A female patient with rheumatoid arthritis has taken leflunomide (Arava) for 1 year. She telephones the clinic nurse and says that a home pregnancy test showed a positive result. The nurse should
a. tell her to stop the drug immediately and notify the prescriber.
b. advise her that it is safe to continue the medication.
c. tell her to stop the drug for the first trimester and restart it at week 13.
d. advise her to take the drug only when needed.
A
Leflunomide is contraindicated during pregnancy, because it is teratogenic and embryotoxic. The medication should be discontinued immediately, and the prescriber should be notified.
The medication should not be taken under any circumstances, to prevent injury to the fetus.
The medication should not be taken at all during pregnancy and should be cleared from the body before becoming pregnant.
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