Dear Sir,

As described in the guideline “The second European evidence-based consensus on the diagnosis and management of Crohn's disease: Special situations” published in the JCC, methotrexate is contraindicated during pregnancy.1 This important publication also emphasizes that, women with Crohn's disease that use methotrexate and wish to become pregnant is recommended to discontinue the medication before conception. The period suggested of 6 weeks, however, seems to be too short because methotrexate can remain in the body for an average period of 15 weeks.2 Therefore, it is safer to plan the conception for about six months after methotrexate suspension.3

Conflict of interest

The authors declare that there are no conflicts of interest to declare.

References

1
Van Assche
G.
Dignass
A.
Reinisch
W.
van der Woude
C.J.
Sturm
A.
De Vos
M.
et al
The second European evidence-based consensus on the diagnosis and management of Crohn's disease: special situations
J Crohns Colitis
 
4
2010 Feb
63
101
2
Dalrymple
J.M.
Stamp
L.K.
O'Donnell
J.L.
Chapman
P.T.
Zhang
M.
Barclay
M.L.
Pharmacokinetics of oral methotrexate in patients with rheumatoid arthritis
Arthritis Rheum
 
58
2008 Nov
3299
3308
3
Mahadevan
U.
Pregnancy and inflammatory bowel disease
Med Clin North Am
 
94
2010 Jan
53
73