Can You Take Xeljanz While Pregnant or Breastfeeding?

Hey there, friend. If you're reading this, chances are you're probably juggling a lot right now. Maybe you're wondering about starting a family, or you're already pregnant, or perhaps you're nursing and questioning whether that medication you've been taking is safe for your little one. Whatever your situation, I want you to know you're not alone in this.

When it comes to autoimmune conditions like rheumatoid arthritis or ulcerative colitis, managing your health while thinking about pregnancy can feel like walking a tightrope. And if you're taking Xeljanz, those concerns become even more complex. Let's talk through this together, shall we?

Is Xeljanz Safe During Pregnancy?

This is probably the biggest question on your mind right now, and honestly, it's a valid concern. Here's what we know from the research: Xeljanz isn't something we'd call "completely safe" during pregnancy, but that doesn't mean you can't have a healthy pregnancy while managing your condition.

Most of the research we have comes from animal studies, which showed some potential risks to developing babies. In the human world, data is still limited, but what we do know is that there might be an increased risk of infections for both mom and baby. Think of your immune system during pregnancy like a protective bubble it's already working overtime, and adding medications that affect immune response requires careful consideration.

Understanding Xeljanz Pregnancy Warnings

Drug Class	FDA Pregnancy Category	Key Notes
Xeljanz	Not assigned; however, carries boxed warning	Use only when benefits outweigh risks
Baricitinib	D	Avoid during pregnancy
Tofacitinib (Xeljanz)	C	Weigh benefit vs. possible fetal risk

Looking at this chart, you might be thinking, "Okay, so it's not ideal, but what does that really mean for me?" Well, it means that doctors typically recommend weighing the benefits of keeping your condition under control against the potential risks to your developing baby. It's not a black-and-white answer it's more like a careful balancing act.

I remember talking to my friend Sarah, who has rheumatoid arthritis, and she said it felt like choosing between her own health and her future baby's wellbeing. But here's the thing that's not actually the choice at all. With proper planning and medical guidance, there are usually safer alternatives that can help manage your condition without putting unnecessary stress on a developing pregnancy.

Potential Risks to Consider

While we're being honest here, let's talk about some of the things you might be worried about. There is some concern about an increased risk of serious infections, which makes sense when you're taking a medication that affects how your immune system works. There's also been some discussion about potential increased chances of preterm birth, though the data isn't completely clear on this yet.

The truth is, we just don't have years and years of data following babies who were exposed to Xeljanz in utero. It's like when a new restaurant opens in your neighborhood you might love it, but you want to see how it holds up over time, right?

Can You Use Xeljanz While Breastfeeding?

Okay, so what if you're not just thinking about pregnancy but actually in the thick of the nursing phase? This is where things get really personal because breastfeeding is such an intimate part of the mother-baby bond.

Here's what the research tells us about Xeljanz and breastfeeding: Small amounts of the medication have been detected in animal milk, but we don't have solid data about what happens in human breast milk. Most experts lean toward caution here, which means they generally recommend avoiding it while nursing if possible.

Talking with Your Doctor About Nursing

This is one of those conversations where you really need to sit down with your doctor and have an honest chat. They'll want to consider factors like:

• How crucial is this medication for keeping your condition under control?
• What are the feeding options available to you?
• What's the risk-benefit ratio for both you and your baby?

I've heard from several moms who worked with their doctors to create a plan where they gradually transitioned off Xeljanz before trying to conceive, or in some cases, they switched to a medication that was considered safer during breastfeeding. The key is communication don't suffer in silence or make sudden changes without talking to your medical team first.

What Might Happen to Your Baby?

Again, we're dealing with limited data here, but some concerns that experts keep an eye on include potential effects on the baby's immune response. Since Xeljanz works by affecting the immune system, there's a theoretical possibility that it could impact how your little one's immune system develops. Premature babies might be at higher risk, which is something to discuss if that applies to your situation.

Look, I know this all sounds scary, but here's the encouraging part there are so many moms out there who have successfully navigated this journey. They've worked with their doctors, made informed decisions, and come out on the other side with healthy babies and manageable conditions.

Planning for Pregnancy While Taking Xeljanz

If you're thinking about getting pregnant, and you're currently on Xeljanz, this is actually great timing to have this conversation with your doctor. Many experts recommend stopping Xeljanz before trying to conceive, but and this is crucial you should never change your medication regimen without medical supervision.

I want to emphasize this because I've seen people try to go it alone, and it rarely works out well. Your doctor needs to help you create a transition plan that keeps your condition stable while minimizing risks to a potential pregnancy.

Safer Medication Alternatives

The good news is that there are several medications that are considered safer during pregnancy and breastfeeding:

• Hydroxychloroquine This one has a long track record of safety during pregnancy
• Sulfasalazine Another option that's been around the block and has good safety data
• Azathioprine Requires monitoring but is generally considered acceptable
• Certain biologics Some are safer than others, so this requires individualized discussion

Your doctor will help you understand which options might work best for your specific situation. What works for your cousin might not work for you, and that's totally normal.

Xeljanz and Birth Control Connection

Here's a topic that doesn't get talked about enough: how Xeljanz might interact with birth control. Now, there's no direct evidence showing that Xeljanz messes with hormonal contraceptives, but some women have reported breakthrough bleeding or changes in their cycles.

If you're trying to prevent pregnancy while on Xeljanz (which is smart given what we've discussed), you might want to consider non-hormonal methods for peace of mind. Some great options include:

• IUDs Both hormonal and non-hormonal versions
• Progesterone-only pills If you prefer oral contraceptives
• Barrier methods plus spermicide Sometimes the simplest solutions work best

I'd recommend sitting down with your gynecologist to discuss what makes the most sense for your lifestyle and health needs. They can give you personalized advice that takes your whole health picture into account.

Could Xeljanz Affect Fertility?

This is a question that often comes up, and it's a really important one. If you're hoping to start a family, you want to know whether the medication you're taking might make that journey more difficult.

The good news is that limited data suggests there isn't strong evidence of fertility issues directly caused by Xeljanz. However, there have been some rare reports of changes in sperm quality in men taking the medication. But here's something that's often overlooked the chronic inflammation itself from untreated autoimmune conditions can pose more of a risk to fertility than the medications used to treat them.

Tips for Starting a Family

If you and your partner are both using Xeljanz and thinking about having kids, here are some things to keep in mind:

• Have open, honest conversations with your doctors about timing and medication switches
• Consider taking supplements like folate before conception if your doctor recommends it
• Remember that untreated RA or UC can also affect fertility and pregnancy outcomes

It's kind of like preparing for a marathon you wouldn't want to start without proper training, and you definitely wouldn't want to run with a sprained ankle. The same principle applies here.

Real Stories from Real Moms

Sometimes hearing from others who've been in your shoes can be incredibly helpful. I want to share a few stories I've heard from women who've navigated this journey:

Sarah B. told me, "I went off Xeljanz at week 6 switched to diet plus low-dose prednisone." She said the transition was scary at first, but working closely with her doctor made all the difference.

Denise M. shared, "I needed help managing flares had to adjust early." She emphasized how important it was to be proactive about her treatment plan changes.

And then there's Leslie R., who said, "I was scared I'd flare and hurt my baby ended up staying in remission though." Her experience reminds us that sometimes our fears don't materialize the way we expect them to.

Every story is different, which is why personalized medical care is so crucial. Your experience might look completely different from any of these, and that's perfectly okay.

Where to Find Reliable Information

When you're researching this topic, you want to make sure you're getting information from trusted sources. Some places I'd recommend checking include:

• UpToDate a resource I've found consistently reliable
• The American College of Rheumatology they have excellent patient resources
• Drugs.com Pregnancy Guide straightforward information
• CDC Guidelines on Contraception and Autoimmune Diseases

Remember, though, that online research should complement, not replace, conversations with your medical team. They know your specific health history and can give you personalized guidance.

Questions to Ask Your Doctor

Before your next appointment, you might want to write down some questions:

1. Is my disease stable enough to consider stopping Xeljanz?
2. Are there safe alternatives I can start before trying to conceive?
3. Can we monitor my condition differently once pregnant?
4. Should I wait to get pregnant until I've fully switched meds?
5. What's the safest plan for nursing?

Having these questions ready can help you make the most of your time with your doctor. Don't be afraid to ask for clarification or to have them explain things in different ways until it clicks for you.

Moving Forward with Confidence

Look, none of this is easy to navigate, and it's natural to feel overwhelmed. But here's what I want you to remember you're taking the right steps by getting informed and thinking ahead. That alone shows incredible strength and wisdom.

Managing autoimmune conditions while thinking about pregnancy isn't about making perfect choices it's about making informed ones with the best available guidance. Your medical team is there to support you through this journey, and there are options available that can help you achieve both good health and your family planning goals.

I know this feels like a lot to process, but you don't have to figure it all out at once. Take it one conversation, one step at a time. Your future family and your current self deserve the care and attention that comes from thoughtful planning.

What matters most right now is that you're having these conversations, asking these questions, and taking proactive steps to protect both your health and your family's wellbeing. That's not just good medicine that's good life.

Remember, you're not walking this path alone. There's a whole community of people who understand what you're going through, and medical professionals who are dedicated to helping you succeed. Trust yourself, trust your medical team, and take it one day at a time.

Your journey might look different from what you expected, but that doesn't mean it can't be beautiful, meaningful, and exactly right for you.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.