OB-GYN-L Messages for April, 2007: Re: Methotrexate

Re: Methotrexate

From: art fougner, md

evsono@pipeline.com

Sun Apr 29 20:54:45 2007

Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, USA.

OBJECTIVE: The purpose of this study was to evaluate oral methotrexate tablets in the treatment of ectopic pregnancy. STUDY DESIGN: Patients with a diagnosis of ectopic pregnancy were offered oral methotrexate tablets rather that intramuscular injection. Oral methotrexate was given in 2 divided doses 2 hours apart at a dose of 60 mg/m(2) with standard 2.5 mg methotrexate tablets. Patients were followed up with the use of the same protocol that was used typically for intramuscular methotrexate. RESULTS: Nineteen of 22 patients (86%) were successfully treated. There was no statistical difference between patients who were treated successfully or unsuccessfully, with respect to initial human chorionic gonadotropin titers (P =.55), ectopic size (P =.77), or methotrexate dose (P =.18). Nineteen of 22 patients (86%) had increased pain during treatment. Outside of pain, gastrointestinal side effects were the most common. Thirty-two percent of patients required more than one treatment cycle. CONCLUSION: Oral methotrexate can be used to treat ectopic pregnancy successfully, but there are few advantages to recommend its use over intramuscular methotrexate.

Art

At Sun, 29 Apr 2007, R. Daniel Braun wrote: >
>Steve,
>Give us a reference ofr that. OR put all your data together and publish it.
>Dan
>
>On 4/29/07, Raymond Stephen <stephen.raymond@dhhs.tas.gov.au> wrote:
>>
>> Yes I have used oral exclusively in the last decade. The dose is the
>> same, but be aware that it is available in small dose tablets (I think 2 or
>> 2.5mg), so ensure that he stocks the larger dose tablets otherwise your
>> patients have to swallow 20 tablets at a time!
>>
>> Steve Raymond
>>
>> ------------------------------
>>
>> ------------------------------
>> ------------------------------
>> ------------------------------
>> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *Elrod,
>> ------------------------------
>> Darryl G Maj 48 MDOS/SGOBO
>> ------------------------------
>> *Sent:* Friday, 27 April 2007 6:47 PM
>> ------------------------------
>> *To:* Multiple recipients of list OB-GYN-L
>> *Subject:* Methotrexate
>>
>> Does anyone have any experience with ORAL methotrexate for treatment of
>> ectopic pregnancy? Our pharmacist is looking to try and get away from
>> having to stock IM methotrexate.
>>
>> Thanks,
>>
>> Glen
>>
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>--
>R. Daniel Braun, MD FACOG(L) CMT
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage everyday".
> Hippocrates
>

-- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton

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