Description
This medicine exhibits cytostatic or cytocidal actions by blocking the transformation of folic acid into its active forms or by being taken up by normal cells or sensitive cancer cells via active transport.
It is usually used to treat acute leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia and trophoblastic diseases (chorioma, destructive hydatidiform mole, hydatidiform mole). It is also used to treat breast cancer, urothelial cancer, sarcoma, acute leukemia, malignant lymphoma and gastric cancer with concomitant use of other medicines.

Ingredients and dosage form
Dosage form: injection

Dosing schedule/Directions
Your dosing schedule must be prescribed by your doctor or a healthcare professional.
• For acute leukemia, chronic lymphocytic leukemia and chronic myeloid leukemia: In general, this medicine is injected 3 to 6 times a week. For meningeal leukemia, this medicine is injected intrathecally once every 2 to 7 days.
• For trophoblastic diseases: In general, for adults, this medicine is injected for 5 consecutive days. Usually, then, off-treatment period is given during the next 7 to 12 days. If any adverse reactions develop, treatment with this medicine should be withdrawn until the reactions disappear.
• In any case, this medicine is injected intravenously, intrathecally or intramuscularly. Intra-arterial or intratumor injection may be performed if necessary.
• For breast cancer and urothelial cancer: In general, this medicine is injected intravenously 2 to 3 times per cycle every 4 weeks with concomitant use of other antitumor medicines.
• For sarcoma, acute leukemia and malignant lymphoma: In general, this medicine is administered by intravenous drip infusion over the period of approximately 6 hours once a week. The dosing interval is 1 to 4 weeks.
• For gastric cancer: In general, this medicine is injected intravenously. The dosing interval is 1 week.
• The treatment span depends on your response to the treatment.

Warnings
Before using this medicine, be sure to tell your doctor and pharmacist
• If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
• If you have: liver disorder, renal disorder, pleural effusion or ascites.
• If you are pregnant or breastfeeding.
• If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Possible adverse reactions to this medicine
• The most commonly reported adverse reactions include nausea/vomiting, loss of appetite, hair loss, anemia, rash, hives, itch, fever, photosensitivity and stomatitis. If any of these symptoms occur, consult with your doctor or pharmacist.

The symptoms described below are rarely seen as initial symptoms of the adverse reactions indicated in brackets. If any of these symptoms occur, stop taking this medicine and see your doctor immediately.
• cold sense, respiratory distress, dropping blood pressure [shock, anaphylaxis]
• fever, sore throat, cold-like symptoms [myelosuppression]
• loss of appetite, general malaise, yellowing of the skin and the white of eyes [fulminant hepatitis, liver failure]
• decreased urine output, edema of face, dry mouth [acute renal disorder, tubular necrosis, severe nephropathy]
• fever, cough (dry cough), respiratory distress [interstitial pneumonia, pulmonary fibrosis, pleural effusion]

The above symptoms do not describe all the adverse reactions to this medicine. Consult with your doctor or pharmacist if you notice any symptoms of concern other than those listed above.

Do not receive live vaccines because use of live vaccines may intensify and continue the vaccine-derived infection during treatment with this medicine.