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SLE patient, 10 weeks pregnant, on hydroxychloroquine sulfat, azathioprine, lisinopril. Is it safe ?

i am dr AAAAA from iran. i am a rheumatologist . I have a patient with SLE . she treates now with hydroxychloroquine sulfat 200 mg/daily azathioprine 50 mg/daily. she has lupus nephritis and treated with 6 month pulse cyclophosphamide and then cellcept .and after treatment of nephritis she is now pregnant 10 week.she continued lisinopril in this 10 week of safe continuation of pregnancy in this patient? she has bilateral AVN in both hips and THR in both hip. and prednisolone not given. lupus nephritis of her is in remision.
Asked On : Sun, 23 Sep 2012
Answers:  2 Views:  365
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Rheumatologist 's  Response
Hydroxychlroquine and azathioprine is safe but lisinopril is absolutely contraindicated in pregnancy.
So it should be stopped immediately, and definitely risk to fetus will be there.
But then the decision has to be taken by patient because risk of deformities in fetus are there.
Answered: Tue, 25 Sep 2012
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