Pregnancy, breastfeeding and fertility while taking methotrexate - Brand names: Jylamvo, Maxtrex, Methofill, Metoject, Nordimet, Zlatal

Methotrexate and pregnancy

Methotrexate is not recommended in pregnancy, as it can cause birth defects.

If you're taking methotrexate and want to get pregnant, speak to your doctor. They'll discuss whether you need to switch to a different medicine before stopping your contraception.

If you become pregnant while taking methotrexate, do not stop taking your medicine but speak to your doctor as soon as possible. They'll review your treatment and help you decide what to do next.

Your doctor will only prescribe methotrexate for you while you're pregnant if the benefits of the medicine outweigh the chances of it being harmful.

Methotrexate and breastfeeding

There is not much information about methotrexate and breastfeeding, but it shows that methotrexate passes into breast milk in tiny amounts. However, since methotrexate can cause some quite serious side effects in rare cases, your doctor or specialist will advise what's best for you and your baby.

If your weekly dose of methotrexate is 25mg or less, it may be possible to breastfeed. However, you must not breastfeed for 24 hours after taking your medicine. Your midwife or health visitor can give you advice about how to feed your baby while you wait 24 hours.

If your weekly dose is more than 25mg, your doctor will talk to you about what's best for you and your baby. You may still be able to breastfeed, but it will depend on your dose of methotrexate and any other medicines you're taking.

If you breastfeed while taking methotrexate, your baby will have blood tests to check for any side effects.

If you notice that your baby is not feeding as well as usual, is being sick or has diarrhoea, seem to be getting infections more regularly, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.

Methotrexate and fertility

Methotrexate may reduce fertility. It may damage sperm in men and egg production in women.

Methotrexate can cause birth defects if taken during pregnancy. Ask your doctor about changing to a different medicine before you stop using contraception.

For more information about how methotrexate could affect you and your baby, visit the Best Use of Medicines in Pregnancy (BUMPs) website.