trimetrexate (Neutrexin)

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Introduction

Tradename: Neutrexin.

Indications

Pneumocystis carinii pneumonia (PCP)

Dosage

  • 45 mg/m2 IV QD over 90 minutes for 21 days Must be given with leucovorin:
  • 20 mg/mg IV every 6 hours over 5-10 minutes or 20 mg/m2 PO every 6 hours (round up to higher 25 mg increment)
  • continue leucovorin for 72 hours past final trimetrexate dose

Powder for injection: 25 mg.

Dosage adjustment for hematologic toxicity:

neutrophils/uL platelets/uL trimetrexate leucovorin
> 1000 > 75,000 45 mg/m2 QD 20 mg/m2 every 6 hours
750-1000 50-75,000 45 mg/m2 QD 40 mg/m2 every 6 hours
500-750 25-50,000 22 mg/m2 QD 40 mg/m2 every 6 hours
< 500 < 25,000 hold* 40 mg/m2 every 6 hours

* hold for 96 hours

Pharmacokinetics

elimination via liver

1/2life = 15-17 hours

Adverse effects

Drug interactions

More general terms

Additional terms

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998

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