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Trexall Side Effects and Tips for Managing Them
Trexall (methotrexate) can cause side effects ranging from mild to serious. More common side effects include nausea and stomach discomfort. If Trexall’s side effects become difficult to tolerate, ask your doctor about coping tips or treatment options.
Trexall is prescribed to treat:
Keep reading to learn about the common, mild, and serious side effects Trexall can cause. To learn more about this medication, including its indications (uses), dosage, and cost, read this Trexall overview.
Trexall has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warnings for Trexall” section.
More common side effects of Trexall
Trexall can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, if they get worse, or if they become too difficult for you to tolerate.
Trexall’s commonly reported side effects include:
Mild side effects of Trexall
Mild side effects have been reported with Trexall. These include:
In most cases, these side effects should be temporary, and some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. Do not stop Trexall treatment unless your doctor recommends it.
Trexall may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
Serious side effects of Trexall
Trexall may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Trexall’s prescribing information.
If you develop serious side effects while taking Trexall, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported include:
Other serious side effects are included in the drug’s boxed warnings. (A boxed warning is the most serious warning from the FDA.) See the “Boxed warnings for Trexall” section for more details on these side effects:
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Trexall and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
For some people, Trexall can cause an allergic reaction. This serious side effect was reported in the drug’s studies. Because of this, Trexall has a boxed warning about serious allergic reaction. A boxed warning is the most serious warning from the FDA. Due to this risk, doctors usually will not prescribe Trexall to people who have ever had a serious allergic reaction to Trexall.
In general, symptoms of an allergic reaction can be mild or serious. But with this drug, keep in mind that a mild reaction could develop into a more serious reaction.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They can also determine whether you should continue Trexall treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms that you’ve had a serious allergic reaction to Trexall, they will likely have you switch to a different treatment.
Boxed warnings for Trexall
Trexall has several boxed warnings. A boxed warning is the most serious warning from the FDA. After each warning, you can find some helpful information about what you can do about it.
Trexall can cause serious harm to a fetus, including death. Because of this, doctors usually will not prescribe Trexall for pregnant people except in certain situations. One example is if Trexall is needed to treat a neoplastic disease, such as cancer.
Before starting Trexall, talk with your doctor if you think you may be pregnant. They might have you complete a pregnancy test before prescribing Trexall.
If your doctor confirms that you are not pregnant, they will likely recommend that you use effective birth control during Trexall treatment:
If you have a neoplastic disease and are pregnant, your doctor will help you determine whether Trexall is right for you.
Note: In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Serious allergic reaction, including anaphylaxis (a life threatening reaction), can occur in people taking Trexall. It’s not known how often this occurs. Due to this risk, doctors usually won’t prescribe Trexall for people who have ever had a severe allergic reaction to the drug. The intensity of allergic reaction to Trexall can vary.
Symptoms of a serious allergic reaction can include:
Before starting Trexall, talk with your doctor about any allergic reaction you’ve ever had to the drug. If your doctor confirms that you’ve had a serious allergic reaction, they will prescribe another medication to treat your condition.
If you experience a severe allergic reaction during Trexall treatment, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
Various serious side effects, possibly including death, can occur in people taking Trexall. Because of this risk, your doctor will monitor you closely for signs of the following side effects during your Trexall treatment:
Blood disorders: Blood disorders were serious side effects reported in studies of Trexall. Blood disorders can occur because Trexall can cause myelosuppression (reduced bone marrow activity).
Lower bone marrow activity can lead to changes in the production of blood cells, as well as certain other problems. These problems may affect your blood cells and platelets. You might not experience any symptoms, but if you do, they can include fever and easy bruising or bleeding.
Serious digestive problems: Trexall can cause serious digestive problems, including inflammation and tears in parts of your digestive system. Symptoms can include:
People with certain digestive problems have a higher risk of experiencing serious digestive conditions, such as stomach ulcer and ulcerative colitis, as a side effect.
Liver problems: Trexall can cause serious liver problems, including liver fibrosis and cirrhosis. In some cases, these problems may not get better, even after you stop taking Trexall. Because of this, it isn’t known whether Trexall is safe for people with liver disease to take.
The following factors can raise your risk of developing liver problems during Trexall treatment:
Symptoms of liver problems can include:
People with psoriasis who take Trexall could have liver problems without any noticeable side effects or abnormal liver tests. For this reason, your doctor might recommend having liver biopsies periodically to detect potential liver problems.
Kidney problems: Trexall can cause serious kidney problems, including kidney failure. A change in the amount of urine you produce could be a symptom of kidney problems.
Symptoms of kidney problems can occur suddenly. In some cases, these problems may not get better, even after you stop taking Trexall.
Lung problems: Trexall can cause serious lung problems, including certain types of interstitial lung disease. These problems can start suddenly or develop over a long period of time.
Symptoms might not get better, even after you stop taking Trexall. They can include:
Serious skin problems: Trexall can cause serious skin problems, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Symptoms can include worsening rash and itchy skin.
Exposing your skin to sunlight while taking Trexall can worsen these symptoms. Certain health conditions, including psoriasis, can also worsen them.
Before you start treatment with Trexall, talk with your doctor to see if any of the health problems mentioned here apply to you. If so, your doctor will have you complete certain lab tests before and during your Trexall treatment. This will help them monitor these problems to be sure they don’t become severe.
If you develop any symptoms relating to the above problems during your Trexall treatment, see your doctor right away. They might determine that the problem needs to be treated or that your Trexall treatment needs to be adjusted or stopped.
Tips for managing side effects
While taking Trexall, you may be able to take steps to make side effects easier to manage.
If you have problems with side effects, if they do not go away, or if they become worse, talk with your doctor or pharmacist. They can discuss options for managing side effects or other available treatment options.
Mouth sores were a common side effect reported in studies of Trexall. These sores typically:
They develop as a result of a low vitamin B9 level in your body, which is caused by taking Trexall.
You can take the following steps to manage symptoms associated with this side effect:
Infertility is a serious side effect that can occur with the use of Trexall. It’s defined as difficulty getting or staying pregnant or difficulty initiating conception or pregnancy. It can be due to various factors.
Symptoms of this serious side effect can include menstrual cycle (period) changes and low sperm production. It’s not known whether infertility is reversible after stopping Trexall treatment. Before starting treatment with Trexall, talk with your doctor about the risk of infertility if this is a concern for you.
Precautions for Trexall
Consider the following important information before taking Trexall.
Trexall has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warnings for Trexall.”
Before taking Trexall, discuss your health history with your doctor. Trexall may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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