No pain or other side effects

[HisMercy]

Hello,
I took Methotrexate on Tuesday morning. It’s nearly two days but I haven’t felt a thing except slight abdominal twitches. Does it mean the drug isn’t having its effect?

[EPT Host 22]

Hi HisMercy,

I'm so sorry you have suffered an ectopic pregnancy and loss. Everyone is different in how they respond to MTX treatment. It is very important that you are continued to be followed up with blood tests. This will determine the decrease in hcg. While you are waiting for your hcg levels to decrease, it's important to take it easy.

The Trust recommends the following after receiving MTX:

• You should stop taking any vitamins, minerals or other medicines unless you have been told by the doctors treating you to continue with them, as some medicines interfere with the effects of methotrexate. It is particularly important that you do not take any folic acid supplements until your doctors are sure that the drug has worked.

• You should not do any heavy lifting or housework until the hCG levels are dropping consistently and should only undertake gentle exercise, such as walking, until the hCG is at non-pregnant level.

• You should avoid sexual intercourse until your hCG is down to non-pregnant level.

• Most people take time off from work initially and do not return to work for at least two weeks while the treatment begins to work. Your hospital can give you a certificate to refrain from work for your employers or the Department of Social Security, so you can claim sickness benefit if you are entitled to it.

• In the first week it is important to avoid pain killers which fall into the NSAID group such as ibuprofen. The preferred painkiller is paracetamol and you should refrain from drinking alcohol until the levels have fallen to a non-pregnant state.

You know your body the best, and while the hcg levels are decreasing, it's important to be mindful of your symptoms until you reach non-pregnant levels, under 5mIU/mL, as there is unfortunately still a chance of rupture. The symptoms of a deteriorating ectopic pregnancy, which include worsening or progressively increasing pain; vaginal bleeding; shortness of breath; feeling faint; and pain in the tip of the shoulder among others, may become noticeable. If you suffer any of these symptoms you will need to be reassessed. Your hospital would give you a number to contact for health advice if you feel that anything is changing, or you will have been told to report to the Accident and Emergency Department (A&E). If you have not been told what to do and need to speak to someone ring the hospital department which is treating you or the NHS 111 Service by dialing 111.

From the bottom of my heart, please be kind to yourself through your recovery. We are here for you whenever you need it.

With good wishes,

Michele

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
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