Trexova 50mg Injection - Methotrexate (50mg/2ml) medicine

Trexova 50mg Injection: Complete Medicine Guide

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🏭 Neova Biogene Private Limited 📦 vial of 2 ml Injection 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Hepatotoxicity Risk ⚠️ Nephrotoxicity Risk 🤰 Pregnancy Category Methotrexate is contraindicated in pregnancy due to known teratogenic and abortifacient effects. It is classified as Pregnancy Category X by the FDA. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: High
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Blood in stool or vomit
  • Severe abdominal pain
  • Chest pain or difficulty breathing
  • Severe headache with visual changes
  • Sudden swelling of face, lips, or throat
  • Yellowing of skin or eyes
  • Decreased urine output
  • Unusual bleeding or bruising
  • Fever or chills
  • New or worsening cough

If experiencing severe symptoms, call emergency services immediately.

What is Trexova 50mg Injection used for?

This medicine is a methotrexate injection used to treat certain cancers and severe autoimmune diseases like rheumatoid arthritis and psoriasis. It works by blocking an enzyme needed for cell division and reducing inflammation. It must be given by a healthcare professional and requires regular blood tests.

  • Generic Name: Methotrexate (50mg/2ml)
  • Manufacturer: Neova Biogene Private Limited
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 Trexova 50mg Injection के बारे में (Hindi Summary)

उपयोग: यह दवा मेथोट्रेक्सेट इंजेक्शन है, जिसका उपयोग कुछ प्रकार के कैंसर जैसे तीव्र लिम्फोब्लास्टिक ल्यूकेमिया, ऑस्टियोसार्कोमा और गंभीर ऑटोइम्यून बीमारियों जैसे रूमेटॉइड आर्थराइटिस और सोरायसिस के इलाज के लिए किया जाता है। यह शरीर में कोशिका विभाजन को रोककर और सूजन को कम करके काम करती है। यह दवा केवल एक योग्य स्वास्थ्य पेशेवर द्वारा ही दी जानी चाहिए।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, मुंह के छाले, थकान और बालों का पतला होना शामिल हैं। गंभीर दुष्प्रभावों में अस्थि मज्जा का दमन, यकृत की क्षति, गुर्दे की चोट और फेफड़ों की सूजन शामिल हो सकती है। किसी भी असामान्य रक्तस्राव, चकत्ते, बुखार या सांस लेने में कठिनाई की तुरंत रिपोर्ट करें।

सुरक्षा सलाह: यह दवा केवल एक स्वास्थ्य पेशेवर द्वारा ही दी जानी चाहिए। नियमित रक्त परीक्षण आवश्यक हैं। शराब का सेवन पूरी तरह से बंद करें। उपचार के दौरान और बाद में गर्भनिरोधक का उपयोग करें। जीवित टीके न लगवाएं। किसी भी संक्रमण, असामान्य रक्तस्राव या त्वचा के पीलेपन की तुरंत रिपोर्ट करें।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 Trexova 50mg Injection Uses & Benefits

[{"condition":"Acute lymphoblastic leukemia (ALL)","description":"Used as part of combination chemotherapy regimens to induce and maintain remission in adults and children.","evidence":"Well-established"},{"condition":"Osteosarcoma","description":"Administered as part of multi-agent chemotherapy for localized and metastatic osteosarcoma.","evidence":"Well-established"},{"condition":"Non-Hodgkin lymphoma","description":"Included in various chemotherapy protocols for certain subtypes of lymphoma.","evidence":"Well-established"},{"condition":"Rheumatoid arthritis","description":"Used as a DMARD to reduce joint inflammation and prevent joint damage in patients with active disease.","evidence":"Well-established"},{"condition":"Severe psoriasis","description":"Prescribed for severe, disabling psoriasis that has not responded to other therapies.","evidence":"Well-established"},{"condition":"Ectopic pregnancy","description":"Used in selected cases to terminate an early ectopic pregnancy when surgery is not preferred.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Crohn's disease","description":"Sometimes used off-label to maintain remission in patients with Crohn's disease.","evidence":"Limited"},{"condition":"Lupus","description":"Occasionally prescribed off-label for systemic lupus erythematosus with joint or skin involvement.","evidence":"Limited"},{"condition":"Vasculitis","description":"May be used off-label in certain types of vasculitis to control inflammation.","evidence":"Limited"}]

Primary treatment for: Rheumatoid arthritis

Also treats: Psoriasis, Acute lymphoblastic leukemia, Osteosarcoma, Non-Hodgkin lymphoma, Ectopic pregnancy

📋 Drug Information

Generic Name(s)Methotrexate (50mg/2ml)
Brand NameTrexova 50mg Injection
ManufacturerNeova Biogene Private Limited
Packaging / Formvial of 2 ml Injection (Allopathy)
Therapeutic Class
Action Class
Route of AdministrationParenteral (intravenous, intramuscular, or intrathecal depending on indication)
StorageStore refrigerated at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. Keep in the original carton until use.
Shelf Life24 months from the date of manufacture.
WHO GuidelineMethotrexate is included in the WHO Model List of Essential Medicines for the treatment of certain cancers and autoimmune diseases.
ICMR GuidelineICMR guidelines recommend methotrexate as a first-line DMARD for rheumatoid arthritis, with regular monitoring.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Ensure regular monitoring of complete blood counts, liver enzymes, and kidney function.
2
Prescribe folic acid supplementation to reduce side effects, except on the day of methotrexate administration.
3
Advise patients to avoid alcohol completely during treatment.
4
Use effective contraception for both male and female patients during and after treatment.
5
Educate patients about the signs of infection, bleeding, and liver toxicity.
6
Adjust dose in elderly patients and those with renal impairment.
7
Avoid concomitant use of NSAIDs and aspirin unless absolutely necessary.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Chronic joint pain
This medicine is commonly prescribed for rheumatoid arthritis.
Likely Use
✅
Skin plaques
This medicine is used for severe psoriasis.
Likely Use
❌
Fever
This medicine is not a primary fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionMethotrexate is administered parenterally, so absorption is complete and rapid. The bioavailability is approximately 100% for intravenous and intramuscular routes.
DistributionMethotrexate distributes widely into body tissues, including the liver, kidneys, and spleen. It can cross the blood-brain barrier at high doses. The volume of distribution is approximately 0.4 to 0.8 L/kg.
Protein BindingApproximately 50% bound to plasma proteins, mainly albumin.
MetabolismMethotrexate is partially metabolized in the liver to polyglutamated forms, which are retained in cells and prolong its effects. It is also converted to 7-hydroxymethotrexate, which is less active.
Half-LifeThe elimination half-life is approximately 3 to 10 hours for low doses and 8 to 15 hours for high doses. It may be prolonged in patients with renal impairment.
ExcretionPrimarily excreted unchanged in the urine by glomerular filtration and active tubular secretion. About 80-90% of a dose is excreted in the urine within 24 hours.
BioavailabilityApproximately 100% for parenteral administration.
Onset of ActionFor cancer, effects may be seen within days to weeks. For autoimmune diseases, clinical improvement typically takes 3 to 6 weeks.
Peak Plasma TimePeak plasma concentrations are reached immediately after intravenous administration and within 30 to 60 minutes after intramuscular injection.
Duration of ActionThe duration of action varies with dose and indication. For low-dose weekly regimens, effects last for several days. For high-dose cancer therapy, effects may persist for weeks.

How It Works

Methotrexate inhibits the enzyme dihydrofolate reductase (DHFR), which converts dihydrofolate to tetrahydrofolate. Tetrahydrofolate is required for the synthesis of thymidylate and purines, which are building blocks of DNA and RNA. By blocking this pathway, methotrexate prevents cell division and slows the growth of rapidly dividing cells such as cancer cells and activated immune cells. In autoimmune diseases, it also reduces the production of inflammatory cytokines and promotes the release of adenosine, which has anti-inflammatory effects.

Mechanism Steps

1
Inhibition of DHFR: Methotrexate binds to and inhibits dihydrofolate reductase, blocking the conversion of dihydrofolate to tetrahydrofolate.
2
Depletion of tetrahydrofolate: Reduced tetrahydrofolate levels impair the synthesis of thymidylate and purines, which are essential for DNA and RNA production.
3
Inhibition of cell division: Without adequate DNA synthesis, rapidly dividing cells cannot proliferate, leading to cell cycle arrest and apoptosis.
4
Anti-inflammatory effects: In autoimmune diseases, methotrexate increases adenosine release and reduces cytokine production, resulting in immunosuppression and reduced inflammation.

💡 How to Take Trexova 50mg Injection

Strength: Injection: 50 mg/2 mL (25 mg/mL) in a single-use vial.

1This medicine is given by a healthcare professional.
2It may be administered intravenously, intramuscularly, or intrathecally.
3The injection site will be cleaned before administration.
4The dose and frequency will be determined by your doctor.
5Do not attempt to self-administer this medicine.

Dosage Information

Adult DosageThe dosage of this medicine is highly individualized and depends on the specific condition being treated, the patient's response, and other factors. For rheumatoid arthritis, a common regimen is 7.5 to 20 mg once weekly, either as a single dose or divided into three doses over 24 hours. For psoriasis, similar weekly doses are used. For cancer, doses can range from 30 to 500 mg/m² or more, given at varying intervals. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of methotrexate, especially bone marrow suppression and liver toxicity. Doses should be adjusted based on renal function and overall health. Close monitoring is required.
Renal ImpairmentDose reduction is required in patients with renal impairment. Methotrexate is contraindicated in severe renal impairment. For moderate impairment, doses should be reduced and monitored closely.
Hepatic ImpairmentDose reduction is required in patients with hepatic impairment. Methotrexate is contraindicated in severe hepatic impairment. Regular monitoring of liver enzymes is essential.
Maximum Daily DoseThe maximum dose varies widely by indication. For cancer, doses up to 12 g/m² have been used in specialized protocols. For autoimmune diseases, the maximum weekly dose is typically 25 mg. Doses must be determined by a qualified clinician.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset.
Grapefruit
Avoid
May increase drug levels.
Alcohol
Avoid completely
Increases risk of liver damage.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of Trexova 50mg Injection

✅ Common Side Effects

Nausea (Common (10-25%))
Take anti-nausea medication as prescribed. Eat small, frequent meals.
Vomiting (Common (5-15%))
Stay hydrated. Inform your doctor if vomiting is severe or persistent.
Mouth sores (Common (10-20%))
Maintain good oral hygiene. Use prescribed mouth rinses. Avoid spicy foods.
Fatigue (Common (10-20%))
Get adequate rest. Pace activities.
Hair thinning (Uncommon (5-10%))
Usually reversible after treatment ends. Discuss with your doctor if distressing.

🚨 Serious Side Effects

Bone marrow suppression (Uncommon (1-5%))
Regular blood tests are required. Report fever, sore throat, or unusual bleeding immediately.
Liver toxicity (Uncommon (1-5%))
Avoid alcohol. Report yellowing of eyes or skin, dark urine, or abdominal pain.
Kidney injury (Rare (<1%))
Stay well hydrated. Report decreased urine output or swelling.
Lung inflammation (pneumonitis) (Rare (<1%))
Report new or worsening cough, shortness of breath, or fever.
Severe skin reactions (Rare (<0.1%))
Seek immediate medical attention if you develop a rash, blisters, or peeling skin.

⚠️ Rare Side Effects

Leukoencephalopathy
Report confusion, seizures, or vision changes immediately.
Anaphylaxis
Seek emergency care for swelling of face, lips, or throat, or difficulty breathing.
Secondary malignancies
Long-term monitoring is required. Report any new lumps or unusual symptoms.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Warfarin Major
Ibuprofen Major
Aspirin Major
Trimethoprim-sulfamethoxazole Major
Probenecid Major
Penicillins Moderate
Phenytoin Moderate
Corticosteroids Moderate
Folic acid Minor
Caffeine Minor

🚨 Major Interactions

  • NSAIDs (e.g., ibuprofen, naproxen)
  • Aspirin
  • Probenecid
  • Trimethoprim-sulfamethoxazole
  • Live vaccines

⚡ Moderate Interactions

  • Penicillins
  • Corticosteroids
  • Phenytoin

🍷 Alcohol Interaction

Alcohol should be completely avoided while taking this medicine because it significantly increases the risk of liver damage and can worsen methotrexate toxicity.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Pregnancy or planning to become pregnant","Breastfeeding","Severe renal impairment","Severe hepatic impairment","Active infection","Bone marrow suppression","Hypersensitivity to methotrexate"]

⚠️ Warnings & Precautions

["This medicine should only be administered by a healthcare professional.","Regular blood tests are mandatory to monitor for toxicity.","Avoid alcohol completely during treatment.","Use effective contraception during and after treatment.","Do not receive live vaccines while on this medicine.","Report any signs of infection, bleeding, or unusual symptoms immediately.","High-dose therapy requires close monitoring and may require leucovorin rescue."]

🤱 Lactation Safety

Methotrexate is excreted in breast milk and may cause serious adverse effects in the nursing infant. Breastfeeding is contraindicated during treatment.

💊 Overdose Management

Overdose of methotrexate can cause severe bone marrow suppression, liver and kidney damage, and mucositis. Immediate medical attention is required. Treatment includes administration of leucovorin (folinic acid) as soon as possible, hydration, and supportive care. Hemodialysis may be considered in severe cases.

⏰ Missed Dose

If a dose is missed, contact your healthcare provider for guidance. Do not double the dose to catch up. The dosing schedule for this medicine is highly individualized and must be strictly followed.

Additional Safety Advice

General Safety

This medicine must only be administered by a healthcare professional. Do not attempt to self-inject. Regular blood tests are essential to monitor blood counts, liver function, and kidney function. Avoid alcohol completely during treatment as it increases the risk of liver damage. Use effective contraception during treatment and for several months after the last dose for both men and women. Do not receive live vaccines while on this medicine. Inform your doctor about all other medicines, especially NSAIDs, aspirin, and certain antibiotics, as they can interact dangerously. Report any signs of infection, unusual bleeding, or yellowing of the eyes or skin immediately.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of bone marrow suppression, liver toxicity, and kidney injury. Doses should be adjusted based on renal function, and monitoring should be more frequent.

🤰 Pregnancy Planning (TTC)

This medicine is contraindicated in pregnancy and should be stopped before attempting to conceive. Both men and women should use effective contraception during treatment and for at least 3 months after the last dose for women and 6 months for men. Consult your doctor for preconception counseling.

🏥 Post-Surgery Considerations

This medicine may impair wound healing and increase the risk of infection after surgery. Inform your surgeon that you are on this medicine. It may need to be temporarily stopped before surgery.

🦷 Dental Procedures

Inform your dentist that you are on this medicine. It may increase the risk of bleeding and infection during dental procedures. Your dentist may recommend postponing elective procedures until your blood counts are normal.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce joint stress.
🥗
Regular low-impact exercise like swimming.
😴
Practice good posture.
💧
Include anti-inflammatory foods in your diet.
🧘
Get adequate sleep.
🌞
Avoid smoking and alcohol.

🏋️ Exercise Considerations

Patients on this medicine may experience fatigue and muscle weakness. Avoid strenuous exercise until you know how the medicine affects you. Consult your doctor before starting any new exercise regimen.

🥗 Diet Recommendations

Include omega-3 rich foods
Reduce processed food intake
Stay well hydrated
Eat plenty of fruits and vegetables
Limit caffeine intake

💼 Impact on Daily Work & Life

This medicine may cause fatigue, dizziness, or nausea, which can affect your ability to drive or operate machinery. Avoid driving if you feel unwell. Discuss with your employer if you need accommodations during treatment.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. Stopping suddenly can cause a flare-up of your underlying condition. Your doctor will decide when and how to stop based on your response and any side effects.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to liver fibrosis, cirrhosis, and bone marrow suppression. Regular monitoring of liver enzymes and blood counts is essential. Patients on long-term therapy should be evaluated periodically for signs of toxicity. The risk of secondary malignancies may be slightly increased.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Physical therapy

Can complement medicine for chronic pain and improve joint function.

Evidence: Well-established
Dietary changes

Anti-inflammatory diet may help reduce symptoms of autoimmune diseases.

Evidence: Limited

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Live vaccines should be avoided during treatment with this medicine due to the risk of infection. Inactivated vaccines may be given, but the immune response may be reduced. Consult your doctor before receiving any vaccine.

📦 Storage Guide

✅ DO

Store refrigerated at 2°C to 8°C

❌ DON'T

Do not freeze

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Protect from light

❌ DON'T

Do not store at room temperature for prolonged periods

✈️ Traveling with This Medicine

When traveling with this medicine, carry it in its original packaging with the prescription label. Keep it refrigerated using a cool pack. Carry a copy of your prescription and a letter from your doctor explaining the need for the injection. Check airline regulations for carrying injectable medicines. Adjust dosing schedule for time zone changes only after consulting your doctor.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 52-year-old woman with severe rheumatoid arthritis
She had been struggling with joint pain and stiffness for years. Her doctor started her on this medicine weekly. After 6 weeks, she noticed significant improvement in her morning stiffness and could perform daily activities with less pain. She experienced mild nausea, which was managed with folic acid and anti-nausea medication.
💡 Lesson: Consistency with weekly dosing and regular monitoring can lead to significant improvement in autoimmune conditions.
👤 A 35-year-old man with psoriasis
His skin plaques were extensive and resistant to topical treatments. He was prescribed this medicine and after 8 weeks, his plaques began to clear. He was advised to avoid alcohol and to use sunscreen. He reported no serious side effects but had regular blood tests to monitor liver function.
💡 Lesson: Methotrexate can be effective for severe psoriasis, but lifestyle modifications and monitoring are crucial.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: For autoimmune diseases, improvement is usually seen within 3 to 6 weeks. For cancer, effects may be seen within days to weeks.

Q: Can I take this medicine if I am pregnant?

A: No, this medicine is contraindicated in pregnancy as it can cause serious harm to the baby.

Q: What should I avoid while taking this medicine?

A: Avoid alcohol, live vaccines, and NSAIDs unless approved by your doctor.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🛑 Myths vs. Facts

  • Myth: Methotrexate is only for cancer.
    Fact: Methotrexate is also used for autoimmune diseases like rheumatoid arthritis and psoriasis at lower doses.
  • Myth: Methotrexate is safe to take without monitoring.
    Fact: Regular blood tests are essential to monitor for liver, kidney, and bone marrow toxicity.
  • Myth: You can stop methotrexate suddenly without consulting your doctor.
    Fact: Stopping suddenly can cause flare-ups of the underlying disease. Always consult your doctor.

🔄 Alternative Options

Generic Alternatives

  • Methotrexate injection (generic)

Brand Alternatives

  • Methotrexate 50mg/2ml Injection (various manufacturers)

📊 Comparison with Similar Medicines

[{"medicine":"Methotrexate","class":"Antimetabolite/DMARD","route":"Parenteral","common_use":"Rheumatoid arthritis, cancer","monitoring":"CBC, LFT, RFT"},{"medicine":"Leflunomide","class":"DMARD","route":"Oral","common_use":"Rheumatoid arthritis","monitoring":"LFT, BP"},{"medicine":"Hydroxychloroquine","class":"DMARD","route":"Oral","common_use":"Rheumatoid arthritis, lupus","monitoring":"Eye exam"}]

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