Trimetrexate (Systemic)

Brand Names : Neutrexin

Before Receiving This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For trimetrexate, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to trimetrexate, methotrexate, or leucovorin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Use of trimetrexate during pregnancy should be avoided whenever possible since trimetrexate has caused birth defects and death of the fetus in animal studies. The use of birth control is recommended during trimetrexate therapy. Tell your doctor immediately if you think you may be pregnant or if you need advice about birth control.

Breast-feeding - It is not known if trimetrexate passes into breast milk. However, breast-feeding should be stopped during treatment with this medicine because trimetrexate may cause serious unwanted effects in nursing babies.

Children - This medicine has been tested in a limited number of children younger than 18 years of age. Trimetrexate can cause serious side effects in any patient. However, in effective doses, this medicine did not cause different side effects or problems in the few children who received it than it does in adults.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of trimetrexate in the elderly with use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking trimetrexate, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Carbamazepine (e.g., Tegretol) or
• Chloroquine (e.g., Aralen) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Estrogens (female hormones) or
• Etretinate (e.g., Tegison) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Phenytoin (e.g., Dilantin) - Use of these medicines while you are taking trimetrexate may decrease the breakdown of trimetrexate in the liver and increase the chance of trimetrexate side effects

• Alcohol or
• Cimetidine (e.g., Tagamet) or
• Diltiazem (e.g., Cardizem) or
• Erythromycins (medicine for infection) or
• Isoniazid (e.g., INH, Nydrazid) or
• Quinine (e.g., Quinamm) or
• Ranitidine (e.g., Zantac) or
• Verapamil (e.g., Calan) - Use of these medicines with trimetrexate may increase the chance of trimetrexate side effects

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicine) or
• Azathioprine (e.g., Imuran) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Zidovudine (e.g., AZT, Retrovir) - Receiving trimetrexate while you are using these medicines may make side effects affecting the blood worse

• Cisplatin (e.g., Platinol) or
• Combination pain medicine containing acetaminophen and aspirin (e.g., Excedrin) or other salicylates (with large amounts taken regularly) or
• Cyclosporine (e.g., Sandimmune) or
• Deferoxamine (e.g., Desferal) (with long-term use) or
• Foscarnet (e.g., Foscavir) or
• Inflammation or pain medicine (except narcotics) or
• Lithium (e.g., Lithane) or
• Penicillamine (e.g., Cuprimine) or
• Streptozocin (e.g., Zanosar) or
• Tiopronin (e.g., Thiola) - Use of these medicines while you are taking trimetrexate may decrease the elimination of trimetrexate through the kidneys and increase the chance of trimetrexate toxicity

• Antithyroid agents (medicine for overactive thyroid) or
• Carmustine (e.g., BiCNU) or
• Chloramphenicol (e.g., Chloromycetin) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Gold salts (medicine for arthritis) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Oral contraceptives (birth control pills) containing estrogen or
• Other anti-infectives (medicine for infection) by mouth or by injection or
• Plicamycin (e.g., Mithracin) or
• Valproic acid (e.g., Depakene) - Use of these medicines with trimetrexate may increase the chance of side effects from trimetrexate

Other medical problems - The presence of other medical problems may affect the use of trimetrexate. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Blood problems or
• Low platelet count or
• Low white blood cell count - Trimetrexate may make any blood diseases that you have worse

• Mouth ulcers or other mouth sores or
• Stomach ulcer or other stomach or intestinal problems - Trimetrexate may make these conditions that you have worse

• Kidney disease or
• Liver disease - Kidney or liver disease may increase the chance of side effects from trimetrexate