Methotrexate For Pregnancy Termination | How It Works
Methotrexate gives women the opportunity to have a termination performed as early as a week prior to missing their period up to 9 weeks from the last menstrual period.
Methotrexate is not only used to stop the growth of pregnancy tissue, but it is used to treat different cancers (head and neck, breast, female genital tract, psoriasis, rheumatoid arthritis, ulcerative colitis, and other chronic diseases that affect are autoimmune disorders.
It is also used to treat patients with ectopic (tubal) pregnancies which are pregnancies that implant outside of the uterus (fallopian tubes, ovaries, abdomen, liver, diaphragm, etc.).
Methotrexate is extremely safe and effective in terminating pregnancies less than 9 weeks gestation. This medication has been used in our offices for over 20 years and used around the world for over 30 years in performing Medical Abortions.
How Does Methotrexate Terminate Pregnancy
Methotrexate works by blocking the body’s ability to use folic acid, a vitamin that rapidly dividing cells need to grow.
During pregnancy, some of the fastest-growing cells are the trophoblastic cells, which later help form the placenta. Methotrexate stops these cells from multiplying, which causes the pregnancy tissue to stop developing.
Methotrexate is most commonly used to treat certain ectopic pregnancies, where a pregnancy develops outside the uterus, usually in a fallopian tube. Once the pregnancy tissue stops growing, the body gradually absorbs it.
After treatment, healthcare providers usually monitor hCG levels to make sure they continue to decrease until the pregnancy has fully resolved.
Methotrexate is different from the standard abortion-pill medications mifepristone and misoprostol. Because ectopic pregnancy can become a medical emergency, methotrexate treatment requires medical supervision and follow-up.
Contraindications To The Use Of Methotrexate
Women who are allergic or have sensitivity to Methotrexate should not receive the medication. Methotrexate can cause fetal death, teratogenic effects and miscarriage when administered to a pregnant woman.
Pregnancy should be avoided if either partner is receiving Methotrexate; during and for a minimum of three months after therapy for male patients, and during and for at least one menstrual cycle after therapy for female patients.
For women who are breastfeeding, Methotrexate is contraindicated due to the complications it can cause infants which are similar to the ones that occur in adults with the passage of the Methotrexate metabolites in the mother’s breast milk.
For women who have blood dyscrasias (blood disorders), anemia, low platelet counts, low white and red blood cell counts) Methotrexate is contraindicated.
The Side Effects
Methotrexate can cause side effects that range from mild to serious. Some people may experience headache, dizziness, drowsiness, tender or swollen gums, red eyes, or temporary hair loss.
More serious reactions can affect the liver, kidneys, lungs, digestive system, immune system, and bone marrow.
Warning signs can include persistent fever or other signs of infection, unusual bruising or bleeding, severe fatigue, breathing difficulties, persistent vomiting or diarrhea, mouth sores, or yellowing of the skin or eyes. Serious skin and allergic reactions can also occur.
Because methotrexate can cause significant complications, medical supervision and appropriate laboratory monitoring are important.
Anyone experiencing severe or unexpected symptoms after receiving methotrexate should contact a healthcare professional promptly.
Where To Get Methotrexate
Methotrexate is a prescription medication and should only be obtained through a licensed healthcare professional or pharmacy.
Because it can cause serious side effects and requires appropriate medical evaluation and monitoring, it should not be purchased from websites or sellers that offer it without a prescription.
The FDA specifically warns against online pharmacies that sell prescription medications without requiring a valid prescription.
When methotrexate is medically appropriate, a healthcare provider can determine whether it is suitable and arrange treatment or provide a prescription through a licensed pharmacy.
Contact us if you need help.
FAQs
1. What Is Methotrexate?
Methotrexate is a prescription medication that belongs to a group of medicines known as antimetabolites. It can slow the growth of certain cells and reduce immune-system activity.
2. What Is Methotrexate Used For?
Methotrexate is used to treat several medical conditions, including certain cancers, rheumatoid arthritis, psoriasis, and other inflammatory or autoimmune conditions. It is also used in some pregnancy-related medical situations under close medical supervision.
3. How Does Methotrexate Work?
Methotrexate interferes with processes cells need to grow and reproduce. In inflammatory conditions, it also reduces immune-system activity, which can help decrease inflammation.
4. Is Methotrexate a Prescription Medication?
Yes. Methotrexate is available only by prescription and should be taken or administered under the supervision of a qualified healthcare professional.
5. How Is Methotrexate Administered?
Methotrexate is available in several forms, including tablets, oral liquid, and injections. The appropriate form depends on the condition being treated and the patient’s medical circumstances.
6. How Long Does Methotrexate Take to Work?
It depends on why methotrexate is being used. For inflammatory conditions such as rheumatoid arthritis, improvement may begin after several weeks, while the full benefit can take longer.
7. What Are the Most Common Side Effects of Methotrexate?
Possible side effects include headache, dizziness, drowsiness, swollen or tender gums, red eyes, and temporary hair loss. Other gastrointestinal symptoms may also occur.
8. What Are the Serious Side Effects of Methotrexate?
Methotrexate can sometimes cause serious problems involving the liver, kidneys, lungs, bone marrow, digestive system, skin, or immune system. Severe reactions require prompt medical attention.
9. Who Should Not Take Methotrexate?
Methotrexate may not be appropriate for people with certain medical conditions, including significant liver, kidney, blood, immune-system, or gastrointestinal problems.
Pregnancy and certain medication interactions can also make methotrexate unsuitable. A healthcare professional should review a patient’s complete medical history first.
10. Does Methotrexate Interact With Other Medications?
Yes. Methotrexate can interact with several prescription and over-the-counter medications, including some anti-inflammatory medicines, antibiotics, proton-pump inhibitors, and other drugs.
Patients should tell their doctor or pharmacist about everything they take, including vitamins and supplements.
11. Do You Need Blood Tests While Taking Methotrexate?
Often, yes. Blood tests may be used to monitor blood-cell counts, liver function, and kidney function and to identify potential complications before they become serious.
12. Can You Drink Alcohol While Taking Methotrexate?
Alcohol and methotrexate can both affect the liver. Recommendations vary according to the methotrexate dose, medical condition, and individual risk factors, so patients should discuss alcohol consumption with their healthcare provider.
13. Does Methotrexate Cause Weight Gain?
Weight gain is not considered a common side effect of methotrexate. More typical side effects include nausea, reduced appetite, fatigue, headaches, and hair loss.
14. Can Methotrexate Cause Cancer?
Methotrexate is not generally considered a common cause of cancer. In fact, it is also used as a chemotherapy drug to treat certain cancers.
However, methotrexate suppresses parts of the immune system, and rare cases of lymphoma and other lymphoproliferative disorders have been reported, particularly in people receiving long-term treatment for autoimmune conditions.
15. Can Methotrexate Cause Hair Loss?
Yes. Hair thinning or hair loss can occur in some people taking methotrexate. It is generally considered a possible side effect rather than something everyone experiences.
16. Can Methotrexate Be Used During Pregnancy?
No. Methotrexate can cause severe harm to a developing pregnancy and is generally contraindicated during pregnancy when it is being used to treat non-pregnancy-related conditions.
There are specific medical circumstances in which clinicians deliberately use methotrexate for pregnancy-related treatment, but this requires professional evaluation and supervision.
17. Can Methotrexate Affect Fertility?
Methotrexate may affect fertility in some people, including sperm production and menstrual function. Anyone concerned about future fertility should discuss these risks with their healthcare provider before treatment.
18. Can You Breastfeed While Taking Methotrexate?
Methotrexate can pass into breast milk. Breastfeeding recommendations depend on the treatment circumstances, but official medication information advises against breastfeeding during methotrexate treatment and for a period after the final dose.
19. How Long Does Methotrexate Remain in the Body?
The time needed to eliminate methotrexate varies according to the dose, kidney function, individual metabolism, and other factors. Some of its biological effects can also continue after the medication itself has been largely eliminated.
For doses below 30 mg/m², the FDA reports a terminal half-life of about 3 to 10 hours. This means that most circulating methotrexate is generally eliminated over the next couple of days.
20. What Painkillers Can I Take With Methotrexate?
Acetaminophen (paracetamol/Tylenol) is commonly considered compatible with methotrexate for many patients when used as directed.
However, because both medicines can involve the liver, it is still wise to confirm with a doctor or pharmacist, especially if methotrexate is used regularly or there is existing liver disease.
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