Trexate (Methotrexate 2.5mg) Tablets

Trexate general information

What is Trexate used for?

Trexate tablets 2.5mg are used for chemotherapy for a wide range of cancers to induce regression of the tumour.  These include solid tumours like lung cancer, breast cancer, cancers that develop after conception at the start of a pregnancy, including gestational choriocarcinoma and chorioadenoma destruens also called hydatidiform mole, which are both tumours of trophoblast tissue which develops into the placenta.  Trexate tablets 2.5mg are also used to treat cancers of the white blood cells, including lymphocytic and lymphoblastic leukaemia, and non-Hodgkin's lymphoma; also, to induce and maintain induced remission of acute lymphoblastic (stem cell) leukaemias.  Other cancers that Trexate Tablets 2.5mg are used for include soft tissue cancers like osteosarcoma, a cancer of the bone.  Trexate Tablets 2.5mg are also used to treat psoriasis, a chronic inflammatory skin disorder that is thought to be an autoimmune disease and is characterised by patches of red, scaly, thickened skin.  Trexate Tablets 2.5mg are only used for severe psoriasis to control symptoms and only if the condition has not responded to other topical treatments.  Trexate Tablets 2.5mg works through the same mechanism to treat these different conditions.

How does Trexate work?

Trexate tablets 2.5mg contains methotrexate, an antimetabolite cytotoxic agent that is used to treat various cancers and severe psoriasis.  Methotrexate in Trexate tablets 2.5mg is a folic acid analogue and antagonist that blocks the action of folic acid (vitamin B9) by binding irreversibly to the enzyme dihydrofolate reductase.  This action of methotrexate in Trexate tablets 2.5mg blocks the conversion of folic acid to tetrahydrofolic acid, which is needed for DNA synthesis, DNA repair and cell proliferation.  The main effect of methotrexate in Trexate tablets 2.5mg is targeted at the S-phase of the cell cycle, which is part of Interphase between the cell growth phases (G1 and G2) when DNA synthesis takes place ready for mitosis or cell division.  This is when the cell is preparing to divide and is why actively proliferating cells like cancer cells are more sensitive to the cytotoxic effects of methotrexate.  Psoriasis is characterised by raised scaly plaques due to excess proliferation and abnormal differentiation of the keratinocytes of the epidermis (upper skin layer); also by infiltration of immune cells, which produce chemicals called cytokines that are thought to be responsible for this abnormal behaviour as well as causing inflammation.  Methotrexate in Trexate tablets 2.5mg restores normal cell growth and behaviour to the epidermal skin cells, which reduces the scaling and thickening of the psoriatic plaques and relieves symptoms of psoriasis.

What does Trexate contain?

Trexate tablets 2.5mg contain the active ingredient methotrexate, an antimetabolite cytotoxic agent that is used to treat various cancers and severe psoriasis.  They also contain lactose monohydrate, dibasic calcium phosphate, sodium starch glycollate, microcrystalline cellulose, purified talc, magnesium stearate.

Treating cancer with Trexate

Trexate tablets 2.5mg contain methotrexate, an antimetabolite cytotoxic agent that is used to treat various cancers.  These cancers include solid tumours like lung cancer, breast cancer, cancers that develop after conception at the start of a pregnancy, including gestational choriocarcinoma and chorioadenoma destruens also called hydatidiform mole, which are both tumours of trophoblast tissue which develops into the placenta.  Trexate Tablets 2.5mg are also used to treat cancers of the white blood cells, including lymphocytic and lymphoblastic leukaemia, and non-Hodgkin's lymphoma; also to induce and maintain induced remission of acute lymphoblastic (stem cell) leukaemias.  Other cancers that Trexate Tablets 2.5mg are used for include soft tissue cancers like osteosarcoma, a cancer of the bone.  Methotrexate in Trexate Tablets 2.5mg is a folic acid analogue and antagonist that blocks the action of folic acid (vitamin B9) by binding irreversibly to the enzyme dihydrofolate reductase, blocking the conversion of folic acid to tetrahydrofolic acid, which is needed for DNA synthesis, DNA repair and cell proliferation.  The main effect of methotrexate in Trexate Tablets 2.5mg is targeted at the S-phase of the cell cycle, which is when the cell is preparing to divide and is why actively proliferating cells like cancer cells are more sensitive to the cytotoxic effects of methotrexate.  Trexate Tablets 2.5mg are used for chemotherapy for a wide range of cancers to induce regression of the tumour. 

Trexate for psoriasis

Trexate tablets 2.5mg contain methotrexate, an antimetabolite cytotoxic agent that is used to treat severe psoriasis if no other treatment has worked.  Psoriasis is a chronic skin condition that causes the appearance of red raised patches of thickened skin covered in a dry silvery scaly rash usually on the skin of the elbows, knees and lower back. Psoriasis is thought to be an autoimmune disorder (when the immune system attacks self), which affects people of any age, usually who have a genetic predisposition. The raised scaly plaques on the skin are due to excess proliferation and abnormal differentiation of the keratinocytes of the epidermis (upper skin layer); also by infiltration of immune cells, which produce chemicals called cytokines that are thought to be responsible for this abnormal behaviour as well as causing inflammation.  Methotrexate in Trexate Tablets 2.5mg is a folic acid analogue and antagonist that blocks the action of folic acid (vitamin B9) by binding irreversibly to the enzyme dihydrofolate reductase, blocking the conversion of folic acid to tetrahydrofolic acid, which is needed for DNA synthesis, DNA repair and cell proliferation.  The main effect of methotrexate in Trexate Tablets 2.5mg is targeted at the S-phase of the cell cycle, which is when the cell is preparing to divide and is why actively proliferating cells like epidermal keratinocytes in psoriasis are more sensitive to the cytotoxic effects of methotrexate.  Trexate tablets 2.5mg helps reduce the excess growth of skin cells in the psoriatic plaques and relieves symptoms of severe psoriasis.  

What are the side effects of Trexate?

The adverse effects of methotrexate in Trexate tablets 2.5mg are mainly due to the cytotoxic effects on normal, rapidly proliferating tissues, particularly in bone marrow and the gastrointestinal tract and may be reversible when treatment stops. The most commonly reported side effects when taking Trexate include ulcerations of the oral mucosa stomatitis (inflammation of the mucous membrane of the mouth), changes in blood cells counts (leukopenia – low white blood cells, thrombocytopenia low platelets), nausea and abdominal pain and upset stomach, malaise (feeling of unease), fatigue, chills and fever, headache, dizziness, drowsiness, tinnitus, blurred vision, eye discomfort and decreased resistance to infection, skin discolouration, nail changes, menstrual dysfunction.

When should Trexate not be used?

You should not use Trexate tablets 2.5mg if you:

• are allergic to methotrexate or any ingredients in Trexate
• are pregnant or are breastfeeding
• have kidney or liver disease
• have any active infectious disease
• have peptic ulcer disease, ulcerative colitis or lung disease
• have a folate deficiency
• are taking medicines that interact with Trexate, including antibiotics like tetracycline, chloramphenicol, penicillins and sulphonamides, probenecid for gout, NSAIDs like diclofenac and indomethacin and aspirin for pain relievers and inflammation, proton pump inhibitors like omeprazole, pantoprazole for stomach ulcers and reflux, vitamin preparations containing folic acid, sulfonylurea medicines for diabetes, sulfasalazine for arthritis, amiodarone for arrhythmia, the immunosuppressive azathioprine, retinoids like acitretin for psoriasis, methoxsalen for psoriasis, mercaptopurine for chemotherapy, sulfonylureas for diabetes, the antiepileptic phenytoin,

What medications interact with Trexate?

Several medications interact with Trexate tablets 2.5mg and should either not be taken while you are taking Trexate or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Trexate: antibiotics like penicillins and sulphonamides, NSAIDs like diclofenac and indomethacin and aspirin for pain relievers and inflammation, sulfasalazine for arthritis; amiodarone for arrhythmia may cause skin lesions in psoriasis, the immunosuppressive azathioprine, retinoids like acitretin for psoriasis, methoxsalen for psoriasis when used with UV light can cause skin cancer, mercaptopurine for chemotherapy, sulfonylureas for diabetes, the antiepileptic phenytoin,
• Drugs that affect Trexate: Vitamin preparations containing folic acid, antibiotics like tetracycline, chloramphenicol, penicillins and sulphonamides, probenecid for gout, NSAIDs like diclofenac and indomethacin and aspirin for pain relievers and inflammation, proton pump inhibitors like omeprazole, pantoprazole for stomach ulcers and reflux, mercaptopurine for chemotherapy, sulfonylureas for diabetes, the antiepileptic phenytoin,
• Drugs that are affected by Trexate: mercaptopurine for chemotherapy

How should Trexate be taken?

You should take your Trexate tablets 2.5mg swallowed whole with a glass of water.  The dose you take and for how long depends on what you are being treated for, your response and your doctor’s recommendation and could be weekly or daily and for several weeks.  Your dose may be adjusted depending on how you respond to treatment.  You should continue to take your Trexate tablets 2.5mg for as long as recommended by your doctor.

How long should you take Trexate?

You should continue to take your Trexate tablets 2.5mg for as long as recommended by your doctor.

Missed dose of Trexate

If you miss a dose of Trexate tablets 2.5mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Trexate be stored?

You should store your Trexate tablets 2.5mg below 25°C in a cool dry place.