Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For raltitrexed, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to raltitrexed.

Pregnancy—Tell your doctor if you are pregnant or if you intend to have children. There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Raltitrexed causes toxic or harmful effects in rats. In addition, many cancer medicines may cause sterility which could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving raltitrexed. Tell your doctor right away if you think you have become pregnant while receiving raltitrexed. Because raltitrexed may cause serious side effects, pregnancy is generally not recommended while you are taking it.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because raltitrexed may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of raltitrexed in children with use in other age groups.

Older adults—Elderly people are especially sensitive to the effects of raltitrexed. Raltitrexed may be more likely to cause side effects such as cracked lips, diarrhea, difficulty in swallowing, sores, ulcers, or white spots on the lips, tongue, or inside the mouth in elderly patients.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving raltitrexed, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Rheumatrex) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines—Raltitrexed may increase the effects of these medicines or radiation therapy on the blood
• Folic acid or
• Leucovorin (e.g., Wellcovorin) or
• Vitamin preparations containing folic or folinic acid—May interfere with the effectiveness of raltitrexed

Other medical problems—The presence of other medical problems may affect the use of raltitrexed. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Infection—Raltitrexed can decrease your body's ability to fight infection

• Kidney disease or
• Liver disease—Effects of raltitrexed may be increased because of slower removal from the body; your doctor may need to change your dose