Is It Safe To Get Pregnant?

Here is My Question:

I was on Aubiago for ten months and was taken off it, due to severe side effects. I was wondering if it is safe to get pregnant? And I was taking Copaxone which was a month of pain. Is it safe to continue my family?

Answer:

Aubagio (or teriflunomide) is a pregnancy category X medication which means that fetal abnormalities are a real risk (this is based on information from a similar medication called leflunomide).  Data presented at the American Academy of Neurology this year indicated 83 reported pregnancies among women exposed to Aubagio.  Among these 83 exposures, 70 were exposed up to week 11 of pregnancy with 26 live births demonstrating no structural or functional abnormality.  Among the rest, 29 patients elected for an induced abortion and 13 had a spontaneous miscarriage (and 2 were unaccounted for).

Family planning is an issue for patients who decide to start Aubagio.  If you are contemplating pregnancy, I would make sure to check a teriflunomide level (blood lab) to ensure that it is adequately out of your system.  Usually, coming off Aubagio means undergoing an “elimination protocol” using a medication called cholestyramine for 11 days.  We do this because Aubagio tends to remain in the body for quite a long time (up to 2 years after the last dose if you don’t do the elimination protocol).  The elimination protocol usually accelerates the removal of Aubagio, but occasionally a second round of cholestyramine is needed.  Before attempting pregnancy, I’d recommend ensuring it is completely out of your system.

Copaxone is a pregnancy category B medication, and should not be a contraindication to pursue pregnancy (as you have been off of it for a while).

I would encourage you to discuss this with your MS provider as there can be other considerations to take into account when planning for pregnancy with MS.  For the average patient, pregnancy has a good effect on MS, and may be on par with many of our disease modifying therapies (especially during the third trimester).  Good luck!

-ASN