Rheumatrex (Trexall, Methotrexate)

Warning:  Rheumatrix is a powerful drug that is used to treat some types of cancer and other serious illnesses.  Because it is very powerful, there are certain side effects and warnings that need to be followed when taking this drug.  One of the most important warnings to follow is to avoid this medication if you are pregnant of plan on becoming pregnant.  Rheumatrex has been shown to cause serious birth defects and even death in unborn babies.

Kidney problems are also associated with prolonged use of this drug, so it will be important for you to drink large amounts of water to keep yourself hydrated and to see a doctor for liver biopsies if you are on the drug for an extended time.

If taken at high dosages, Rheumatrix has been shown to cause severe bone marrow suppression and even stomach and intestinal diseases.  These usually occur when the drug is taken at the same time as a non steroidal, anti-inflammatory drug.

Obviously there are other side effects that can be caused by using Rheumatrix, so it will be crucial that you speak to your physician before you start taking the drug.

Indications: Rheumatrix is typically used to treat certain types of cancer, although it can also be effective for treating other severe conditions like psoriasis and rheumatoid arthritis.  The mechanism of action for this drug is inhibition of cellular growth and suppression of the immune system.

Common Cancers the drug is used to treat include:

  • leukemia
  • breast cancer
  • psoriasis
  • head and neck cancer
  • lung cancer
  • stomach cancer
  • non-Hodgkin’s lymphoma
  • gestational trophoblastic cancer
  • esophageal cancer( cancer of theesophagus)
  • osteosarcoma ( 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.

Dosage: Rheumatrex can be taken several ways:

  • by mouth, in pill form
  • intravenous infusion (into the vein IV)
  • intramuscular injection (into the muscle)
  • intraventricular infusion (within a ventricle)
  • Intrathecal infusion (inside the spinal canal).

There is no real recommended universal dosage for Rheumatrix.  This is because the dosage will depend on the medical condition that you are trying to treat and your response to the therapy. Rheumatrix has a variety of different dosing schedules, so it will be important for you to consult your doctor before you start taking this drug.

Overdose: when patients taking the medication in hospital by professionals, the risk of overdose is almost nonexistent. When the drug is taken at home, 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 as pneumonia
  • bone and soft tissue damage
  • 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.

Missing dose: all medications should be taken exactly as precribed. 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. If you 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 dose.

Contraindications:  Make sure to tell your doctor about any allergies that you have before starting this or any other medication.  As mentioned above, you want to make sure that you are not pregnant, and that you do not become pregnant while taking this medication.

In general, Rheumatrex is contraindicated or should be used with precaution in the following medical conditions:

  • alcohol addiction
  • excess fluid in the stomach area or around the lungs
  • low number of blood cells
  • kidney failure
  • liver failure
  • pregnancy
  • breast-feeding
  • allergy to Rheumatrex or any of its ingredients
  • allergy to antimetabolites in general
  • Elderly, infants or children should be treated with Rheumatrex only under medical supervision.

Interactions: As with most powerful drugs, other chemicals can change the effects that the drug has on your body.  There are some severe interactions that can cause very serious side effects and even death as with most prescription medications.  You will want to make sure that you tell your doctor about any drugs that you are currently taking so he or she can minimize the risk of a serious interaction.  Some of the drugs that you will want to be certain to avoid are natalizumab, acitretin, ciprofloxacic, asparaginase, digoxin, penicillins, procarbazine, theophylline, and phenytoin.

Side effects: Rheumatrex not only attack cancer cells but also healthy cells, which often leads to, in most patients, the following side effects:

  • dry skin
  • itching
  • rash
  • acne
  • mouth sores
  • weight loss
  • weakness
  • hair loss
  • decreased appetite
  • trouble sleeping
  • Mild nausea and vomiting

You need to immediately see your health care provider 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 bone: bone pain, fever, rash, blisters, peeling skin, yellowing of the skin or eyes, or purple, blue or black discoloration of the skin.

Other problems : anxiety, depression, dehydration, nose bleeding, vision changes, red itchy eye, or intense headaches.

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