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Methotrexate - no symptoms

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Joined: Wed Mar 10, 2021 10:48 am

Methotrexate - no symptoms

Post by Lra27 »

I had a methotrexate injection last Friday to treat a pregnancy of unknown location with rising HCG levels (but very low - around 150 last week). I haven't had any symptoms since apart from a headache on the second day. No pain, bleeding. I know it can take a while to work and everyone reacts differently but I'm worried it's not going to work at all. Not sure what I'm looking for but just really want this to be over now!

EPT Host 22
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Re: Methotrexate - no symptoms

Post by EPT Host 22 »

Hi Lra27,

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,


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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Joined: Wed Mar 10, 2021 10:48 am

Re: Methotrexate - no symptoms

Post by Lra27 »

Thank you so much, Michele. This is really helpful. They are only doing bloods on day 10 after the injection at the moment to avoid too many trips to the ward due to covid, so I'll find out on Sunday. Fingers crossed something has worked.

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Joined: Sun Feb 21, 2021 9:49 pm

Re: Methotrexate - no symptoms

Post by miranda864 »


How did you end up going? I hope you had a good outcome.

I didn't really have methotrexate symptoms either, and it was successful for me. I had slight fatigue (or maybe that was just because I'd been expected fatigue, or because I was emotionally exhausted!) but not much else. Didn't get any nausea, gastro etc. I did have one day of cramping and a decidual cast, but I'd already been bleeding so that may have happened anyway. About three weeks later I got some pain from internal bleeding/fluid (also may have happened anyway). So in my case the lack of symptoms wasn't an indication of success!

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Joined: Thu Oct 29, 2020 9:45 pm

Re: Methotrexate - no symptoms

Post by Esb27 »

Hi Lra27,

It might be that because your levels were so low that maybe it worked quicker and therefore you had less symptoms? Obviously everyone's body deals with it differently.

I had mine 8 days ago, had in total two days of feeling really really awful (not consecutively) but mostly feeling okay (just the odd cramp and the bleeding stopped on day 7). I wondered if I feel okay now because my levels seem to be dropping insanely fast (started on 1900 hgc last Thursday, then down to 542 on Sunday to around 100 yesterday). Everyone else on here seems to have their hgc rise or at least drop slowly - so can't tell if that's normal or not. Either way am counting myself lucky (considering this situation).

Hopefully you'll continue to have no symptoms!

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