Here is some info on methotrexate for you taken fron EPT site. Link to site here
What happens after treatment?
Your hospital will make arrangements for you to have the hormone level checked. The level frequently rises in the first week and it will take between 2 and 4 weeks for them to fall to normal, sometimes it may take longer. You will need regular blood tests until the beta hCG levels are undetectable. A few days after the injection it is usual to begin to bleed and
this bleeding can last between a few days and up to 6 weeks but not all women bleed immediately. It is usual to have some discomfort and pain initially but as long as this isn?t severe and you are feeling well this is nothing to worry about. If it is severe, or you feel faint, you will need to go to hospital immediately, as this may be a sign that the tube has ruptured. The following points are important:
- Avoid alcohol and vitamin preparations containing folic acid
until the hormone level is undetectable
- Avoid Aspirin or drugs such as Ibuprofen for 1 week after treatment. Paracetamol is safe to use (up to two tablets, four times a day).
- You should use reliable contraception for three months after a single injection and six months after more than one injection, as Methotrexate may affect the development of the baby if a new pregnancy occurs within that period.
What are the side effects?
Sometimes you may notice abdominal pain. This tends to occur on the third or fourth day after treatment and is sometimes referred to as separation pain. Other occasional side effects (affecting up to 15% of patients) include nausea, indigestion, diarrhoea, sore mouth and fatigue. Very occasionally, changes in the blood count, liver and kidney function may occur, but these are usually temporary.
How successful is it?
Studies show that on average only 1 in 15 women require surgery as a result of unsuccessful treatment. Also, Methotrexate is at least as good as surgery in terms of subsequent successful pregnancies. This may be due to the fact that medical treatment is non-invasive where as surgery may cause some scarring around the tube.
How effective is the treatment and when should I be concerned?
The main risk associated with treating you medically, is that the medicine won?t work and the cells of the ectopic pregnancy might continue to divide, which could result in there still being a need surgery. It is thought that up to 15% of women who are treated with Methotrexate initially, go to on to need surgical treatment. Doctors can tell if the specialised cells of a pregnancy that produce the hCG hormone are dividing because the hCG level will rise and not fall. If after 10 days you have persistent pain or the pain changes but remains uncomfortable you should report that to your doctors.