Xatmep

Xatmep is a prescription medication used to treat acute lymphoblastic leukemia (ALL) and active polyarticular juvenile idiopathic arthritis (pJIA). 

Xatmep belongs to a group of drugs called antimetabolites. These work by inhibiting the immune system and slowing the growth of cancer cells.

Xatmep comes as a solution and is taken by mouth once weekly, with or without food. Xatmep should only be taken orally with an approved measuring device from your healthcare provider or pharmacist. 

Common side effects of Xatmep include stomach ulcers, a decrease in white blood cells, nausea, and stomach pain. 

WARNING:

• Xatmep should be used only in life threatening neoplastic diseaes, or in patients with psoriasis or rheumatoid athritis with sever, recalcitrant, disabiling disease which is not adequately responsive to other forms of therapy
• Deaths have been reported with the use of Xatmep in the treatment of malignancy, psoriasis, and rheumatoid arthritis. Patients should be closely monitored for bone marrow, liver, lung, and kidney toxicity
• Patients should be informed by their physician of the risks involved and be under a phsycian's care throughout therapy
• Xatmep has been reported to cause fetal death and/or congenital anomalies.Therefore, it is not recommended for women of childbearing potential unless there is clear medical evidence that the benefits can be expected to outweigh the considered risks. Pregnant women with psoriasis or rheumatoid arthritis should not receive methotrexate
• Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs)
• Xatmep elimination is reduced in patients with impaired renal functions, ascites, or pleural effusions. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of Xatmep administration
• Xatmep causes hepatotoxicity, fibrosis and cirrhosis, but generally only after prolonged use. Acutely, liver enzyme elevations are frequently seen. These are usually transient and asymptomatic, and also do not appear predictive of subsequent hepatic disease. Liver biopsy after sustained use often shows histologic changes, and fibrosis and cirrhosis have been reported; these latter lesions may not be preceded by symptoms or abnormal liver function tests in the psoriasis population. For this reason, periodic liver biopsies are usually recommended for psoriatic patients who are under long-term treatment. Persistent abnormalities in liver function tests may precede appearance of fibrosis or cirrhosis in the rheumatoid arthritis population
• Xatmep-induced lung disease, including acute or chronic interstitial pneumonitis, is a potentially dangerous lesion, which may occur acutely at any time during therapy and has been reported at low doses. It is not always fully reversible and fatalities have been reported. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation
• Diarrhea and ulcerative stomatitis require interruption of therapy: otherwise, hemorrhagic enteritis and death from intestinal perforation may occur. Malignant lymphomas, which may regress following withdrawal of Xatmep, may occur in patients receiving low-dose Xatmep and, thus, may not require cytotoxic treatment. Discontinue methotrexate first and, if the lymphoma does not regress, appropriate treatment should be instituted
• Like other cytotoxic drugs, Xatmep may induce“tumor lysis syndrome” in patients with rapidly growing tumors. Appropriate supportive and pharmacologic measures may prevent or alleviate this complication
• Severe, occasionally fatal, skin reactions have been reported following single or multiple doses of Xatemp. Reactions have occurred within days of oral Xatmep administration. Recovery has been reported with discontinuation of therapy.
• Potentially fatal opportunistic infections, especially Pneumocystis carinii pneumonia, may occur with Xatmep therapy
• Xamep given concomitantly with radiotherapy may increase the risk of soft tissue necrosis and osteonecrosis