Disease-modifying antirheumatic drugs (DMARDs) may harm fetal development. Consequently,  sexually active men and women using DMARDs should use effective means of contraception during every sexual encounter. In most cases, women who are pregnant or breastfeeding or who may become pregnant are advised not to take DMARDs.

In addition, it is important to note that some DMARDs may decrease the effect of birth control pills (oral contraceptives). Patients using these contraceptives are advised to ask their physician about alternate methods of birth control.

DMARDs are acceptable for children in certain circumstances, such as juvenile rheumatoid arthritis or organ transplantation, but children are monitored closely for possible side effects. Occasionally, lower doses of DMARDs may be required for elderly individuals. However, they generally are at no greater risk for side effects than younger adults.