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Few Advantages to Methotrexate Tablets Over Intramuscular In Ectopic Pregnancy

Oral methotrexate can be used successfully to treat ectopic pregnancy, however, there are few advantages in recommending the oral versus the intramuscular form, a study in the United States has found.

Gary H. Lipscomb, MD, and colleagues from the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, evaluated use of oral methotrexate tablets in women with ectopic pregnancy.

Twenty two women with a diagnosis of ectopic pregnancy were given the option of receiving methotrexate orally in tablet form rather than by intramuscular injection.

The oral methotrexate was given in two divided doses two hours apart at a dose of 60 mg/mē with standard 2.5 mg methotrexate tablets. Follow-up used the protocol typically used for intramuscular methotrexate.

Nineteen patients were treated successfully, and there were no marked differences between patients treated successfully or unsuccessfully in terms of initial human chorionic gonadotropin titers, ectopic size or methotrexate dose.

The most common side effects were gastrointestinal although 19 patients (86 percent) did experience an increase in pain during the treatment.

Overall, 32 percent of patients required more than one treatment cycle.
Am J Obstet Gynecol 2002;186:1192-5. "Oral methotrexate for treatment of ectopic pregnancy"

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