What are the guidelines on the use of methotrexate (MTX) by pregnant women with rheumatoid arthritis (RA)?

Updated: May 11, 2018
  • Author: Katherine K Temprano, MD; Chief Editor: Christine Isaacs, MD  more...
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Both the EULAR and BSR-BHPR guidelines recommend MTX at any dose should be avoided in pregnancy and stopped 3 months in advance of conception. [18, 19]   BSR-BHPR guidelines further recommend that women treated with low-dose MTX within 3 months of conception receive folic acid supplementation prior to and throughout pregnancy. In the case of accidental pregnancy in a woman on low-dose MTX, the drug should be stopped immediately, folic acid supplementation continued, and a careful evaluation of fetal risk carried out by local experts. [19]  

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