- May 12, 2022
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Brand Name :
Neutrexin
Synonyms :
Trimetrexato, trimetrexatum, trimetrexate glucuronate
Class :
Anticancer: antimetabolites: folate antagonists
Dosage forms & Strengths
Lyophilized powder for solution
200 mg/16ml
25 mg/2ml
Powder for solution
25 mg/vial
Note: administer with leucovorin or folic acid to avoid life-threatening adverse effects of trimetrexate
General adult dose: trimetrexate glucuronate is administered at a dose of 45 mg/m2 slowly over 60 minutes followed by leucovorin rescue at a dose of 20 mg/m2 over 5 to 10 minutes.
Neutrexin is recommended based on patient’s body weight:
Dose modification according to hematologic toxicity:
Neutrophils <500/mm3 & platelets < 25,000/mm3: discontinue for day 1-9 and administer leucovorin 40 mg/m2, on day 10 start with neutrexin 22 mg/m2 IV once daily with leucovorin 40 mg/m2 every 6 hrs
Dosage forms & Strengths
Lyophilized powder for solution
200 mg/16ml
25 mg/2ml
Powder for solution
25 mg/vial
Note: administer with leucovorin or folic acid to avoid life-threatening adverse effects of trimetrexate
Limited data available for dosing of neutrexin in patients under 18 years
For children > 15 years: 45 mg/m2 of trimetrexate once a day for 21 days with leucovorin 20 mg/m2 every 6 hrs for 24 days has been found to be safe
may enhance the hepatotoxic adverse effects of trimetrexate
trimetrexate may diminish the therapeutic effects of BCG vaccine
interaction with trimetrexate may diminish the therapeutic effects of the vaccine, avoid combination
interaction with trimetrexate may increase the neutropenic adverse effect of deferiprone
increases the risk of serious infection as a result of the immunosuppressive effect
take the vaccine at least 2 weeks prior to trimetrexate initiation to avoid interaction. The interaction may reduce the therapeutic effect of the vaccine
interaction with proton pump inhibitors may cause delayed elimination of trimetrexate
may reduce the time of elimination and increase the serum concentration of trimetrexate
the interaction may enhance hepatotoxic and haematotoxic effects of trimetrexate
trimetrexate may decrease the therapeutic effects of lenograstim, avoid within 24 hours of administration of antineoplastic agents
may diminish the therapeutic effects of lipegfilgrastim
may enhance the severity of oral mucositis
avoid interaction, as it may increase hepatotoxicity and serum concentration of trimetrexate
high risk of serious infection due to immunosuppressive effects
may enhance the toxic effect of trimetrexate, avoid combination
diminish the therapeutic effects of the vaccine
avoid using trimetrexate while taking tetanus toxoid, may decrease therapeutic effects
interaction with trimetrexate may cause liver problems
increase myelosuppression and affect bone marrow function
may increase the serum concentration of trimetrexate
increase the risk of serious infection due to the immunosuppressive effect
increases immunosuppressive effects of trimetrexate
hepatotoxic effects of trimetrexate may increase the risk of liver failure
may enhance the risk of serious infection by increasing the immunosuppressive effect of trimetrexate
trimetrexate may diminish the therapeutic effect of brincidofovir
may enhance the immunosuppressive and hepatotoxic effects of trimetrexate
may enhance the adverse myelosuppressive effects of chloramphenicol
may reduce the therapeutic effects of cimetidine
may enhance the adverse myelosuppressive effects of clozapine
may diminish the therapeutic effect of the covid-19 vaccine
may increase the hepatotoxic adverse effects of trimetrexate by enhancing the serum concentration
interaction with trimetrexate may increase liver toxicity, induce vomiting and abdominal pain
may increase the serum concentration of trimetrexate
trimetrexate may enhance the immunosuppressive effect of inebilizumab
may increase the serum concentration of trimetrexate
trimetrexate may increase the serum concentration of mercaptopurine
may enhance the hepatotoxic effect of trimetrexate
may decrease the serum concentration of trimetrexate
may increase serum concentration of OAT1/3 substrates
may enhance the immunosuppressive effects of ocrelizumab
may enhance the immunosuppressive effects of trimetrexate
myelosuppressive agents may enhance adverse myelosuppressive effects of Olaparib
trimetrexate may diminish the therapeutic effects of pidotimod
may enhance adverse myelosuppressive effects
may enhance adverse toxic effects of trimetrexate
may decrease serum concentration of sepropterin
may enhance hepatotoxic adverse effects of trimetrexate
may increase the serum concentration of trimetrexate
trimetrexate may increase the photosensitizing effects of trimetrexate
it may diminish the excretion rate when combined with permethrin, resulting in an enhanced serum level
may increase the hypotensive effect of Blood Pressure Lowering Agents
decreases renal elimination of trimetrexate may lead to renal toxicity
may lead to increased myelosuppression
increased serum concentration of trimetrexate may lead to toxic effects
high risk of severe infection due to immunosuppression
increase hepatotoxicity due to decreased elimination
increase the metabolism of trimetrexate
Frequency defined:
>10%:
Fever
Nausea (11%)
Vomiting (11%)
Weight loss
Increased liver enzymes (14%)
Mucositis
Myelosuppression
1% to 10%
Alopecia (10%)
Dermatitis (3%)
Burning sensation of the skin
Skin photosensitivity
Gastrointestinal ulcer (10%)
Pruritis
Leukopenia
Pancytopenia
Thrombocytopenia
Dizziness
Frequency not defined:
Cerebral thrombosis
Arterial thrombosis
Hypotension
Decreased libido
Menstrual diseases
Pancreatitis
Hepatic failure
Nonimmune anaphylaxis
Haematuria
Infertility
Vaginal discharge
Bone fracture
Osteoporosis
Pregnancy consideration: Trimetrexate is assigned under pregnancy category D. Avoid during pregnancy.
Lactation: limited reports available describing the presence of trimetrexate in breastmilk. Because of potential adverse effects, it is advised to avoid breastfeeding during trimetrexate therapy.
Pregnancy category:
Pronunciation: tri-mi-trek-sat
Use: It is an anti-infective drug used to treat Pneumocystis Carinii Pneumonia.
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Founded in 2014, medtigo is committed to providing high-quality, friendly physicians, transparent pricing, and a focus on building relationships and a lifestyle brand for medical professionals nationwide.
MASSACHUSETTS – USA
60 Roberts Drive, Suite 313,
North Adams, MA 01247
MAHARASHTRA – INDIA
7, Shree Krishna, 2nd Floor,
Opp Kiosk Koffee,
Shirole Lane, Off FC Road,
Pune 411004, Maharashtra
