Re: Methotrexate
From: art fougner, md (evsono@pipeline.com)
Tue May 1 22:18:48 2007
All using same protocol? If so, then Dan's advice still goes.
Art
At Wed, 2 May 2007, Raymond Stephen wrote:
>
>On enquiring of my colleagues in this (my new) hospital workplace, I
>find that all are using oral methotrexate and have been for a long time!
>
>Steve
>
>________________________________
>
>________________________________
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R.
>
>--
>________________________________
>Daniel Braun
>________________________________
>Sent: Tuesday, 1 May 2007 2:55 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Methotrexate
>
>So it looks like therre is a higher number o fpatients requiring 2 or 3
>courses of treatment. The total number of pregnancies is way too small
>to conclude that.
>
>Steve,
>
>Publish your data!
>
>Dan
>
>On 4/29/07, art fougner, md <evsono@pipeline.com> wrote:
>
>Am J Obstet Gynecol. 2002 Jun;186(6):1192-5.
>Oral methotrexate for treatment of ectopic pregnancy.
>Lipscomb GH, Meyer NL, Flynn DE, Peterson M, Ling FW.
>
>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
>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
>
>--
>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
>
>CONFIDENTIALITY NOTICE AND DISCLAIMER
>
>other purpose.
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
