For patients
TNF inhibitors
anti-TNF, adalimumab, etanercept, infliximab, certolizumab, golimumab
Are you a clinician? See the clinical version of this page.
The short versionTNF inhibitors are commonly continued in pregnancy to keep disease under control, and they are considered compatible with breastfeeding. How much medicine reaches the baby depends on which one you take; certolizumab reaches the baby the least. Your team may adjust timing later in pregnancy and will advise on your baby's first vaccinations.
- Keeping disease controlled with a TNF inhibitor is usually better for the pregnancy than stopping and risking a flare.
Through your pregnancy journey
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Before pregnancy
Usually continued while planning a pregnancy.
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First trimester
Usually continued.
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Second & third trimester
Often continued; your team may adjust the timing of later doses depending on which one you take.
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Breastfeeding
Considered compatible with breastfeeding; very little passes into milk.
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For fathers-to-be
Considered compatible for fathers-to-be.
iThis page helps you prepare a conversation with your care team. It does not replace individual medical advice. Always confirm your own plan with your rheumatology and pregnancy team.
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When to call your team
- Do not stop your biologic on your own; talk to your team before making changes.
- Tell your baby's care team which biologic you took and when, so the baby's vaccines can be planned.
- Ask your team about dose timing in the third trimester.