Methotrexate and Alcohol

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1

Hi all,

I was diagnosed with a small ectopic about 3 weeks ago. After the watch and wait method didn’t work we decided to treat with one shot of methotrexate, which I had on the 13/7. hCG on day 1 was 195 and now fast forward to day 7 and blood test results have just come in with a rapid drop to 24 - such a relief!

I’ve been reading a lot about things to avoid after methotrexate and I wanted to ask about alcohol because I’ve seen / received conflicting advice.

The day I had my injection, the NHS doctor I spoke to said to avoid alcohol for only 48 hours. Today I asked a nurse again (it’s my 30th birthday tomorrow and I have a wedding later in the week) and she said to avoid it for 2 months. Various online advice from different NHS trusts differs between wait until your hormones go down to pre-pregnancy levels (which considering I’m already down to 24, could be as early as next week) and just waiting for 2 weeks to avoid it interacting with your liver. I’m not exactly a heavy drinker and I have no intention of actually getting drunk - but I could do with a glass of Prosecco here and there over the summer, it’s been a rough year! Considering as I have to wait to TTC until October anyway, it would do me some good to just relax!

So that’s 48 hours, 2 weeks, 2 months and “pre-pregnancy levels” all from different and official NHS sources - including different advice between my nurse and my doctor :? :? :?

Any advice??

Thank you!

2

Dear demgreen,

I am so sorry to hear of your ectopic pregnancy and loss,

This is taken from our website information.

You should refrain from drinking alcohol until hCG has fallen to a non-pregnant level and not drink alcohol for a few weeks after that.

This is because methotrexate and alcohol can affect your liver.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

3

Hi Karen,

Thank you for the advice.

So if my hCG has fallen back by next week, day 14 after treatment, and I wait 3 weeks after that (so a total of 5 weeks after treatment) - that should be enough?

Thank you :blush:

4

Dear demgreen,

Yes that sounds about right, unless your medical team have told you differently due to any personal circumstances.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

5

Thank you so much Karen. Luckily today I was signed off from the hospital as my hCG was well below 10 (a tiny 1.8) :pray:t2::pray:t2::pray:t2:

Now that my hCG is basically back to normal, I was wondering at what point I should re-start taking folic acid supplements again to re-build up my body’s supply? I know we can’t try for 12 weeks since the injection but I feel like I should be getting my vitamins etc in the meantime. Is there any guidance?

I was also wondering if the fact that my hCG is now down means that the ectopic pregnancy has now been absorbed by my body or if it’s still there and will go away in the comings weeks? Just wondering because if it’s still there doesn’t that mean it might still rupture and I should be careful about certain things? Or in general does back to normal hCG mean it’s gone?

Thanks so much for all your help :pray:t2:

6

Dear Demgreen

Thanks for your message and it is reassuring to hear that your recovery is going as smoothly as it can, with levels returned to non-pregnant.

The information we provide is that women should take a folic acid supplement from the point at which their hormone levels return to non-pregnant for 12 weeks before trying to conceive again. Now that your levels are back down to non-pregnant, you can start to take a folic acid supplement. As the pregnancy is sadly no longer developing, there is also not the risk of rupture.

With methotrexate treatment, once the pregnancy cells no longer divide, the pregnancy is ended and the whole pregnancy sac, including any cells that might eventually have grown into a baby, is usually reabsorbed by the mother. This happens because it is our own cellular material and so the body treats it like the reassignment of resources. This is normal and happens in many cases of miscarriage. The ‘reabsorption’ can take weeks and sometimes months to be complete and is monitored through beta hCG blood tests. In some instances, the Fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink, and, occasionally, it may not shrink and will leave a blockage in the Fallopian tube by way of a small cyst. However, the use of methotrexate does not reduce the chances of successful future pregnancy, whatever the outcome in the affected Fallopian tube. Occasionally, the tissue can separate from the tubal wall and be passed in the blood which is flowing out of the uterine cavity into the vagina.

I hope that this can help and I send you good wishes.

Munira

x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team