First, I’m having a terrible time remembering the word “methotrexate.” I don’t know why my brain just doesn’t want to put those sounds in that order.
With an eye towards future blog visitors, a quick background. On December 20, at 6 weeks pregnant, I had a miscarriage. After three weeks, my hcg levels stalled out indicating that my body had not rid itself entirely of what is referred to as “products of conception.” On January 14, I received an injection of methotrexate to give my body a shove in the right direction.
Methotrexate is most commonly used to treat some neoplastic diseases (cancers), psoriasis and rheumatoid arthritis. It works by interfering with the growth of new cells. It is an antimetabolite and a folic acid antagonist. It is also commonly used to treat ectopic pregnancies, although the FDA has not approved it for this purpose. For obvious reasons, it is a category X drug, meaning it should not be taken if you are pregnant, think you might be pregnant, or might become pregnant.
It is given as an intramuscular injection in the hip. Based on my experience with progesterone in oil, this injection was much less painful. That’s probably due to the thick consistency of the PIO, which requires more time to inject. Following the injection, I did feel a slight burning sensation for about 30-40 minutes. It felt like a bad bee sting.
Side effects at the dosage used for treatment of an ectopic pregnancy (and, I assume, for miscarriage) are uncommon according to the information sheet the clinic gave me. They can include vomiting, diarrhea, mouth ulcers, and liver problems. Prior to being given methotrexate, a metabolic panel should be done to make sure your liver is functioning well as methotrexate is metabolized by the liver. That also generally means no alcohol. I’m also going to take a break from my metformin. It probably isn’t necessary, but metformin is also metabolized by the liver (I have to have a metabolic panel every three months because of it) and I don’t see any reason to make my liver work any harder than it has to. But, I’m not a doctor, so don’t take my paranoia as medical advice.
Because folic acid interferes with methotrexate, stop taking any pre-natal vitamins while undergoing treatment. We asked about avoiding folic acid-rich foods but the PA who gave my injection wasn’t the most knowledgeable. Just to be on the safe side, I plan to avoid store-bought orange juice, store-bought breads, and dark green leafy vegetables until this passes. Better safe than sorry and while I love my almost daily serving of kale, I’ll gladly give it up if it ensures that this works.
The protocol going forward is a beta every 3-7 days (I picked 3 for the first one. After all, who doesn’t enjoy starting their Saturday with a blood draw?) until we get to less than 5. If I don’t show “progress” I may need a repeat injection.
Ok. That’s the more technical stuff. So, how does taking methotrexate make me feel? Right now, it’s been about 2.5 hours. I’m really tired and have that uncomfortable-in-my-own-skin feeling, but I woke up at 3:45 this morning and never went back to sleep, so I doubt it’s the drug causing it. My stomach feels “off.” Not really nauseous or even upset, just something I’m aware of. I was particularly anxious about all of this this morning, so it could be from that. The injection site no longer stings and isn’t sore to the touch. Hopefully, that will be the case from here on out. I’d like to not have to update this with more side effects, but if any rear their ugly heads, I’ll write ’em down for posterity’s sake.
Live side effect monitor:
1. Gross metallic taste in my mouth. Pretty sure that’s from the mtx.
2. stomach is mildly upset. lower digestive system is a bit more upset…rather like when I first started taking metformin.
That’s all I’ve got. I’m going to let myself spend the day on the sofa, surfing for fun, searching for a job, and working on getting a huge stack of cds imported into iTunes. I figure I’ve earned that.