Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy

Kurt Barnhart, Amy C. Hummel, Mary D. Sammel, Seema Menon, John Jain, Nahida Chakhtoura

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objective: To evaluate the safety and acceptability of a novel dosing regimen of methotrexate to treat ectopic pregnancy. Design: Prospective study. Setting: Three academic medical centers. Patient(s): One hundred one patients with ectopic pregnancy who elected to have medical therapy. Intervention(s): Intramuscular methotrexate 50 mg/m2 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. Main Outcome Measure(s): Adverse events, acceptability, and resolution of pregnancy without surgical treatment. Result(s): 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. Conclusion(s): 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.

Original languageEnglish
Pages (from-to)250-256
Number of pages7
JournalFertility and Sterility
Volume87
Issue number2
DOIs
StatePublished - Feb 1 2007

Fingerprint

Ectopic Pregnancy
Methotrexate
Safety
Leucovorin
Rupture
Therapeutics
Outcome Assessment (Health Care)
Prospective Studies
Pregnancy
Injections

Keywords

  • Ectopic pregnancy
  • medical management
  • methotrexate
  • safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Barnhart, K., Hummel, A. C., Sammel, M. D., Menon, S., Jain, J., & Chakhtoura, N. (2007). Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy. Fertility and Sterility, 87(2), 250-256. https://doi.org/10.1016/j.fertnstert.2006.06.054

Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy. / Barnhart, Kurt; Hummel, Amy C.; Sammel, Mary D.; Menon, Seema; Jain, John; Chakhtoura, Nahida.

In: Fertility and Sterility, Vol. 87, No. 2, 01.02.2007, p. 250-256.

Research output: Contribution to journalArticle

Barnhart, K, Hummel, AC, Sammel, MD, Menon, S, Jain, J & Chakhtoura, N 2007, 'Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy', Fertility and Sterility, vol. 87, no. 2, pp. 250-256. https://doi.org/10.1016/j.fertnstert.2006.06.054
Barnhart K, Hummel AC, Sammel MD, Menon S, Jain J, Chakhtoura N. Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy. Fertility and Sterility. 2007 Feb 1;87(2):250-256. https://doi.org/10.1016/j.fertnstert.2006.06.054
Barnhart, Kurt ; Hummel, Amy C. ; Sammel, Mary D. ; Menon, Seema ; Jain, John ; Chakhtoura, Nahida. / Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy. In: Fertility and Sterility. 2007 ; Vol. 87, No. 2. pp. 250-256.
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