Rheumatrex
 
What is Rheumatrex and why is it prescribed?
Rheumatrex is an anticancer drug used in the treatment of lymphoma and certain forms of leukemia. It is also given to treat some forms of cancers of the uterus, breast, lung, head, neck, and ovary. Rheumatrex is also given to treat rheumatoid arthritis when other treatments have proved ineffective, and is sometimes used to treat very severe and disabling psoriasis. Be certain to remember that in the treatment of psoriasis and rheumatoid arthritis, Rheumatrex is taken once a week, not once a day. Accidentally taking the recommended weekly dosage on a daily basis can lead to fatal overdosage. Be sure to read the patient instructions that come with the package.

How should you take Rheumatrex?
Follow your doctors directions for taking Rheumatrex. Report to your doctor any new symptoms that may develop. Rheumatrex is given at a higher dosage for cancer than for psoriasis or rheumatoid arthritis. After high-dose Rheumatrex treatment, a drug called leucovorin may be given to limit the toxic effects. If you miss a dose skip it and go back to your regular schedule. Do not take two doses at once. Store Rheumatrex at room temperature, away from light.

Are there any Rheumatrex side effects?
Rheumatrex side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. More common Rheumatrex side effects may include abdominal pain and upset, chills and fever, decreased resistance to infection, dizziness, fatigue, general feeling of illness, mouth ulcers, and nausea. Less common Rheumatrex side effects may include abortion, acne, anemia, birth defects, black or tarry stool, boils, bruises, changes in skin coloration, convulsions, diarrhea, drowsiness, eye or vision problems, fatigue, hair loss, headaches, hives, inability to speak, infection of hair follicles, infertility, inflammation of the gums or mouth, intestinal inflammation, kidney failure, loss of appetite, lung disease, menstrual problems, partial or complete paralysis, rash or itching, red patches on skin, sensitivity to light, skin peeling or flaking, sore throat, stomach and intestinal ulcers and bleeding, stomach pain, vaginal discharge, vomiting, and vomiting blood. Rare Rheumatrex side effects may include diabetes, impotence, infection, joint pain, loss of sexual desire, muscular pain, osteoporosis, ringing in the ears, severe allergic reaction, shortness of breath, sleepiness, sudden death, and sweating. If you are taking Rheumatrex for psoriasis, you may also experience hair loss and/or sun sensitivity, and your patches of psoriasis may give a burning sensation. Rheumatrex can sometimes cause serious lung damage that makes it necessary to limit the treatment. If you experience a dry cough, fever, or breathing difficulties while taking Rheumatrex, be sure to tell your doctor right away. During and immediately after treatment with Rheumatrex, fertility may be impaired. Men may have an abnormally low sperm count; women may have menstrual irregularities. People on high doses of Rheumatrex may develop a brain condition signaled by confusion, partial paralysis, seizures, or coma.

What are the possible food and drug interactions when taking Rheumatrex?
If Rheumatrex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Be sure to inform your doctor of all the prescription and over the counter medications you are taking. If you are being given Rheumatrex for the treatment of cancer or psoriasis, you should not take aspirin or other nonsteroidal painkillers such as Advil or Naprosyn; this combination could increase the toxic effects of Rheumatrex. If you are taking Rheumatrex for rheumatoid arthritis, you may be able to continue taking aspirin or a nonsteroidal painkiller, but your doctor should monitor you carefully. Other drugs that may increase the toxic effects of Rheumatrex include Cisplatin (Platinol), Penicillins, Phenylbutazone, Phenytoin (Dilantin), Probenecid, Retinoid drugs (such as Retin-A and Renova), or Sulfa drugs (such as Bactrim and Gantrisin). Sulfa drugs may increase Rheumatrex's toxic effect on the bone marrow, where new blood cells are made. Certain antibiotics, including tetracycline (Sumycin) and chloramphenicol (Chloromycetin), may reduce the effectiveness of Rheumatrex. This is also true of vitamin preparations that contain folic acid. In addition, Rheumatrex can alter the effect of theophylline (Quibron, Theo-Dur).

Are there any special warnings about Rheumatrex?
Before you start taking Rheumatrex, your doctor will do a chest X-ray plus blood tests to determine your blood cell counts, liver enzyme levels, and the efficiency of your kidney function. While you are taking Rheumatrex, the blood tests will be repeated at regular intervals; if you develop a cough or chest pain, the chest X-ray will be repeated. If you are being treated for psoriasis or rheumatoid arthritis, your doctor will test your liver function at regular intervals. You should avoid alcoholic beverages while taking Rheumatrex. You may develop an opportunistic infection while you are taking Rheumatrex. Before receiving an immunization or vaccination, be sure to inform health care workers that you are taking this drug. Older or physically debilitated people are particularly vulnerable to toxic effects from Rheumatrex. Your doctor will prescribe Rheumatrex with great caution if you have any of the following: Active infection, Liver disease, Peptic ulcer, or Ulcerative colitis.
 

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