Ciclosporin

Date: August 2022, Version 3

Quick read

Ciclosporin can be used in pregnancy to keep an inflammatory illness under control or to prevent rejection of a transplanted organ.

What is it?

Ciclosporin (Capsorin®, Neoral®, Sandimmun®, Vanquoral®, Deximune®) is used to treat a number of inflammatory illnesses, such as ulcerative colitis, rheumatoid arthritis, nephrotic syndrome, uveitis and psoriasis, and to prevent the rejection of transplanted organs.

Benefits

What are the benefits of taking ciclosporin in pregnancy?

Ciclosporin reduces the symptoms of inflammatory illnesses by stopping the immune system from attacking the body’s tissues. Ciclosporin may also lower the chance of some pregnancy problems linked to uncontrolled inflammation, including miscarriage and lower birth weight.

In women with organ transplants, ciclosporin can prevent rejection, which would be dangerous to both mother and baby.

Risks

Are there any risks of taking ciclosporin in pregnancy?

Use of ciclosporin in pregnancy is not known to cause problems in the baby.

Alternatives

Are there any alternatives to taking ciclosporin in pregnancy?

Possibly. While many women can stay on ciclosporin in pregnancy, for some, switching to a different drug may be a better option. Some women find that an inflammatory illness improves during pregnancy, and so a doctor may advise that treatment can be altered.

Women taking ciclosporin who are planning a pregnancy or who become pregnant should arrange to see their doctor or specialist as soon as possible to decide on the best treatment.

No treatment

What if I prefer not to take medicines in pregnancy?

Poorly controlled inflammatory disease puts pregnancies at risk as it is linked to miscarriage, preterm delivery and low infant birth weight. To help reduce the chance of these outcomes and to stop an inflammatory disease from flaring, most women will be advised to take some form of medication during pregnancy.

A doctor will only prescribe medicines when necessary and will be happy to talk about any concerns.

Will I or my baby need extra monitoring?

As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required, although extra growth scans may be offered.

Are there any risks to my baby if the father has used ciclosporin?

There is currently no evidence that ciclosporin used by the father can harm the baby through effects on the sperm.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.