Introduction
Your doctor has suggested that you have Methotrexate treatment for your ectopic pregnancy. This leaflet will provide you with information about this drug.
What is Methotrexate?
This is a drug that stops cell growth and will prevent the ectopic pregnancy tissue from growing and make it degenerate.
Therefore, it medically removes the ectopic pregnancy.
Methotrexate has been used for the treatment of ectopic pregnancy for many years and is safe and very effective. Therefore, although the manufacturer’s licence for this drug does not specifically cover the use in ectopic pregnancy, your doctor is happy to recommend its use. It can be used both as an initial treatment for an ectopic pregnancy or as additional treatment after surgery to conserve the tube
How effective is it?
It is effective in over 90% of cases. Most women require only one single dose but occasionally a second dose is necessary. You will need to have weekly hormone levels checked to be sure that the treatment has been effective.
How is Methotrexate given?
It is given by an injection into the arm or hip muscle.
Are there any side effects?
Most women experience no side effects after treatment but often there is some lower abdominal pain after a few days as the treatment is starting to work.
Occasionally other side effects occur such as diarrhoea, indigestion and tiredness, please do not let this worry you if you do suffer from them. However, if any of the following side effects appear, then you must report this to Early Pregnancy Unit/H4/H5 immediately: nausea and vomiting, sore mouth, bruising, mouth ulcers, severe abdominal pain, darkness of urine or shortness of breath.
You may have some bleeding, like a period for up to 2 weeks. It is not unusual to have some spotting up until your next period. Please use sanitary towels and not tampons.
Your next period should come around 3 to 8 weeks after your treatment.
Risks factors
- Failed procedure - which may result in surgery being required and removal of the tube
- Risk of toxicity - nausea, ulcerated mouth, bone marrow suppression, inflamed lungs and liver problems
Benefits
- Not requiring an operation and removal of the tube
- General anaesthetic avoided
- Good success rates in appropriately selected cases
- Comparable to conservative surgery in terms of subsequent fertility
Sex
Please do not have sexual intercourse until the bleeding has stopped and you feel ready in yourself. It is important that you use contraception for at least 3 months after the treatment.
If you have not already decided, we can help you choose the method that it is best suited to your individual needs.
Feelings
It is normal to feel a range of emotions after a pregnancy loss. You may feel sad, numb, confused and angry. It is common to feel up and down. If you need to talk to someone, arrangements can be made for you to see the Counsellor for support.
Important points
- Avoid alcohol, direct sunlight and vitamin preparations containing folic acid until the ectopic pregnancy has completely resolved
- Do not use aspirin or ibuprofen for a week after treatment. You can use paracetamol. Please consult your pharmacist if you are in any doubt
- It is important that you use adequate contraception for at least 3 months after treatment as the injection could harm a baby that is conceived within this period
- If you have severe abdominal pain, feel faint dizzy or unwell, collapse or have heavy vaginal bleeding please contact your family doctor or dial 999
- Be sure that all your questions have been answered and you understand all procedures
We hope that the service has met your needs and that we have helped you through this difficult time.
If you have any comments or concerns about the service, then please let us know, either during your admission or via telephone to the Early Pregnancy Unit.
For further information and professional advice between appointments please contact:
Useful contact numbers
The Early Pregnancy Unit – 0161 206 1480/0161 206 0095
Gynaecology Services:
Surgical Triage Unit - 0161 206 4992
The Ectopic Pregnancy Trust – 01895 238025
Useful Websites
Date of Review: April 2025
Date of Next Review: April 2027
Ref No: PI_SU_2062 (Salford)