raltitrexed at a glance
Medicine class
Antifolate cytotoxic chemotherapy and thymidylate synthase inhibitor
Licensed use
Advanced colorectal cancer when fluorouracil and folinic acid treatment is unsuitable or not tolerated
Administration
Given into a vein by a specialist cancer-treatment team
Key monitoring
Blood count, kidney function and liver tests
What is raltitrexed used for?
Licensed use:
Palliative treatment of advanced colorectal cancer when fluorouracil and folinic acid-based treatment is not tolerated or is considered inappropriate.
How does raltitrexed work?
Raltitrexed enters cells through a folate transporter and is converted into forms retained inside the cell. These inhibit thymidylate synthase, reducing production of a building block needed for DNA synthesis and limiting growth of rapidly dividing cancer cells.
How to take raltitrexed
Raltitrexed is prepared and administered into a vein by an experienced cancer-treatment team. It is not taken at home. Other medicines should not be mixed with it in the same infusion container.
Attend scheduled blood tests and treatment appointments.
Tell the team promptly about diarrhoea, vomiting, mouth soreness, fever or infection symptoms.
There are no special food or drink requirements specifically associated with its administration.
raltitrexed side effects
Common or expected effects
- Nausea, vomiting, diarrhoea, abdominal pain or constipation
- Reduced appetite, indigestion or weight loss
- Mouth or gut inflammation and mouth ulcers
- Tiredness, weakness, fever or feeling generally unwell
- Rash or itching
- Reduced white or red blood cells
- Temporary increases in liver enzymes
Get urgent medical advice
- Fever, chills, sore throat or other infection symptoms, which may indicate neutropenia or sepsis
- Severe diarrhoea or vomiting, especially with weakness, reduced urine or other dehydration symptoms
- Severe mouth or gut inflammation
- Unexpected bruising, bleeding or blood in stools
- Marked weakness or deterioration alongside gastrointestinal symptoms
- Yellowing of the skin or eyes
raltitrexed in pregnancy
Raltitrexed is contraindicated during pregnancy, and pregnancy should be excluded before treatment. Conception should be avoided while either partner is receiving it and for at least six months afterwards. Discuss contraception, fertility preservation and any suspected pregnancy promptly with the specialist team.
raltitrexed while breastfeeding
Raltitrexed must not be given during breastfeeding. A cancer specialist should advise on feeding options and when breastfeeding could safely be reconsidered.
raltitrexed interactions
Give the cancer team a complete list of prescribed, non-prescribed, vitamin and complementary products.
Folinic acid, folic acid and vitamins containing them
Use immediately before or during raltitrexed is contraindicated because these products may interfere with its action.
Non-steroidal anti-inflammatory drugs
They may compete with raltitrexed for active kidney secretion, so concurrent use requires medication and renal-function review; clinical significance is uncertain.
Warfarin and other anticoagulants
The cancer team should know about anticoagulant treatment; available raltitrexed data did not identify a clinically significant interaction with warfarin.
Common questions about raltitrexed
Answers are fully visible for fast scanning and source review.
Is raltitrexed chemotherapy?
Yes. Raltitrexed is an antifolate cytotoxic chemotherapy that inhibits thymidylate synthase.
Why is raltitrexed used for colorectal cancer?
It is licensed for advanced colorectal cancer when fluorouracil and folinic acid treatment is unsuitable or not tolerated.
How is raltitrexed given?
A specialist cancer-treatment team prepares it and administers it into a vein; it is not taken at home.
Can I eat normally before raltitrexed?
There are no medicine-specific food or drink restrictions, unless your treatment team gives different instructions for your wider care.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.