Tips for managing methotrexate treatment for ectopic pregnancy

Methotrexate side effects are more likely to cause problems when treatment lasts for many months, which is common in cancer and rheumatoid arthritis treatment. However, side effects do occur when methotrexate is given to end an ectopic pregnancy.

The most common side effects of methotrexate treatment for ectopic pregnancy are nausea and indigestion. Side effects vary from woman to woman; some women do not experience any. When being treated with methotrexate, you will be followed closely by your health professional.

The suggestions below may help you manage methotrexate side effects. Tell your health professional about any symptoms you develop during treatment.

For nausea

• Eat small meals more frequently instead of three large meals daily.
• Ask your health professional about using an antinausea (antiemetic) medicine, such as prochlorperazine (Compazine, for example) or ondansetron (Zofran), to prevent or decrease nausea.
• Rest as much as possible.
• Try to eliminate strong odors from your surroundings.
• Do not use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, which can increase the risk of stomach irritation.
• Drink plenty of water to avoid dehydration.

For more information on the treatment of nausea, see the Home Treatment section of the topic Nausea and Vomiting, Age 4 and Older.

For fatigue

• Plan several rest periods throughout the day.
• Ask for help from family members or friends.

For more information on the treatment of fatigue, see the topic Weakness and Fatigue.

For lightheadedness or dizziness

• Rest frequently.
• Change positions slowly, especially when moving from a sitting to a standing position.
• Allow others to assist you when you walk.

For more information, see the topic Dizziness: Lightheadedness and Vertigo.

For a sore mouth and throat (stomatitis)

• Avoid coffee, spicy and salty foods, and citrus fruits. These foods can further aggravate your sore mouth.
• Eat soft foods such as ice cream, custards, or gelatin.
• Rinse your mouth every 2 hours with a lukewarm saltwater solution. Mix 1tsp (5g) of table salt in 8fl oz of lukewarm water. Do not swallow the saltwater solution because it can upset your stomach.

For diarrhea

• Eat mild foods, such as rice, dry toast or crackers, bananas, and applesauce. Avoid spicy foods, other fruits, alcohol, coffee, and dairy products.
• Drink plenty of water to avoid dehydration.

For more information, see the Home Treatment section of the topic Diarrhea, Age 12 and Older.