Side Effects Associated with
Methotrexate Treatment
Drug side effects
Nausea
Vomiting
Stomatitis
Diarrhea
Gastric distress
Dizziness
Severe neutropenia (rare)
Reversible alopecia (rare)
Pneumonitis
Treatment effects
Increase in abdominal pain (occurs in up to two
thirds of patients)
Increase in β-hCG levels during first 1–3 days of
treatment
Vaginal bleeding or spotting
Signs of treatment failure and tubal rupture
Significantly worsening abdominal pain, regardless
of change in β-hCG levels
Hemodynamic instability
Levels of β-hCG that do not decline by at least
15% between day 4 and day 7 postinjection
Increasing or plateauing β-hCG levels after the first
week of treatment