Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy.
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.
Barnhart
Kurt
K
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA. kbarnhart@obgyn.upenn.edu
Hummel
Amy C
AC
Sammel
Mary D
MD
Menon
Seema
S
Jain
John
J
Chakhtoura
Nahida
N
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
D008727:Methotrexate