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Table 4 Multiple dose methotrexate (MTX) and leucovorin (LEU) for treatment of ectopic pregnancy

From: Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review

  Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8
Labs 1. β-hCG   β-hCG   β-hCG   β-hCG  
  2. Safety labs (complete blood count, BUN, creatinine, AST, ALT)        
3. Blood type and antibody screen        
Action MTX (1 mg/kg, IM) LEU (0.1 mg/kg, IM) β-hCG decline <15 % from Day 1 to Day 3: Give MTX LEU β-hCG decline <15 % from Day 3 to Day 5: Give MTX LEU β-hCG decline <15 % from Day 5 to Day 7: Give MTX LEU
β-hCG decline >15 % from Day 1 to Day 3: Check β-hCG at one week intervals until zero.   β-hCG decline >15 % from Day 3 to Day 5: Check β-hCG at one week intervals until zero.   β-hCG decline >15 % from Day 5 to Day 7: Check β-hCG at one week intervals until zero.