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. 2014 Oct;60(10):905-6.

Safety of tacrolimus in pregnancy

Will Nevers, Anna Pupco, Gideon Koren, Pina Bozzo

Safety of tacrolimus in pregnancy

Will Nevers et al. Can Fam Physician. 2014 Oct.

Abstract
in English, French

Question: I have a 30-year-old patient who had a kidney transplant 2 years ago. She is now planning a pregnancy. She has been treated with tacrolimus since her transplant. Will it be safe for the fetus if she continues to take it during the pregnancy or should she switch to a different antirejection medication?

Answer: If your patient is stable while taking tacrolimus, there is no reason to switch. The current available information does not suggest that tacrolimus increases the risk of major congenital malformations above the baseline risk in the general population. Premature birth and low birth weight are often reported in this population; however, these effects are frequently reported in pregnant transplant patients treated with other immunosuppressant agents and probably reflect the effects of the maternal condition. As there are some reports of hyperkalemia and renal impairment in infants exposed to tacrolimus in utero, kidney function and electrolytes should be monitored in exposed neonates.

Question J’ai une patiente de 30 ans qui a subi une greffe de rein il y a 2 ans. Elle planifie actuellement une grossesse. Elle prend du tacrolimus depuis sa transplantation. Est-ce sécuritaire pour le fœtus si elle continue ce traitement durant la grossesse ou devrait-elle changer pour un médicament antirejet différent?

Réponse Si votre patiente est stable en prenant du tacrolimus, il n’y a pas de raison de changer. Les renseignements actuellement disponibles n’indiquent pas que le tacrolimus augmente le risque de malformations congénitales majeures au-delà du risque normal dans la population en général. On signale souvent des cas de naissance prématurée et de faible poids à la naissance chez les femmes greffées du rein; toutefois, ces issues sont souvent rapportées chez de telles patientes enceintes qui prennent d’autres agents immunosuppresseurs et sont probablement attribuables aux effets de l’état de santé maternel. Étant donné qu’on a certains signalements d’hyperkaliémie et d’atteintes rénales chez les nourrissons exposés in utero au tacrolimus, il faudrait surveiller la fonction rénale et les électrolytes chez les nouveau-nés exposés.

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References

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