!
Good luck.

dlt
New Member


Date Joined Oct 2008
Total Posts : 1
   Posted 10/23/2008 3:29 PM (GMT -6)   
Hi,
I just joined and I am very interested in this topic.  I am a 33 yr old female who was diagnosed with UC at the age of 20.  My UC progressively got worse and about 5 years ago after spending a year on prednisone, my dr. switched me to 6MP which has done a great job at controlling my UC.  I've followed the pregnancy debate since then, but am now getting married in a month and will be ready to start trying to get pregnant soon.  My dr assures me that it is totally safe to be pregnant on 6MP, but I have heard enough controversy to wonder if there are enough studies.  I don't want to compromise my health or a baby's health, but it is so hard to weigh it all out. 
 
My biggest question is are there long term effects on a child.  I feel okay about the birth defect risk being low, but have any of you with older children seen any development or learning disabilities that could be attributed to your use of 6MP during pregnancy?
 
Thanks!!!
 
 

jenjim
Regular Member


Date Joined Apr 2008
Total Posts : 55
   Posted 10/23/2008 9:23 PM (GMT -6)   
My son is 5 and he is fine developmentally. I was on Imuran, 150mg and 5mg Pred throughout pregnancy. This was the consensus between the GI Dr and the perinatologist. I also breastfed for over 2 years on Imuran, I'm not saying you should do this, but I did and my son is great. I hope some people with older kids can chime in, too! This is a big decision you and your hubby have to make with your Drs. I guess. It may also be worth looking at at board on fertility, some of those ladies have some good thoughts, too. Good luck.

Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 5/17/2009 1:53 PM (GMT -6)   
Found this older thread, and have been reading all the threads about 6MP and pregnancy that I can find. We think we may be ready to entertain the idea of baby #2 now that our first child is 2 and a 1/2. The only thing I took during my first pregnancy for UC was Dipentum. The pregnancy was perfect and I had not one day of flare symptoms. Breastfeeding didn't work out for us on #1 so I'm not worried about it for #2 but I was wondering if all the 6MP babies and Mommies are all still doing well and if there were any new 6MP babies/pregnancies since these posts last year.
  • 26 years old, married, Stay-at-home Mommy to 2 year old daughter 
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-July 08 
  • Currently taking:75mg 6MP, 4 Lialda, Loestrin 24, Allergy meds., Digestive Advantage Sustenex, Maxalt when I get a migraine, Zanaflex to prevent migraines, and allergy shots once a month 
  • 10/6/08 Found a 1cm kidney stone in right kidney.  Had the stone blasted and passed the fragments.

 


MissKitty
New Member


Date Joined Feb 2007
Total Posts : 13
   Posted 5/19/2009 9:33 PM (GMT -6)   
Mommy Pooh - I am glad this thread is still around. My son is now 1 and still as healthly as ever. I never got back to breast feeding, but was told at the time that it wasn't an issue to do so well taking aza (Imuran).
 
I am doing okay... not great but not bad. My Dr is now looking into Remicade. I am hoping it is okay to have a baby while taking that since we would like to have another child next year.
 
Good luck!
No day but today... Defy gravity... Measure in love...
 
26 year old female from Ontario, Canada.
 
*Told I have UC in Jan '07. Found out it was of the whole colon while in the hospital being treated for a flare (March 6/07 to March 16/07)
*Hospitalized again May/June '08 for 9 days after c-section for infection of incision and small flare
*Taking Azathioprine (Imuran)... 150mg (3 50mg pills) at bedtime, pred again (40mg) ugh... Remi in the near future if approved
 
Mommy to Lliam (born May 16th 2008)
 


Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 5/20/2009 10:45 AM (GMT -6)   
Thanks for the update!! I seem to be having some sort of "mini flare" or issues. Sure hope it's not the start of another long flare like last time. Will see my GI this afternoon and hopefully we can knock this back with a new med and steroid supp. We really want to start "trying" in July but I need to be sure my UC is quiet. I was in remission before, during, and 6 weeks after my daughter. I know a lot of people said they flared after baby but I thought my flare was brought on by quiting UC meds after baby and starting back on birth control. Both of my flares started soon after starting on the pill. If we get a second baby here, I am going to have my tubes tied during the next c-section and no more BC pills for me. Will be another c-section b/c I don't want to risk VBAC. Baby #1 was breech.
  • 26 years old, married, Stay-at-home Mommy to 2 year old daughter 
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-July 08 
  • Currently taking:75mg 6MP, 4 Lialda, Loestrin 24, Allergy meds., Digestive Advantage Sustenex, Maxalt when I get a migraine, Zanaflex to prevent migraines, and allergy shots once a month 
  • 10/6/08 Found a 1cm kidney stone in right kidney.  Had the stone blasted and passed the fragments.

 


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 5/20/2009 10:54 AM (GMT -6)   
There's a great article that you can get to from the CCFA about pregnancy in women with IBD. It's got a lot of info on medications and if they're safe for pregnancy and breastfeeding.

Go here,
http://www.ccfa.org/ccfaprof/ibd-journal/archive

then scroll part way down the page and there's a link to the article. It's from the December 2008 issue.
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, Culturelle probiotic, and Zoloft (25 mg).

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