Neutrexin Side Effects
Generic name: trimetrexate
Note: This document provides detailed information about Neutrexin Side Effects associated with trimetrexate. Some dosage forms listed on this page may not apply specifically to the brand name Neutrexin.
Applies to trimetrexate: intravenous powder for solution.
Important warnings
This medicine can cause some serious health issues
Intravenous routePowder for Solution. Trimetrexate glucuronate for injection must be used with concurrent leucovorin (leucovorin protection) to avoid potentially serious or life-threatening toxicities.
Trimetrexate glucuronate for injection must be used with concurrent leucovorin (leucovorin protection) to avoid potentially serious or life-threatening toxicities.
Serious side effects of Neutrexin
Along with its needed effects, trimetrexate (the active ingredient contained in Neutrexin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking trimetrexate:
More common side effects
- abdominal pain or tenderness
- black, tarry stools
- blood in urine or stools
- clay-colored stools
- dark urine
- decreased appetite
- fever and sore throat
- headache
- itching
- loss of appetite
- nausea and vomiting
- pinpoint red spots on skin
- skin rash
- swelling of feet or lower legs
- unusual bleeding or bruising
- unusual tiredness or weakness
- yellow eyes or skin
Less common side effects
- abdominal cramps
- coma
- confusion
- convulsions
- decreased urine output
- difficulty in breathing
- dizziness
- fast or irregular heartbeat
- hypocalcemia
- increased thirst
- mood or mental changes
- muscle cramps in hands, arms, feet, legs, or face
- muscle pain
- mouth sores or ulcers
- numbness and tingling around the mouth, fingertips, or feet
- skin rash and itching
- shortness of breath
- tremor
Rare side effects
- cough
- difficulty swallowing
- fainting or loss of consciousness
- fast or irregular breathing
- hives
- puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
- swelling of eyes or eyelids
- tightness in chest
- trouble in breathing
- wheezing
Other side effects of Neutrexin
Some side effects of trimetrexate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common side effects
- fatigue
- stomach pain
For healthcare professionals
Applies to trimetrexate: intravenous powder for injection.
General adverse events
Because many patients in clinical trials had advanced HIV disease, it was difficult to distinguish between trimetrexate-associated side effects and underlying medical conditions. In a clinical trial, 10% of patients in the trimetrexate-leucovorin group discontinued treatment due to side effects, as compared to 29% in the sulfamethoxazole-trimethoprim group.[Ref]
Hematologic
Hematologic toxicity has been the primary dose-limiting adverse effect. In a clinical trial (n=109) trimetrexate (the active ingredient contained in Neutrexin) commonly caused myelosuppression, resulting in neutropenia (<= 1000/mm3) in 30%, thrombocytopenia (<=75,000/mm3) in 10%, and anemia (Hgb<8 g/dL) in 7% of patients also treated with leucovorin. Therapy was discontinued in 3.7% of patients due to hematologic toxicity.[Ref]
Renal
Renal toxicity consisting of elevations in serum creatinine greater than 3 times upper normal limits has occurred in 0.9% of clinical trial patients treated with trimetrexate (the active ingredient contained in Neutrexin) and leucovorin.[Ref]
Gastrointestinal
Gastrointestinal side effects associated with trimetrexate (the active ingredient contained in Neutrexin) have included nausea and vomiting in 5% or more of patients also treated with leucovorin. Mucositis and diarrhea also occur relatively often.[Ref]
Hepatic
Hepatic side effects have included transient elevations in liver function tests in up to 14% (n=109) of trial patients who also received leucovorin with increases greater than 5 times upper normal limits in AST (13.8%), ALT (11%), alkaline phosphatase (4.6%), and 2.5 times upper normal limit increases in bilirubin (1.8%). Discontinuation of therapy was necessary in approximately 3% of cases.[Ref]
Hypersensitivity
Hypersensitivity reactions to trimetrexate (the active ingredient contained in Neutrexin) have occurred and are generally limited to skin rash and pruritus. However, severe reactions consisting of bronchospasm, hypotension, rigors, and fever have occurred rarely.[Ref]
Respiratory
Respiratory side effects have included dyspnea and rare cases of pneumonitis.[Ref]
Metabolic
Metabolic abnormalities have included hyponatremia (4.6%) and hypocalcemia (1.8%).[Ref]
Dermatologic
Dermatologic side effects have included alopecia in a few patients treated with trimetrexate (the active ingredient contained in Neutrexin) [Ref]
Nervous system
Nervous system side effects have included confusion (2.8%) and fatigue (1.8%).[Ref]
References
1. Amsden GW, Kowalsky SF, Morse GD (1992) "Trimetrexate for Pneumocystis carinii pneumonia in patients with AIDS." Ann Pharmacother, 26, p. 218-26
2. (2022) "Product Information. NeuTrexin (trimetrexate)." Apothecon Inc
3. Gesme DH, Jr Jett JR, Schreffler DD, Su JQ, Mailliard JA, Foley JF, Krook JE, Maksymiuk AW, Hatfield AK, Ebbert LP, et al. (1993) "A randomized phase II trial of amonafide or trimetrexate in patients with advanced non-small cell lung cancer. A trial of the North Central Cancer Treatment Group." Cancer, 71, p. 2723-6
4. Weiss GR, Liu PY, O'Sullivan J, Alberts DS, Brown TD, Neefe JR, Hutchins LF (1992) "A randomized phase II trial of trimetrexate or didemnin B for the treatment of metastatic or recurrent squamous carcinoma of the uterine cervix: a Southwest Oncology Group trial." Gynecol Oncol, 45, p. 303-6
5. Witte RS, Elson P, Bryan GT, Trump DL (1992) "Trimetrexate in advanced renal cell carcinoma. An ECOG phase II trial." Invest New Drugs, 10, p. 51-4
6. Fossella FV, Winn RJ, Holoye PY, Hallinan B, Raber MN, Hoelzer K, Young JA, Readling J, Bowers B, Hong WK (1992) "Phase II trial of trimetrexate for unresectable or metastatic non- small cell bronchogenic carcinoma." Invest New Drugs, 10, p. 331-5
7. Conti JA, Kemeny N, Goker E, Tong W, Colofiore J, Andre M, Ragusa K, Bertino JR (1993) "A Phase I trial of sequential trimetrexate (TMTX), fluorouracil (FU) and high-dose leucovorin (LV) in previously treated patients (pts) with gastrointestinal (GI) carcinoma (Ca) (Meeting abstract)." Proc Annu Meet Am Soc Clin Oncol, 12, a567
8. Hum M, Holcenberg JS, Tkaczewski I, Weaver JW, Wilson J, Kamen BA (1998) "High-dose trimetrexate and minimal-dose leucovorin: a case for selective protection?" Clin Cancer Res, 4, p. 2981-4
9. Allegra CJ, Chabner BA, Tuazon CU, et al. (1987) "Trimetrexate for the treatment of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome." N Engl J Med, 317, p. 978-85
10. Grem JL, King SA, Costanza ME, Brown TD (1990) "Hypersensitivity reactions to trimetrexate." Invest New Drugs, 8, p. 211-4
11. King SA, Grem JL (1988) "Acute allergic reactions to trimetrexate (TMTX) (meeting abstract)." Proc Annu Meet Am Soc Clin Oncol, 7, a284
More about Neutrexin (trimetrexate)
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- During pregnancy
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Further information
Neutrexin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.