The effects of methotrexate on pregnancy, fertility and lactation

Abstract
Low-dose weekly methotrexate (MTX) is widely used in the treatment of rheumatoid arthritis1 and is now increasingly used in other rheumatic conditions, including systemic lupus erythematosus and juvenile arthritis. Because of its anti-metabolic and cytotoxic actions, questions of its safety in those of childbearing age are likely to become increasingly important. The aim of this review is to aid clinicians in the counselling and education of patients taking or about to start taking low-dose MTX. We examine the effects of MTX with respect to fertility, pregnancy and lactation, based upon information obtained using `Medline' search strategies from 1966 to 1997, hand search through the last ten years of the journal Teratology, source paper references and data from the UK National Teratology Information Service (NTIS) from 1992.

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