Methotrexate Treatment for an Ectopic Pregnancy Information

Methotrexate is a medicine that treats an ectopic pregnancy. An ectopic pregnancy is a pregnancy in which the fetus develops outside the uterus. This kind of pregnancy can be dangerous.

Methotrexate works by stopping the growth of the fertilized egg. It also helps your body absorb tissue from the egg. This takes between 2–6 weeks. Most ectopic pregnancies can be successfully treated with methotrexate if they are diagnosed early.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe treatment. However, problems may occur, including:

• Nausea or vomiting or both.
• Vaginal bleeding or spotting.
• Diarrhea.
• Abdominal cramping.
• Dizziness or feeling lightheaded.
• Mouth sores.
• Swelling or irritation of the lining of your lungs (pneumonitis).
• Liver damage.
• Hair loss.

There is a risk that methotrexate treatment will fail and your pregnancy will continue. There is also a risk that the ectopic pregnancy might rupture while you are using this medicine.

What happens before the procedure?

• Liver tests, kidney tests, and a complete blood test will be done.
• Blood tests will be done to measure the pregnancy hormone levels and to determine your blood type.
• If you are Rh-negative and the father is Rh-positive or his Rh type is not known, you will be given a Rho (D) immune globulin shot.

What happens during the procedure?

Your health care provider may give you methotrexate by injection or in the form of a pill. Methotrexate may be given as a single dose of medicine or a series of doses, depending on your response to the treatment.

• Methotrexate injections will be given by your health care provider. This is the most common way that methotrexate is used to treat an ectopic pregnancy.
• If you are prescribed oral methotrexate, it is very important that you follow your health care provider’s instructions on how to take oral methotrexate.

Additional medicines may be needed to manage an ectopic pregnancy.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may have abdominal cramping, vaginal bleeding, and fatigue.
• Blood tests will be taken at timed intervals for several days or weeks to check your pregnancy hormone levels. The blood tests will be done until the pregnancy hormone can no longer be detected in the blood.
• You may need to have a surgical procedure to remove the ectopic pregnancy if methotrexate treatment fails.
• Follow instructions from your health care provider on how and when to report any symptoms that may indicate a ruptured ectopic pregnancy.

Summary

• Methotrexate is a medicine that treats an ectopic pregnancy.
• Methotrexate may be given in a single dose or a series of doses over time.
• Blood tests will be taken at timed intervals for several days or weeks to check your pregnancy hormone levels. The blood tests will be done until no more pregnancy hormone is detected in the blood.
• There is a risk that methotrexate treatment will fail and your pregnancy will continue. There is also a risk that the ectopic pregnancy might rupture while you are using this medicine.

Methotrexate Treatment for an Ectopic Pregnancy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Abdominal cramping.
• Vaginal bleeding.
• Fatigue.
• Nausea.
• Vomiting.
• Diarrhea.

Blood tests will be taken at timed intervals for several days or weeks to check your pregnancy hormone levels. The blood tests will be done until the pregnancy hormone can no longer be detected in the blood.

Follow these instructions at home:

Activity

• Do not have sex until your health care provider approves.
• Limit activities that take a lot of effort as told by your health care provider.

Medicines

• Take over the counter and prescription medicines only as told by your health care provider.
• Do not take aspirin, ibuprofen, naproxen, or any other NSAIDs.
• Do not take folic acid, prenatal vitamins, or other vitamins that contain folic acid.

General instructions

• Do not drink alcohol.
• Follow instructions from your health care provider on how and when to report any symptoms that may indicate a ruptured ectopic pregnancy.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have persistent nausea and vomiting.
• You have persistent diarrhea.
• You are having a reaction to the medicine, such as:
  • Tiredness.
  • Skin rash.
  • Hair loss.

Get help right away if:

• Your abdominal or pelvic pain gets worse.
• You have more vaginal bleeding.
• You feel light-headed or you faint.
• You have shortness of breath.
• Your heart rate increases.
• You develop a cough.
• You have chills.
• You have a fever.

Summary

• After the procedure, it is common to have symptoms of abdominal cramping, vaginal bleeding and fatigue. You may also experience other symptoms.
• Blood tests will be taken at timed intervals for several days or weeks to check your pregnancy hormone levels. The blood tests will be done until the pregnancy hormone can no longer be detected in the blood.
• Limit strenuous activity as told by your health care provider.
• Follow instructions from your health care provider on how and when to report any symptoms that may indicate a ruptured ectopic pregnancy.