Is Methotrexate safe while trying to conceive?

Question

Hi doctor,

I am 34 years old and recently diagnosed with psoriatic arthritis. My doctor suggested Methotrexate, but I have read it is dangerous in pregnancy. My husband and I were planning to start trying in 6 to 8 months. Should I delay treatment or go for a safer option? My joints are getting worse, especially my knees and toes.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

Methotrexate is a strong and effective medicine for psoriatic arthritis, but it is not safe during pregnancy and has to be stopped at least three months before trying to conceive. Since your joint pain is getting worse, especially in your knees and toes, starting treatment soon could help prevent long-term damage. One option is to take Methotrexate now to get the disease under control, then stop it in time to safely plan your pregnancy. Another option is to use medicines that are safer in pregnancy, like Sulfasalazine or certain biologics. But they may not be as strong for more severe symptoms. It depends on how active your disease is and how flexible your timeline is for trying to conceive. I would recommend speaking with both your rheumatologist and gynecologist so you can make the best decision for your health and future plans.

Thank you.