Trixilem

Country of origin - Mexico
Pharm-Group - Antimetabolites - folic acid analogues

Manufacturers - Lemery (Mexico)
International name - Methotrexate
Synonyms - Vero-Methotrexate, Zexat, Methotrexate, Methotrexate (Emtexate), Methotrexate for injection, Methotrexate Lachem, Methotrexate sodium, Methotrexate-LENS, Methotrexate-Teva, Methotrexate-Ferein, Methotrexate-EBEVE, Trexan
Dosage forms - solution for injection 5 mg, solution for injection 50 mg, solution for injection 500 mg, solution for injection 1000 mg, tablets 2.5 mg
Composition - Active ingredient - Methotrexate.
Indications for use - Uterine chorionic carcinoma, chorioadenoma, acute lymphocytic leukemia, breast cancer, epidermoid cancer of the head and neck, lung cancer, Hodgkin's disease and non-Hodgkin's lymphoma, osteosarcoma, psoriasis, rheumatoid arthritis, bronchial asthma (steroid-dependent form), juvenile rheumatoid arthritis, Felty's syndrome , Reiter's syndrome, graft-versus-host disease, Crohn's disease, ulcerative colitis, lichen planus, mycosis fungoides (local treatment), psoriatic arthritis, reticular erythroderma, neuroleukemia, Sezary syndrome.
Contraindications - Hypersensitivity, immunodeficiency, anemia (including hypo- and aplastic), leukopenia, thrombocytopenia, liver disease, pregnancy, breastfeeding.
Side effects - Headache, blurred vision, drowsiness, aphasia, paresis, convulsions, interstitial pneumonitis, gingivitis, pharyngitis, ulcerative stomatitis, anorexia, nausea, vomiting, diarrhea, melena, ulceration of the gastrointestinal mucosa, gastrointestinal bleeding, liver damage, acute renal failure, azotemia, cystitis, anemia, leukopenia, thrombocytopenia, secondary (bacterial, viral, fungal, protozoal) infection, dysmenorrhea, oligospermia, alopecia, ecchymosis, acne, furunculosis, skin hyperpigmentation, allergic reactions (fever, chills, skin rashes).
Interaction - Tetracyclines, chloramphenicol increase absorption from the gastrointestinal tract. Trimethoprim and its combinations with sulfonamides, NSAIDs, and nephrotoxic drugs increase the risk of side effects. Folic acid and its derivatives reduce effectiveness.
Overdose - There are no specific symptoms. Overdose is diagnosed by the concentration of methotrexate in plasma. Normally, it is: after 24 hours - 10 µM, and after 48 and 72 hours - 1 and 0.2 µM, respectively. Treatment: intravenous administration of fluid at a rate of at least 3 l/sq.m/
Special instructions - Simultaneously with parenteral administration, it is necessary to prescribe at least 2 liters of liquid per day and 40 ml of 4.2% sodium bicarbonate solution intravenously (to alkalize urine). During therapy, patients are examined at least 3 times a week for formed elements in peripheral blood. Use in a daily dose of 5 mg and above is carried out only under the control of plasma concentrations. In the following cases, methotrexate therapy is discontinued: lymphocyte count less than 1500/μl, neutrophil count less than 200/μl, platelet count less than 75,000/μl, increased concentrations of bilirubin and transaminases in the blood serum.
Literature - Encyclopedia of Medicines 2004