Published: 2020-06-25

Case report on toxicity of methotrexate in tubal ectopic pregnancy

Surbhi Lodha, Kimaya Mali


Ectopic pregnancy is defined as pregnancy outside uterine cavity. Of all ectopic pregnancy, tubal ectopic is most common. Most cases today are diagnosed early and hence timely treatment is possible. In stable patients, medical line of management with methotrexate can be used. With early diagnosis and medical line of treatment, use of injectable methotrexate is on rise. Being aware of characteristics of methotrexate like mechanism, dosage, side effects and contraindications, appropriate patient selection and watchful monitoring will help reduce methotrexate induced toxicity.


Contraindication, Methotrexate, Side effects, Tubal ectopic pregnancy

Full Text:



Practice Committee of the American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100(3):638-44.

Chabner BA. Antineoplastic agents. Chapter 61: Cytotoxic Agents Goodman and Gilman's the pharmacological basis of therapeutics; 1996.

Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 2007;87(3):481-4.

Gutierrez‐Ureña S, Molina JF, García CO, Cuéllar ML, Espinoza LR. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis rheumatism. J Am Col Rheumatol. 1996;39(2):272-6.

Schwartz S, Borner K, Müller K, Martus P, Fischer L, Korfel A, et al. Glucarpidase (carboxypeptidase g2) intervention in adult and elderly cancer patients with renal dysfunction and delayed methotrexate elimination after high-dose methotrexate therapy. The Oncol. 2007;12(11):1299-308.