Trexonate 10mg Tablet

✔️ How does

Methotrexate inhibits dihydrofolic acid reductase, an enzyme essential for converting dihydrofolates to tetrahydrofolates. This process is necessary for purine nucleotide and thymidylate synthesis. By interfering with DNA synthesis, repair, and replication, methotrexate targets rapidly proliferating cells, such as malignant cells, bone marrow, and epithelial cells, while sparing most normal tissues. In psoriasis, methotrexate reduces the excessive production of epithelial cells, thereby controlling the condition.

✔️ Administration: Trexonate 10

• Take on an empty stomach.
• May be taken with meals to reduce gastrointestinal discomfort. Avoid milk-rich products.

Use this medication only as directed by a registered physician.

✔️ Dosage: Trexonate 10

Neoplastic Diseases:

• Choriocarcinoma and similar trophoblastic diseases: 15–30 mg orally or intramuscularly daily for five days. Rest periods of one or more weeks are interposed between courses.
• Acute Lymphoblastic Leukemia:
  • Induction dose: 3.3 mg/m² with prednisone 60 mg/m² daily for 4–6 weeks.
  • Maintenance dose: 30 mg/m² orally or IM weekly, or 2.5 mg/kg IV every 14 days.
• Lymphoma:
  • Burkitt's tumor Stages I–II: 10–25 mg daily for 4–8 days.
  • Burkitt's tumor Stage III: Administered with other antitumor agents.
  • Lymphosarcoma Stage III: 0.625–2.5 mg/kg daily as part of combination chemotherapy.
• Mycosis Fungoides: 5–50 mg weekly or 15–37.5 mg twice weekly.
• Breast Cancer: 40 mg/m² IV on the 1st and 8th day every 4 weeks, in combination with other agents, for 6–12 cycles.
• Head and Neck Cancer: 40 mg/m² IV weekly until disease progression or unacceptable toxicity.

Rheumatoid Arthritis:

• Adults: 7.5 mg weekly (maximum 20 mg/week).
• Children (polyarticular-course juvenile rheumatoid arthritis): 10 mg/m² weekly.

Psoriasis:

• Single weekly dose: 10–25 mg (maximum 30 mg/week).

• Pediatrics: Use with caution, weighing benefits against potential risks.
• Geriatrics: Monitor closely for hepatic, bone marrow, and renal toxicity.

✔️ Side Effects: Trexonate 10

• Common: Ulcerative stomatitis, leukopenia, nausea, abdominal discomfort.
• Others: Fatigue, malaise, chills, fever, dizziness, increased infection risk.
• Fertility effects: May cause reversible oligospermia and menstrual dysfunction.

✔️ Interactions: Trexonate 10

• NSAIDs: Should not be used with high doses of methotrexate (e.g., in osteosarcoma).
• Salicylates, Phenylbutazone, Phenytoin, Sulfonamides: May increase toxicity.
• Penicillin, Theophylline, Probenecid, Azathioprine, Retinoids, Sulfasalazine: Increased risk of hepatotoxicity.
• Cisplatin: Use with caution if combined with high-dose methotrexate.
• Mercaptopurine: Plasma levels may increase.
• Vitamin supplements containing folic acid: May reduce methotrexate efficacy.
• Trimethoprim/Sulfamethoxazole: Rarely increases bone marrow suppression.

✔️ Contraindications: Trexonate 10

• Alcoholism or chronic liver disease.
• Immunodeficiency syndromes.
• Pre-existing blood dyscrasias (e.g., leukopenia, thrombocytopenia, significant anemia).
• Hypersensitivity to methotrexate.
• Pregnant women with psoriasis or rheumatoid arthritis.
• Women of childbearing potential and nursing mothers.
• Pregnancy must be avoided during and after therapy (3 months for males, one ovulatory cycle for females).

✔️ Pregnancy & Lactation

• Pregnancy Category X (FDA): Methotrexate is contraindicated in pregnant and nursing mothers due to severe fetal risk.

✔️ Precautions & Warnings

• Methotrexate formulations with preservatives must not be used for intrathecal or high-dose therapy.
• Persistent liver function abnormalities or low serum albumin may indicate serious liver toxicity.
• Folate deficiency may exacerbate methotrexate toxicity.

✔️ Storage

• Store at temperatures below 30°C in a dry place. Protect from light and moisture