1-877-327-4636 Alcohol and Substance
1-800-436-8477 Morning Sickness
1-888-246-5840 HIV and HIV Treatment
1-877-439-2744 Motherisk Helpline
416-813-6780 Motherisk Helpline
Pregnancy & Breastfeeding Resources
Motherisk Update 2014
Fetal Alcohol Canadian Expertise (FACE) Satellite Meeting,
Details to be announced
- Read more in our News Archive
Current Studies at Motherisk
Neurodevelopment of Children Exposed in-Utero to Chemotherapy for Maternal Breast Cancer (Dr. I Nulman)
Diclegis Surveillance Program Study
Diclectin Surveillance Program Study
Study seeks women between 4 and 12 weeks in their pregnancy with morning sickness (NVP)
Pregnancy in Women with Multiple Sclerosis
Environmental Exposures and Children's Health
Alcohol Use during Pregnancy
Control of Hypertension in Pregnancy Study
Folic Acid Before and During Pregnancy
Lamisil in Pregnancy
Meridia in Pregnancy
Autoimmune Diseases in Pregnancy Project
The Cancer in Pregnancy ForumArchived Questions and Answers
This Forum has been the centre of an exceptional exchange of knowledge diagnosis, treatment, symptoms and other effects of cancer during pregnancy and lactation. All are welcome to review the Questions and Answers posted here, provided that they acknowledge and accept the important proviso and disclaimer below.
I have rheumatoid arthiritis. I am currently taking 25 Mg of methotrexate sod (by injection) and 50 mg of Enbrel (also by injection) per week. I am also taking 5 mg of Folic Acid, a prenatal vitamin with 1 mg of Folic acid, and calcium supplements everyday. I am planning on getting pregnant this summer. My Rheumatologist has advised me to stop methotrexate and Enbrel one month prior to when I want to conceive. He also said that I can continue on with the Folic Acid (5 mg/day) throughout the pregnancy. My question is - can a person obtain too much folic acid (is that possible)? Do I continue taking the prenatal vitamin if I continue to take the prescription folic acid? Is one month sufficient time to stop the Enbrel and Methotrexate prior to conception?
Consult your physician. The following information should not replace the assessment and advice you have been receiving from your physician (cancer specialist, obstetrician, or any other healthcare provider). It is offered for your information only.
Methotrexate is a structural analogue of folic acid and because of its short half-life, it will not stay in the body for more than a few days. There have been reports of women who have discontinued methotrexate prior to conception and they delivered healthy infants without birth defects (Briggs 2005). Several sources have suggested that women wait at least 12 weeks after stopping therapy before conceiving (Ann Int Med 1977;86:1999). It is sensible for you to take 5mg of folic acid, as it gives better protection against neural tube defects especially because you received an antifolate drug (methotrexate).
With regards to Enbrel, there are no current recommendations about how long one should not be taking it before trying to conceive. However, due to the longer half-life of the drug it would take approximately one month for the drug to be removed from the body (Hale 2006).