Does Arava Cause Birth Defects While Trying To Conceive?

Posted on Thu, 5 Dec 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 5 Dec 2013 Answered on

Mon, 6 Jan 2014 Last reviewed on

Question : Hello - I have had a myriad of health issues - my Immuno wants me to take Arava now.. I have only taken one tablet so far - we wanted to try for a baby, but I see that we cant as Arava can cause birth defects - Being on the very very very safe side, how long would i have to be of Arava - beofe we could be absolutely certain that we could concieve without birth defects.......so how long would I need to wait after a 6 month trial... and also if I stopped now after only one tablet... how long before we could go and freeze some sperm?

Answered by Dr. Prahlad Duggal (11 days later)

Brief Answer: Please consult your doctor before any plan Detailed Answer: Hi, Thanks for the query. Arava has got long elimination time from the body. A regular use of Arava requires a drug elimination procedure to be employed before the planning for pregnancy. Without this, the active metabolite of drug may take upto 2 years for elimination from body. Monitoring of plasma levels of the active metabolite (M1) s required before planning pregnancy and a level of less than 0.02 mg/L (0.02 μg/mL) is expected to have minimal risk based on available animal data. All these statements hold for females and available information does not suggest that ARAVA would be associated with an increased risk of male-mediated fetal toxicity. However, animal studies to evaluate this specific risk have not been conducted. To minimize any possible risk, men wishing to father a child should consider discontinuing use of ARAVA and taking cholestyramine 8 grams 3 times daily for 11 days. All these things can only be done in consultation with a specialist and please do not venture to go for this on your own. Whether you plan to go for pregnancy after a single tablet or a six month trial or for freezing the sperms, please go for estimation of plasma levels of active metabolite (M1) of the drug. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prahlad Duggal (13 hours later)

I have only taken one single tablet..would I still need a wash out?

Answered by Dr. Prahlad Duggal (6 hours later)

Brief Answer: No evidence in literature to comment on ur stutus Detailed Answer: Thanks for the query. As such there is no evidence in literature regarding the effect of drug on male associated fetal abnormalities. So commenting on your condition with evidence is not possible. Without evidence I would like to suggest that you should go for plasma level estimation of active metabolite and if the levels are below the permissible limit as stated in previous reply, please go ahead with your plans. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar