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These brands contain the same active ingredient (Methotrexate). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Trexall
Other strengths and forms by Healthcare Pharmaceuticals Ltd.
Indications & Uses
Trexall is indicated for:
Pharmacology
Methotrexate works by inhibiting dihydrofolic acid reductase. Normally, this enzyme reduces dihydrofolates to tetrahydrofolates, which the body needs as carriers of one carbon groups when building purine nucleotides and thymidylate. By blocking this step, methotrexate interferes with DNA synthesis, repair, and cell replication. Tissues that proliferate rapidly, such as malignant cells, bone marrow, fetal cells, the lining of the mouth and intestines, and cells of the urinary bladder, tend to be more sensitive to this effect. Because malignant tissue often proliferates faster than most normal tissue, methotrexate can suppress malignant growth without causing irreversible damage to normal tissues. In psoriasis, skin cells are produced at a much faster rate than in normal skin, and it is this heightened rate of proliferation that methotrexate acts on to help control the psoriatic process.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Neoplastic diseases. Choriocarcinoma and similar trophoblastic diseases: given orally or intramuscularly in doses of 15 to 30 mg daily for a five-day course. The courses are usually repeated 3 to 5 times as required, with rest periods of one or more weeks interposed between courses, until any manifesting toxic symptoms subside. Since hydatidiform mole may precede choriocarcinoma, prophylactic chemotherapy with methotrexate has been recommended. Chorioadenoma destruens is considered to be an invasive form of hydatidiform mole. Methotrexate is administered in these disease states in doses similar to those recommended for choriocarcinoma.
Acute lymphoblastic leukemia. Induction dose: 3.3 mg/m2 in combination with prednisone 60 mg/m2 daily for 4 to 6 weeks. Maintenance dose: given orally or intramuscularly 2 times a week in total weekly doses of 30 mg/m2. Alternate maintenance dose: 2.5 mg/kg intravenously every 14 days. If and when relapse does occur, reinduction of remission can again usually be obtained by repeating the initial induction regimen.
Lymphoma. Burkitt's tumor, stages I to II: 10 to 25 mg once a day for 4 to 8 days. Burkitt's tumor, stage III: methotrexate is commonly given concomitantly with other antitumor agents. Duration of therapy: all stages usually require several courses of therapy interposed with 7 to 10 day rest periods. Lymphosarcoma, stage III: 0.625 to 2.5 mg/kg daily as part of combination chemotherapy.
Mycosis fungoides. Early stage dosing: 5 to 50 mg once a week; alternatively, 15 to 37.5 mg 2 times a week may be used in patients who have responded poorly to weekly therapy.
Breast cancer: 40 mg/m2 intravenously on the 1st and 8th day every 4 weeks in combination with cyclophosphamide and fluoracil for 6 to 12 cycles.
Head and neck cancer: 40 mg/m2 intravenously weekly until disease progression or unacceptable toxicity (3 weeks equals one cycle; the goal is to complete at least six cycles).
Adult rheumatoid arthritis: single doses of 7.5 mg once per week. Maximum dose: 20 mg/week in adults.
Polyarticular-course juvenile rheumatoid arthritis: 10 mg/m2 once weekly.
Psoriasis: single dose of 10 to 25 mg once per week. Maximum dose: 30 mg/week.
Side Effects
The most frequently reported side effects include ulcerative stomatitis, a drop in white blood cell count (leukopenia), nausea, and abdominal discomfort. Other common effects are malaise, unusual tiredness, chills and fever, dizziness, and lowered resistance to infection. Trexall has also been reported to affect fertility in humans, causing a reduced sperm count (oligospermia) and menstrual irregularities, both during treatment and for a short time after it is stopped.
Cautions & Contraindications
Warnings & Precautions
Trexall products and diluents that contain preservatives must not be used for intrathecal therapy or for high dose Trexall therapy. Patients on Trexall need to be followed closely for signs of toxicity. If adverse reactions occur, the dose should be reduced or the drug discontinued, and appropriate corrective measures should be taken; if necessary, this may include the use of leucovorin calcium. If Trexall therapy is restarted, it should be done cautiously, with careful consideration of the patient's continued need for the drug and with increased alertness to the possible return of toxicity. Persistent abnormalities in liver function tests and/or a drop in serum albumin may point to serious liver toxicity and should be evaluated. Folate deficiency may increase the toxicity of Trexall.
Contraindications
Methotrexate should not be used in people with alcoholism, alcoholic liver disease or any other chronic liver disease. It should also be avoided in people with immunodeficiency syndromes, or with blood disorders that already exist, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia. Anyone who has had a hypersensitivity reaction to methotrexate should not take it again. Pregnant women with psoriasis or rheumatoid arthritis should not take methotrexate, and women who could become pregnant should avoid it. Nursing mothers should not use it either. Pregnancy should be avoided if either partner is taking methotrexate. For male patients, that means during treatment and for at least three months after therapy ends. For female patients, it means during treatment and for at least one ovulatory cycle after therapy ends.
Pregnancy & Breastfeeding
In the United States, the FDA places methotrexate in Pregnancy Category X. This means it should be used for cancer treatment only when the possible benefit clearly outweighs the risk to the unborn baby. Methotrexate is also not to be given to mothers who are breastfeeding.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric patients: Before using Methotrexate on its own or together with other drugs, the doctor should weigh the benefits against the possible risks. This applies especially to children and young adults.
Geriatric patients: Elderly patients need close monitoring for early signs of liver, bone marrow and kidney toxicity.
Overdose
If Methotrexate is given by mistake in too large an amount, Leucovorin is used to reduce the toxicity and counteract its effect. It should be started as soon as possible.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep methotrexate in a dry place, at a temperature not above 30°C. Protect it from light and moisture.
Drug Interactions
Common questions about Trexall 10 mg
What is Trexall 10 mg Tablet?
Trexall 10 mg Tablet is a medicine that contains Methotrexate. It is made by Healthcare Pharmaceuticals Ltd. It belongs to the Antidote preparations group of medicines.
What is Trexall used for?
Trexall is used for: Rheumatoid Arthritis, Psoriasis, Cancer, Inflammation.
What are the side effects of Trexall?
The most frequently reported side effects include ulcerative stomatitis, a drop in white blood cell count (leukopenia), nausea, and abdominal discomfort. Other common effects are malaise, unusual tiredness, chills and fever, dizziness, and lowered resistance to infection.
Can I take Trexall during pregnancy or while breastfeeding?
In the United States, the FDA places methotrexate in Pregnancy Category X. This means it should be used for cancer treatment only when the possible benefit clearly outweighs the risk to the unborn baby. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Trexall?
If Methotrexate is given by mistake in too large an amount, Leucovorin is used to reduce the toxicity and counteract its effect. It should be started as soon as possible. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Trexall?
Keep methotrexate in a dry place, at a temperature not above 30°C. Protect it from light and moisture.
Can I take other medicines with Trexall?
Some medicines can interact with Methotrexate, for example: Ibuprofen, Diclofenac Sodium, Diclofenac Sodium + Lidocaine Hydrochloride, Acitretin, Diclofenac Potassium, Chloramphenicol. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Meth by Drug International Unani Ltd. has the same ingredient and strength for ৳12.00 per unit, compared with ৳15.00 for Trexall. Ask your doctor or pharmacist before switching.
Do I need a prescription for Trexall?
Trexall is a prescription (Rx) medicine. Take it as your doctor advises.