• Trimetrexate Glucuronate

    (tri me trex' ate)

    IMPORTANT WARNING:

    Trimetrexate glucuronate is no longer available in the U.S. If you are currently receiving trimetrexate glucuronate, you should call your doctor to discuss switching to another treatment.

    IMPORTANT WARNING:

    It is important to remember to take trimetrexate with leucovorin as directed by your doctor. If you miss a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Call your doctor if you miss a dose.

    WHY is this medicine prescribed?

    Your doctor has ordered the drug trimetrexate to help treat your illness. The drug can be given by injection into a vein.
    This medication is used to treat:
    • infections caused by the bacteria Pneumocystis carinii in patients that do not have a fully functioning immune system
    This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
    Trimetrexate resembles a normal nutrient needed for cell growth. The Pneumocystis bacteria and cancer cells take in trimetrexate, which then interferes with their growth. You also will be given the drug leucovorin with each trimetrexate treatment. Leucovorin replaces the same needed nutrient in normal cells. Pneumocystis bacteria and cancer cells cannot use leucovorin. Take leucovorin exactly as prescribed by your doctor.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking trimetrexate,
    • tell your doctor and pharmacist if you are allergic to trimetrexate or any other drugs.
    • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially acetaminophen (Tylenol), aspirin, clotrimazole (Mycelex), erythromycin, fluconazole (Diflucan), ketoconazole (Nizoral), miconazole(Monistat), rifabutin (Mycobutin), rifampin (Rifadin), zidovudine (AZT, Retrovir), and vitamins.
    • tell your doctor if you have or have ever had kidney or liver disease, stomach ulcers, or intestinal disease.
    • you should know that trimetrexate may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Trimetrexate may harm the fetus.
    • do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

    What SIDE EFFECTS can this medicine cause?

    Side effects from trimetrexate may occur and include:
    • nausea
    • loss of appetite or weight
    Tell your doctor if either of these symptoms is severe or lasts for several hours:
    • mouth blistering
    • fatigue
    If you experience any of the following symptoms, call your doctor immediately:
    • painful urination or red urine
    • black, tarry stools
    • diarrhea
    • unusual bruising or bleeding
    • fever
    • cough
    • difficulty swallowing
    • dizziness
    • chills
    • shortness of breath
    • severe vomiting
    • rash
    • yellowing of the skin or eyes
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    What OTHER INFORMATION should I know?

    • The most common side effect of trimetrexate is a decrease in the number of blood cells. Your doctor may order tests before, during, and after your treatment to see if your blood cells are affected by the drug.
    • It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

    Brand Names

    • Neutrexin®
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