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Leflunomide pregnancy — SCE Rheumatology MCQ

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ModerateRheumatological pharmacologyLeflunomide pregnancySCE Rheumatology

A 34-year-old woman on leflunomide for RA has an unplanned pregnancy. Examination shows joint disease is quiet. Investigations show pregnancy test is positive and liver tests are normal. What is the most appropriate management?

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Correct answer: E — Stop leflunomide and arrange washout with colestyramine

Stop leflunomide and arrange washout with colestyramine is the safest management step for this treatment-related scenario. The alternatives either continue a potentially harmful drug, omit essential monitoring, or address the wrong risk. Shared-care DMARD prescribing depends on clear monitoring thresholds and rapid communication with rheumatology.

Reference: BNF; SPS DMARD monitoring guidance; BSR DMARD prescribing guideline