title: Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy.
abstract: OBJECTIVE
  To evaluate the safety and acceptability of a novel dosing regimen of methotrexate to treat ectopic pregnancy.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Three academic medical centers.
  
  
  METHODS
  One hundred one patients with ectopic pregnancy who elected to have medical therapy.
  
  
  METHODS
  Intramuscular methotrexate 50 mg/m(2) was administered on days 0 and 4; additional doses of methotrexate were given on day 7 and/or day 11 if hCG levels did not decrease by 15% during the follow-up period.
  
  
  METHODS
  Adverse events, acceptability, and resolution of pregnancy without surgical treatment.
  
  
  RESULTS
  With this protocol, 87% of patients were treated successfully. Of those protocols that were considered failures, only 3% of patients experienced rupture of ectopic pregnancy. Treatment was well-tolerated; most side effects were reported as mild and transient. Ninety-one percent of the 61.5% of patients who responded to the satisfaction questionnaire reported satisfaction with this regimen.
  
  
  CONCLUSIONS
  This "2-dose" protocol minimizes the number of injections and surveillance visits, compared with the "multiple dose" regimen, and methotrexate is administered more frequently than with the "single dose" regimen. The protocol may optimize the balance between convenience and efficacy. In a limited number of women, no safety concerns were noted with up to 4 doses of methotrexate in a 2-week period without leucovorin rescue.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA. kbarnhart@obgyn.upenn.edu
authors.forename: Kurt
authors.initials: K
authors.lastname: Barnhart
authors.forename: Amy C
authors.initials: AC
authors.lastname: Hummel
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Seema
authors.initials: S
authors.lastname: Menon
authors.forename: John
authors.initials: J
authors.lastname: Jain
authors.forename: Nahida
authors.initials: N
authors.lastname: Chakhtoura
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate