Close

We are using cookies to give you the best experience on our site. Cookies are files stored in your browser and are used by most websites to help personalise your web experience.

By continuing to use our website without changing the settings, you are agreeing to our use of cookies.

Find out more
For more information, go to www.arthritisresearchuk.org

How long should I come off methotrexate before trying to conceive?

Q) I am 32 and have rheumatoid arthritis. I take methotrexate and have eight weekly infusions of infliximab. My husband and I would like a family, however I have been told I have to come off all treatment for six months before trying to conceive. Last year my eight-weekly treatment was delayed by one week and I deteriorated badly and quickly. The thought of not having treatment for six months is not good, but I would like a family. Is there anything that can be done?
Mrs Anne Shenton, Weeping Cross, Stafford (Winter 2012)

A) This is a common problem. Methotrexate can cause birth defects and should be stopped before trying to conceive. Just how long the drug should be stopped for is under debate – some say six months, some three months. It is also recommended by the manufacturers that TNF inhibitors are also discontinued prior to conception but the evidence that these drugs cause birth defects is not anywhere near as strong. My practice is to recommend discontinuation of methotrexate for three months before trying for a baby and to advise the prospective parents of the recommendations and risks of continuing with TNF inhibitors. If the prospective parents are not prepared to risk continuing with TNF inhibitors then other drugs, known to be relatively safe, must be given. These may include hydroxychloroquine, sulfasalazine and steroids. The good news is that for most people the arthritis will improve during the pregnancy.

Helpline

0800 5200 520

Our new helpline: Call us for free information, help and advice on your type of arthritis.

All calls are recorded for training and quality purposes

More Information Close
For more information, go to www.arthritisresearchuk.org/arthritis-information or call 0300 790 0400 to order the complete printed booklet.
Arthritis Research UK fund research into the cause, treatment and cure of arthritis. You can support Arthritis Research UK by volunteering, donating or visiting our shops.