Methotrexate is typically given by injection. Two injection
sites are sometimes used to administer one dose. This method increases
absorption of all of the medicine.
Methotrexate stops the growth of rapidly
dividing cells, such as
fetal, and early
Methotrexate treatment can be given as a single shot or as
several injections. If an ectopic pregnancy continues after 2 or 3 doses of
methotrexate, surgical treatment is needed to remove the ectopic
During the week that you
have methotrexate injections, your pregnancy hormone levels (human chorionic
gonadotropin, or hCG) are tested several times. Your doctor will look for a
drop in hCG levels, which is a sign that the pregnancy is ending (hCG levels
sometimes rise during the first few days of treatment, then drop).
Methotrexate series. Although it
is an uncommon practice, methotrexate can be given every other day until
pregnancy hormone (hCG) blood tests confirm that the pregnancy has ended. On
alternate days, a medicine called
leucovorin (folinic acid) is given by injection to
decrease methotrexate side effects. Treatment time for a methotrexate series
varies from case to case but can take a month or longer.
Methotrexate can be used to:
It is also used to treat certain types of cancer,
rheumatoid arthritis, and as part of an induced
Methotrexate works as well as surgery (salpingotomy) for treating an ectopic pregnancy when:1
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine. Severe side effects from methotrexate are most likely to develop with long-term use, such as when it is used for cancer treatment.
Call 911 or other emergency services right away if you have:
Call your doctor if you have:
Common side effects include:
Rare side effects include:
Because of the risk of side effects, methotrexate treatment
requires close medical supervision by a doctor who is experienced with this
medicine. During methotrexate treatment, keep your doctor informed of
any symptoms that you have.
Reference for a full list of side effects. (Drug Reference is not available in
You will be advised to avoid the following until your treatment has
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
CitationsVarma R, Gupta J (2009). Tubal ectopic pregnancy, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
May 14, 2012
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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