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Thymidylate synthase inhibitor

Raltitrexed (Specialist drug)

Brand names: Tomudex

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC
Route: IV
Frequency: every 3 weeks

Clinical pearls

  • Advanced colorectal cancer when 5-FU/folinic acid not tolerated
  • Specialist oncology

Contraindications

  • Severe renal/hepatic impairment
  • Severe myelosuppression
  • Pregnancy

Side effects

  • Myelosuppression
  • GI toxicity
  • Hepatotoxicity
  • Asthenia

Interactions

  • Folate antagonists
  • Live vaccines

Monitoring

  • FBC
  • LFTs
  • Renal function

Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/raltitrexed-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.