Rheumatrex (TrexallTM, Methotrexate)
Brand name: Rheumatrex®,
Other names: Amethopterin, MTX, Methotrexate Sodium
Distributor: Sanofi Aventis
Rheumatrex is available by
Indications: Rheumatrex is used to
treat a variety of cancers, mainly:
- head and neck
( a common form of bone cancer)
- Cutaneous T-cell
lymphoma (also known as mycosis fungoides).
Rheumatrex is also used to treat
certain non-cancerous conditions such as psoriasis, rheumatoid arthritis, polymyalgia rheumatica (PMR) and
Crohn's disease. Talk to your doctor or pharmacist for more information.
form: Rheumatrex can be taken several ways:
- by mouth, in pill
infusion (into the vein IV)
injection (into the muscle)
infusion (within a ventricle)
- Intrathecal infusion
(inside the spinal canal).
Rheumatrex comes as a tablet and injection. The form of treatment (pill or injection) and dosage prescribed by your
doctor depends on several criteria: your health status, type of cancer being treated and its severity. In addition,
you doctor will consider your body surface area (weight and height) and whether or not you are taking other drugs.
In case you are prescribed injection, the treatment usually consists of injecting a dose of Rheumatrex one or
several times per week. The drug can be taken every few weeks, or on a regular basis, depending on the condition
oncologist may recommend that you take
mouth. In this case, you will be prescribed an appropriate dosage capable of fighting the disease. It is important
that you follow the instruction or the directions on the prescription label carefully. Take Rheumatrex and all
drugs exactly as indicated by your health care provider. Do not change or stop the treatment without first
consulting your doctor.
when Rheumatrex is given in hospital by professionals, the risk of overdose is almost nonexistent; however,
accidental overdose or administrative mistake can happen. When the drug is taken by mouth, chance of overdose
increases considerably. An overdose of Rheumatrex can cause a decrease in the number of blood cells in your bone
marrow, which can lead to severe health problems and even death. Even in absence of therapeutic overdose,
Rheumatrex intoxication can lead to:
- damage to the lining
of the mouth, stomach or intestines
- severe skin reactions
- lung Infections such
- bone and soft tissue
- severe damage to the
liver, kidney, lungs, and gastrointestinal tract
- lymphoma, a cancer
that rises in the lymphocytes of the immune system
- Tumor lysis syndrome, a
life-threatening complication of cancer treatment.
experience any symptom (see
that may indicate presence of these medical conditions, contact your physician or emergency clinic/hospital
as soon as possible. Even in the absence of signs, it is important to see your doctor regularly during the
treatment; do not neglect the appointments with your doctor and the laboratory.
Rheumatrex is given by injection, it is administered in hospital; missing dose is basically difficult if you
keep all your doctor’s appointments. If for some reasons you cannot be present at the hospital for the
treatment, contact your health care provider before the date scheduled for the injection.
are recommended to take Rheumatrex by mouth in tablet form, it may happen you forget to take it. If you miss a
dose, take it as soon as you remember it if it is not almost time to take the next dose. If you forgot to take
the medicine, and it is almost time for the nest dose, wait for the next one; in any case, do not double the
is contraindicated or should be used with precaution in the following medical conditions:
- excess fluid in the
stomach area or around the lungs
- low number of blood
to Rheumatrex or any of its ingredients
to antimetabolites in general
infants or children should be treated with Rheumatrex only under medical supervision.
Mechanism of action (MOA): Rheumatrex is classified as an
“antimetabolite”; it slows the proliferation of cancer cells by blocking DNA synthesis aswell as regeneration and replication of cancer
Some medicines may interact with Rheumatrex
, and increase your risk of developing side effects. Talk you to your doctor before
vitamins, nutritional supplements, and all nonsteroidal anti-inflammatory drugs
(NSAID): aspirin, salsalate, choline magnesium trisalicylate (Tricosal, Trilisate), ibuprofen (Advil, Motrin),
magnesium salicylate (Doan's), and naproxen (Aleve, Naprosyn).
In addition, talk to your doctor before taking
thiazide diuretics, amoxicillin (Amoxil)
and other penicillins, acitretin (Soriatane), azathioprine
(Imuran), isotretinoin (Accutane), sulfasalazine (Azulfidine), or tretinoin (Vesanoid).
Side effects: Rheumatrex not only attack
cells but also healthy
cells, which often leads to, in most patients, the following side effects:
- Mild nausea and vomiting.
If the side
effects above persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you
experience symptoms that indicate:
Damage to the liver, heart or lung: persistent nausea, extreme tiredness,
pain in the upper right part of the stomach, dry cough, fast and irregular heartbeat, fever, shortness of breath or
any flu-like symptom.
Damage to the lining of the mouth,
stomach or intestine: mouth sores, persistent diarrhea,
black, tarry or bloody stools, sore throat, or bloody vomitting.
Damage to the skin or
pain, fever, rash, blisters, peeling skin, yellowing of the skin or eyes, or
purple, blue or black discoloration of the skin.
: anxiety, depression, dehydration, nose bleeding, vision
changes, red itchy eye, or intense headaches.