Drugs used in pregnancy include corticosteroids and NSAIDS, but your obstetrician will work closely with your rheumatologist in determining which drugs are best for you as an individual.
Fortunately, RA symptoms tend to improve during pregnancy due to naturally occurring substances produced as a result of the pregnancy.
I urge you to consider pregnancy earlier rather than later due to increasing risks with increased age and you should see your gynecologist for preconception counseling prior to stopping any contraceptive method you may be using.
You are correct about not being able to take methotrexate during pregnancy. The good news is pregnancy state improves rheumatoid arthritis in 70% of women. This lasts all throughout pregnancy only to flare up during the postpartum period. There are alternative medications that can be used during conception and pregnancy such as steroids, NSAIDs, azathioprine etc depending on symptoms. The hardest part is getting pregnant, women with RA can take a long time to get pregnant, on average over 12 months. Hope this helps, good luck! RB
If you plan to have pregnancy , then stop methotraxate 3 months before your plan and you can take plaquanil before(while planningfor pregnancy) and during pregnancy and also RA itself has less chances to flare up during pregnancy. so less medications needed. also prednisone can be useful if needed.
The most important thing is for you to have a great trusting relationship with your rheumatologist. Let them know what you are thinking about. It will be important to discuss if and when you are planning to get pregnant. Methotrexate is associated with birth defects. If you start thinking about conception, you will want to be off methotrexate for at least a few weeks before you start trying. Often but not always the RA will go into a remission during pregnancy. If that occurs you will need little or no medications throughout the pregnancy. However if the RA flares there are still some medications that you can take safely during pregnancy such as low dose prednisone and hydroxychloroquine (plaquenil). You will also want to discuss if you plan to breast feed as that will impact what medications you can take for the RA after you deliver the baby. It will be important to re-start medication post partum because even if the RA goes into remission during the pregnancy, it often flares after the baby is born.