Medication	Patients trying to conceive	Pregnant	Breastfeeding
Nonbiologics
Acritretin	Safe in men Do not use in women (stop three years before conception)	Do not use	Do not use
Apremilast (Otezla)	Do not use (stop at least 2 days before conception)	Likely do not use (based on animal models)	Unknown
Cyclosporine	Likely safe in men Do not use in women	Likely safe (reports of low birth weight, prematurity, and maternal infection)	Do not use
Deucravacitinib (Sotyktu)	Unknown; not included in current safety trials	Unknown	Unknown
Methotrexate	Likely safe in men (reduced sperm count only) Do not use in women (stop 3 months before conception)	Do not use	Do not use
Biologics
Interleukin-12/23 inhibitors (e.g., ustekinumab [Stelara])	Safe in men Unknown safety in women	Likely safe (no harm in limited human studies)	Likely safe (minimal transfer in breastmilk)
Interleukin-17 inhibitors (e.g., secukinumab [Cosentyx], ixekizumab [Taltz])	Safe in men Unknown safety in women	Likely safe (no harm in limited human studies)	Likely safe (minimal transfer in breastmilk)
Tumor necrosis factor-alpha inhibitors (e.g., etanercept, infliximab, adalimumab)	Safe	Safe (recommend stopping early in the third trimester and infant should avoid live vaccines for the first 6 months of life)	Safe