What is the role of azathioprine in the treatment of multiple sclerosis during pregnancy?

Updated: Aug 20, 2019
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Despite azathioprine’s category D rating, some believe that this agent is potentially useful for treating MS in pregnancy. Although azathioprine crosses the placenta, the fetus lacks the enzymes that convert the drug into its active metabolites; this lack may protect the fetus from the potential teratogenic effects of azathioprine. [55, 56] Nevertheless, given the category D rating, the use of this drug in pregnancy should be avoided if at all possible.

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