Table 4 DMT use and family planning
DMT | Discontinuation before pregnancy | Use in pregnancy | Breastfeeding |
|---|---|---|---|
glatiramer acetate | not necessary | compatible | compatible |
INF-β | not necessary | compatible | compatible |
dimethyl-fumarate / diroximel-fumarate | not necessary | contraindicated | contraindicated |
teriflunomide | accelerated elimination | contraindicated | contraindicated |
fingolimod | at least 2 months | contraindicated | contraindicated |
siponimod | at least 10 days | contraindicated | contraindicated |
ozanimod | at least 3 months | contraindicated | contraindicated |
ponesimod | at least 1 week | contraindicated | contraindicated |
cladribine | at least 6 months | contraindicated | 7 days after the drug intake breastfeeding is compatible |
natalizumab | not necessary | compatible in very active disease; stop at 30–34 GW; extended interval dosing (6 weeks) | compatible, no interval between infusion and next breastfeeding |
ocrelizumab | until pregnancy | contraindicated | probably compatible, wait at least 4 h after infusion |
ofatumumab | until pregnancy | contraindicated | compatible (except the first days after birth) |
alemtuzumab | last dose 4 months before conception | contraindicated | probably compatible EMA: 4 months after the last infusion |