If you recently found out you’re pregnant and don’t want to be, you might be looking for quick, easy options. In searching for options, you might have come across abortions using Methotrexate.
Before you go down that path, it’s important to understand the serious risks associated with this drug and what steps you should take to protect your health. Let’s look at what a Methotrexate Abortion is together.
Please note: this article is for informational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always consult a healthcare professional for medical concerns or emergencies.
What You Need to Know About Methotrexate Abortions First
What is Methotrexate used for?
Methotrexate is a powerful drug that works to reduce inflammation and slow down cellular growth. It is prescribed for a variety of health conditions such as:
- Certain Cancers
- Autoimmune Diseases
- Inflammatory Diseases
- Ectopic Pregnancies (a pregnancy outside of the uterus)
What is Methotrexate Abortion?
While some providers may prescribe methotrexate for a viable pregnancy, it is not FDA-approved for elective abortion. That means there is limited research about its use for abortions, no standardized dosing, and a higher risk of complications.
When used for abortion, methotrexate stops the pregnancy from developing. Misoprostol is then taken 5 to 7 days later to expel the pregnancy from the uterus. This combination seems to be most effective when used in the first 6-7 weeks of pregnancy.
Because it is not approved by the FDA, a provider should thoroughly discuss the risks, side effects, process, requirements, and necessity of follow up appointments before prescribing the drug.
How does it differ from the abortion pill?
Similar to mifepristone (the 1st abortion pill), methotrexate stops the pregnancy from progressing.
- With methotrexate, you wait 5-7 days before taking misoprostol
- With mifepristone, misoprostol is typically taken 24-72 hours after mifepristone
Methotrexate is a much slower, less predictable form of abortion that can lead to prolonged bleeding, physical pain, and emotional stress. It can take a week or longer for the abortion to be complete, and bleeding may continue for several weeks after.
Methotrexate also has a higher failure rate (up to 14%), meaning you might need an additional dose of misoprostol or undergo surgical abortion.

Can Methotrexate be used alone to cause an abortion?
Using methotrexate without misoprostol increases the risk of an incomplete abortion. This means part of the pregnancy tissue might not fully get expelled during the abortion process and can pose a risk of serious infection and surgical abortion to complete it.
How is methotrexate used for ectopic pregnancies?
Methotrexate is often used to treat an ectopic pregnancy that is located outside of the uterus. However, using this drug to treat ectopic pregnancies is still considered “off-label” and not approved by the FDA.
Frequent follow-ups and blood tests are required to ensure pregnancy hormones drop properly.
What are the side effects and risks of toxicity with methotrexate?
Even small doses of methotrexate can be dangerous. Possible methotrexate side effects include:

- Nausea
- Vomiting
- Diarrhea
- Dizziness
- Serious infections
- Infertility (May damage and decrease egg production. It is not known if the infertility may be reversed after taking methotrexate)
- Fetal harm/death (if the abortion doesn’t work and the pregnancy continues)
In severe cases, incorrect use has led to hospitalizations, life-threatening reactions, and death.
Because methotrexate can affect even the growth of healthy cells, it can impact various organs and cause severe side effects like:
- Liver toxicity
- Lung Toxicity
- Kidney Toxicity
- Bone Marrow Suppression
- Nephrotoxicity
- Pulmonary fibrosis
- Sepsis
- Anaphylaxis (severe, life-threatening allergic reaction)
- Gastrointestinal Toxicity
- Skin Reactions
- Increase risk of cancer (lymphoma and skin cancer)
- Death from taking too much or too frequently
It is advised to refrain from sex or use effective contraception for up to 6 months after the final dose, as it can cause birth defects if you were to become pregnant again.
What should I do before taking methotrexate for abortion?
Before taking methotrexate, you should know several things first:
- Where is my pregnancy located?
- How far along am I?
- Do I have a condition that makes me not qualified for this drug?
- Is there an emergency room nearby?
- Will my provider be checking up on me and available if something is wrong?
At Harmony Women’s Care we can help get you answers to these questions with a no-cost appointment.
Get Answers about Methotrexate Abortion Today.
Methotrexate is a serious drug and should only be used when absolutely necessary. If you’re considering it for abortion, it’s essential to talk to a healthcare provider, understand the possible complications, and explore all options.
At Harmony Women’s Care, our compassionate team is here to help you understand your options and support you every step of the way.