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Copaxone and TTC

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  • Copaxone and TTC

    We want to have a second child, I take Copaxone. During dicussions with my neuro i was advised the following:
    1) be on copaxone 1 - 1.5yrs before TTC, that way it has had time to start to have some effect and build up in my system
    2) come off copaxone but wait 2 months before TTC
    3) not to take it while pregnant or breastfeeding.

    Has anyone else had similar discussions with their neuro, or recieved advice about this? I was so disheartened when I was told all this. We are very excited to try for another baby and I am not getting any younger and this all basically means waiting 6 months from now (coming off copaxone after 1 year on it) before TTC and who knows how long it will take to get pregnant.

    The decision to have another baby gets more complicated when you have MS, and the therapy questions just make it even harder and more confusing.

  • #2
    Dear Bouncycat,

    We, at the InfantRisk Center, can give information from current medical research about the effect of Copaxone on pregnancy and breastfeeding. Thus far, there are no adequate, well-controlled human studies on the use of Copaxone in pregnancy. There are a few case studies that indicate an increase in the risk of miscarriage when used in the first trimester of pregnancy, but no increase in the risk of birth defects. In one case study with 128 pregnant women with MS, 14 % were taking Copaxone, 48 % of the women were on interferon beta, and 7 % were on other medications. Ninety percent of the 128 pregnancies had a favorable outcome when the medications were used after the first trimester. (Finkelsztejn, et al) You should have a risk/benefit discussion with your OB physician and neurologist about the use of Copaxone during your pregnancy. The interferons appear to be similar to Copaxone in the risk of miscarriage, but again no increase in the risk of birth defects. Remember, for each pregnancy, there is a risk of 1 to 3 % for birth defects without taking any medications. That is the national average in the United States.
    For breastfeeding, the interferons beta 1 A & B are very large molecules so they would only minimally be transferred into breastmilk. We do not have data on the transfer of Copaxone into breastmilk, but it is also a large molecule (although somewhat smaller than the interferons)and would likely only be present in small amounts in breastmilk. Dr. Hale recommends to pump and discard milk after Copaxone administration then wait 1 hour before breastfeeding. Dr. Hale thinks these medications are compatible with breastfeeding. For further information, please call the InfantRisk Center at 806-352-2519, Monday through Friday, 8 to 5 CST.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center
    Last edited by cpride; 08-04-2011, 12:46 PM.

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    • #3
      Thus far, there are no adequate, well-controlled human studies on the use of Copaxone in pregnancy. There are a few case studies that indicate an increase in the risk of miscarriage when used in the first trimester of pregnancy, but no increase in the risk of birth defects. In one case study with 128 pregnant women with MS, 14 % were taking Copaxone, 48 % of the women were on interferon beta, and 7 % were on other medications. Ninety percent of the 128 pregnancies had a favorable outcome when the medications were used after the first trimester.

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      • #4
        According to me, there is no specific adequate or specific period to use Copaxone. There are many risks to use and many benefits as well, while using in that particular period when you want to conceive.. First of all Physician who should have experience with knowledge about Copaxone's drawbacks can give better choice for you. Otherwise learn about Copaxone as you can.

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