Q: I am 33-years-old female. I have been taking methotrexate for treatment of still’s disease for the past four years. I would like to conceive soon. For how long should I stop methotrexate before conceiving? What would be the ideal time so that there are no side effects? I have also been taking naproxen for pain management. Is this safe during conception and pregnancy? If not, what could be other choice?

A:Methotrexate must be discontinued for at least three months before planning pregnancy and must not be taken during the entire gestation period and for the entire period when the baby is breastfed. Naproxen can impair fertility and hence is not recommended for use in women planning to conceive. There is absolute no contraindication to its use during pregnancy though it should be avoided during the last month since it can prolong labour and delay delivery. It should also be avoided when breast-feeding even though only about 1% of this medicine appears in the mother's milk.