How does it work?

Trimetrexate is a medicine that is used to treat chest infections caused by Pneumocystis carinii. This infection is most likely to occur in those who have poor immune system function, or those who are infected with human immunodeficiency virus (HIV). Trimetrexate is thought to work by interfering with the enzyme responsible for the production of folinic acid. Folinic acid is essential in the production of genetic material (DNA). DNA is necessary for the cells to reproduce, therefore by blocking it's formation trimetrexate prevents them from increasing in number. Trimetrexate is not used as a first line treatment but is reserved for the treatment of moderate to severe pneumocystis infections in AIDS patients who are intolerant of, or refractory to, standard therapy or for whom standard therapy is not suitable. It is administered by intravenous infusion only.

What is it used for?

Pneumonia caused by Pneumocystis carinii pneumonia (PCP), often seen in patients with decreased immune system function

Warning!

This drug can cause serious or even life threatening suppression of the bone-marrow.

Treatment with this medicine needs very close monitoring of bodily functions and levels of the medicine being administered.

It is important for both sexes to avoid conceiving children during treatment and for at least six months after treatment finishes.

Calcium folinate (folinic acid) must be administered during treatment and for 72 hours after the last dose. This is to avoid potentially serious or life-threatening complications such as bone marrow suppression, mouth and gut mucosal ulceration, and kidney and liver damage.

Use with caution in

Combination with drugs that are myelosuppressive (reduce the blood cell production in the bone marrow) or potentially toxic to the kidney or liver

Decreased blood cell production by the bone marrow

Decreased kidney function

Decreased liver function

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Seek medical advice from your doctor.

There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Rash

Alteration in results of liver function tests

Low red blood cell count (anaemia)

Seizures

Decrease in the number of platelets in the blood (thrombocytopenia)

Reduction in the number of granulocytes (a type of white cell) in the blood (granulocytopenia)

Ulceration of the mucosa (membrane lining) of the mouth and gut

Diarrhoea

Vomiting

Fever (pyrexia)

Confusion

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

There is limited information available on the interactions with trimetrexate and other medications, however there are the potential for very serious interactions. Consult the company product literature for details.

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