Drug FDA Category RecommendationsforPregnancy Breastfeeding Adalimumab B Limited human data: lowriskaLikelycross placenta No human data: probably compatible Azathioprine/6-mercaptopurine D Data in IBD, transplantliteraturesuggestsomerisk, butlow Limited transfer. Likely compatible Balsalazide B Lowrisk No human data: potentialdiarrhea Budesonide C Data withinhaleddruglowrisk. Limited human data for oral drug No human data Certolizumab B Limited human data: lowriskLimited transfer across placenta No evidence of transfer. Likely compatible Corticosteroids C Lowrisk: possiblesmallrisk of cleftpalate, adrenal insufficiency, prematurerupture of membranes Compatible Cyclosporine C Lowrisk Limited human data: potentialtoxicity Infliximab B Lowrisk: limited human data: crosses placenta and detectable in infantafterbirth No evidence of transfer. Likely compatible Mesalamine B Lowrisk Limited human data: potentialdiarrhea Methotrexate X Contraindicated: teratogenic Contraindicated Olsalazine C Lowrisk Limited human data: potentialdiarrhea Sulfasalazine B Lowrisk. Givefolate 2 mg daily Limited human data: potentialdiarrhea Tacrolimus C Lowrisk Limited human data: potentialtoxicity Thalidomide X Contraindicated: teratogenic No human data: potentialtoxicity Abbreviations: FDA, Food and Drug Administration; IBD, Inflammatory Bowel Disease. aLow risk is defined as ‘the human pregnancy data do not suggest a significant risk of embryo or fetal harm.’ [18]

Table 2: Medications used in the treatment of inflammatory bowel disease.