What Is Methotrexate, Exactly, and How Does It Play Into America’s Conversation About Abortion?

What Is Methotrexate, Exactly, and How Does It Play Into America’s Conversation About Abortion?

There have been a lot of questions about medical care and treatment in the wake of the overturning of Roe v. Wade, the landmark legislation that previously made abortion legal in the U.S. on a federal level. Now, states are making their own legislation around abortion and it’s already causing some unintended consequences.

People with rheumatoid arthritis, lupus, and other inflammatory conditions have gone on social media to talk about restrictions on a particular medication, methotrexate, which is often used to treat ectopic pregnancies. An ectopic pregnancy, in case you’re not familiar with it, is a pregnancy that starts outside the uterus (typically in the fallopian tubes) and is not considered viable, per the American College of Obstetricians and Gynecologists (ACOG). In the event of an ectopic pregnancy, methotrexate stops cells from growing, which ends the pregnancy, ACOG explains. If an ectopic pregnancy progresses and is not treated with methotrexate, it can cause a woman’s fallopian tube to rupture and lead to life-threatening internal bleeding.

But methotrexate is also used to treat other health issues and people with certain chronic conditions are expressing concerns about being able to access the drug.

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Methotrexate is also getting attention after a new study published in The Lancet Respiratory Medicine found that it doubles antibodies to COVID-19 when people stop taking it.

But what is methotrexate, exactly, and how does it work? Here’s what you need to know.

What is methotrexate?

Methotrexate is in a class of medications called antimetabolites, according to the U.S. National Library of Medicine. “Methotrexate inhibits an enzyme called dihydrofolate reductase in the body,” explains Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University. “This enzyme is involved in making building blocks for DNA.”

“Blood cells, immune cells, and the developing embryo have cells that divide rapidly and need these DNA building blocks,” Alan continues. “They are incredibly sensitive to inhibition of this enzyme and depletion of DNA building blocks.”

Methotrexate may be given by injection or tablet, depending on what health condition it’s being used to treat.

What is methotrexate used to treat?

A lot, actually. According to the U.S. National Library of Medicine, methotrexate can be used to treat a slew of health conditions, including:

  • Severe psoriasis that can’t be controlled by other treatments
  • Severe rheumatoid arthritis
  • Ectopic pregnancy
  • Certain types of cancer, including:
    • Cancers that begin in the tissues that form around a fertilized egg in the uterus
    • Breast cancer
    • Lung cancer
    • Certain cancers of the head and neck
    • Certain types of lymphoma
    • Leukemia

    What are the potential side effects of methotrexate?

    Like all medications, it’s possible to experience side effects while taking methotrexate. Per the U.S. National Library of Medicine, those can include:

    • Dizziness
    • Drowsiness
    • Headache
    • Swollen, tender gums
    • Decreased appetite
    • Reddened eyes
    • Hair loss

      It’s also possible to develop serious side effects while taking methotrexate. You should call your doctor immediately if you experience any of these, the U.S. National Library of Medicine says:

      • Blurred vision or sudden loss of vision
      • Seizures
      • Confusion
      • Weakness or difficulty moving one or both sides of the body
      • Loss of consciousness

        What alternatives are available for methotrexate if you take it for a health condition?

        It depends on what the condition is that you’re using methotrexate to treat, Alan says. “There isn’t a go-to swap anymore since there are so many other drugs available,” she says.

        If you’re taking methotrexate for a particular health condition and are having trouble accessing it, Alan recommends talking to your doctor about other medications that may also work for you.

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