много благодаря, намах и представа дори

господи, явно съм проспал тоя момент, иначе RUто не е регистрирано в България

та и аз се разтърсих и намерих това за метотрексата:

MONOTHERAPY:
A study has found single-agent intramuscular methotrexate (50 milligrams/square meter (mg/m(2)) to be effective in the induction of medical termination of early pregnancy. Study subjects (n=40) received an intramuscular (IM) injection of methotrexate 50 mg/m(2); control subjects (n=53) received the same dose of methotrexate plus were instructed to administer 800 micrograms of misoprostol vaginally 3 to 7 days after the methotrexate injection if no bleeding had
occurred. Twenty-eight (70%) of the study patients had a complete abortion within 21 days. However, the median time to the beginning of bleeding and the passing of contraception products was significantly longer for the study group (15.5 days) versus the control group (8.1 days) (p = 0.0003). No significant difference in side effects between the two groups were noted. The authors concluded that methotrexate (50 mg/m(2) IM) as a single-agent was effective in medical termination of early pregnancy; however, the process was accelerated with the addition of misoprostol, which would decrease patient anxiety (Schaff, et al, 1997).

Methotrexate 80 milligrams (mg) intramuscularly successfully terminated a pregnancy within a very thin uterine scar, a rare but possibly life-threatening complication. Plasma beta human chorionic gonadotropin concentration decreased over eight weeks to 20 mIU/mL. No adverse effects were observed (Ravhon et al, 1997).

COMBINATION THERAPY:
The combination of methotrexate and misoprostolis safe and effective for the termination of early pregnancy (Schaff et al, 1997; Creinin et al, 1996). In a study of 300 pregnant women at less than 8 weeks gestation, each subject received an intramuscular dose of methotrexate 50 milligrams/square meter (mg/(2)). Seven days later, 800 micrograms of misoprostol was administered intravaginally by placing four 200 mcg tablets into the vagina with a speculum. If the abortion did not occur, the dose of misoprostol was repeated. If cardiac activity was present on vaginal
ultrasound after five days, vacuum aspiration was performed. Eighty-eight percent of the women had successful medical abortions; 65% experienced an abortion within 24 hours after either the first or second dose of misoprostol. Vaginal bleeding occurred for a mean of 14 days in those women who immediately aborted and for a mean of 11 days in those women whose abortions were delayed. Nausea and vomiting were the most commonly reported side effects, occurring in 19% and 9% of women, respectively (Creinin et al, 1996). Similar results were reported in a trial of 178 women with early pregnancy with a 96% success rate (Hausknecht, 1995).

ORAL methotrexatefollowed by vaginal MISOPROSTOL was effective in termination of pregnancy in a small group of women (n=20) at less than 49 days gestation. Methotrexate was given as a dose of 25 or 50 milligrams;even days later, 800 micrograms of misoprostol was administered intravaginally. If the abortion did not occur, a second dose of methotrexate was given a day later. Eighty percent of women who received the 50 mg methotrexate dose experienced bleeding and termination of the pregnancy within 24 hours of the first or second dose of methotrexate as
compared to 50% of women who received the 25 mg dose. Bleeding and cramping generally occurred approximately 4 hours after misoprostol was administered. Although this was a small sample size, oral methotrexate appears safe and
effective and may minimize the problems potentially encountered with parenteral administration of a chemotherapeutic medication (Creinin, 1996). In a similar trial, 60 milligrams/square meter (mg/m(2)) IM dose was as effective and safe as
50 mg/m(2) dose (Creinin & Krohn, 1997).

Methotrexate plus MISOPROSTOL was more effective than misoprostol alone for medical abortion in a study involving 61 women who were 56 days' gestation or less seeking elective abortion. Patients received methotrexate 50 milligrams/square meter (mg/m(2)) followed 3 days later by misoprostol 800 mcg (n=31) vaginally or misoprostol 800 mcg alone (n=30). Complete abortion occurred in 90% of patients receiving both drugs versus 47% of patients receiving misoprostol alone. There were 3 and 16 treatment failures in group 1 (both drugs) and group 2 (misoprostol alone), respectively. The authors conclude that the combination of methotrexate plus misoprostol may represent an alternative to the use of antiprogestin plus prostaglandin for medical abortion (Creinin & Vittinghoff, 1994).

CERVICAL PREGNANCY, traditionally treated with hysterectomy, was conservatively managed with methotrexateand citrovorumand angiographic embolization to control profuse bleeding. Intramuscular methotrexate 1 milligram/kilogram/day was alternated with citrovorum 0.1 milligram/kilogram/day for 4 days. The patient
received a total of 8 doses (2 courses) with 6 days off drug between treatments. Reproductive capability was preserved and the patient delivered a subsequent infant 12 months later (Marston et al, 1996).