TREXLIEVA 500 mg contains Methotrexate, an antimetabolite and antifolate chemotherapeutic agent. It inhibits dihydrofolate reductase (DHFR), blocking folate metabolism and DNA synthesis in rapidly dividing cells. This strength is commonly used in high-dose methotrexate (HD-MTX) oncology protocols.

Methotrexate 500 mg is used mainly in oncology, including:

1. Acute Lymphoblastic Leukemia (ALL)

2. Non-Hodgkin’s Lymphoma

3. Osteosarcoma (high-dose regimens)

4. Choriocarcinoma & Gestational Trophoblastic Disease

5. Breast Cancer

6. Head & Neck Cancers

(Lower doses are used for RA, psoriasis, ectopic pregnancy)

Common side effects:

•  Severe myelosuppression

•  Nausea, vomiting

•  Mucositis, stomatitis

•  Fatigue

Serious / dose-related side effects:

•  Nephrotoxicity (especially high doses)

•  Hepatotoxicity

•  Pulmonary toxicity

•  Severe infections

Requires strict monitoring of CBC, LFTs, RFTs, and serum methotrexate levels.

Dosage depends on cancer type and protocol.

Typical oncology dosing:

•  500 mg/m² to several g/m² IV (high-dose MTX)
•  Given as IV infusion
Leucovorin rescue is mandatory with high-dose methotrexate.


NOTE: This medicine should be taken only under a doctor’s supervision.