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Methotrexate for Trophoblastic Cancer


Generic NameBrand Name

How It Works

Methotrexate stops the growth of rapidly reproducing cells, such as cancer cells or fetal cells.

Why It Is Used

Methotrexate is the drug of choice for treating trophoblastic cancer that affects the uterus only, which accounts for the vast majority of cancer caused by molar pregnancy.

Methotrexate can be used to prevent trophoblastic cancer in women who are considered high risk for developing cancer after removal of a molar pregnancy.

How Well It Works

Methotrexate cures about 90% of trophoblastic cancer that is confined to the uterus.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Methotrexate side effects are most likely to occur with long-term use.

Callor other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Severe pain in your belly or pelvis.
  • Bloody vomit.
  • Signs of unusual bleeding or bruising, such as black and tarry stools or blood in the urine.
  • Sores in the mouth or on the lips.

Common side effects of this medicine include:

  • Mild abdominal (belly) pain. Cramping belly pain is the most common side effect. It usually occurs during the first 2 to 3 days of treatment.
  • Vaginal bleeding or spotting.
  • Nausea, vomiting, and indigestion.
  • Fatigue, lightheadedness, or dizziness.

Rare side effects include:

  • Skin sensitivity to sunlight.
  • Inflammation of the membrane covering the eye.
  • Sore mouth and throat.
  • Temporary hair loss.
  • Severe low blood counts (bone marrow suppression).
  • Inflammation of the lung (pneumonitis).

Because of the risk of side effects, methotrexate treatment requires close medical supervision by a doctor who is experienced with this medicine. During methotrexate treatment, keep your doctor informed of any symptoms that you have.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

You will be advised to avoid the following until your treatment has finished:

  • Vitamins containing folic acid, including prenatal vitamins.
  • Alcohol.
  • Penicillin.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. If you are treated with methotrexate, talk to your doctor before using NSAIDs.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.



  1. Berkowitz RS, Goldstein DP (2007). Gestational trophoblastic disease. In JS Berek, ed., Berek and Novak's Gynecology, 14th ed., pp. 1581–1603. Philadelphia: Lippincott Williams and Wilkins.


ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Specialist Medical ReviewerDeborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Last RevisedMay 14, 2012

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