Raltitrexed (Tomudex®)
Raltitrexed (pronounced ral-ti-trex-ed) is a chemotherapy drug that is given as a treatment for some types of cancer. It is also known as Tomudex®. It is most commonly used to treat cancer of the large bowel. This information describes raltitrexed, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy.
If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.
- What raltitrexed looks like
- How it is given
- Possible side effects
- Less common side effects
- Additional information
What raltitrexed looks like
Raltitrexed is a colourless fluid after being dissolved from powdered form.
How it is given
Raltitrexed may be given:
- as a drip (infusion) through a fine tube (cannula) inserted into a vein. It is given over a short period of time
- through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line, which is inserted into a vein in the crook of the arm.
Possible side effects
Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given raltitrexed and may be different if you are having more than one chemotherapy drug.
We have outlined the most common and less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
Nausea (feeling sick) and vomiting If you feel sick it may begin a few hours after the treatment is given and can last for up to a day. This is usually mild and your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled or continues, tell your doctor, who can prescribe other anti-sickness drugs that may be more effective.
Loss of appetite This is also usually mild and may last a day or so. A dietitian or specialist nurse at your hospital can give you advice on boosting your appetite, coping with eating difficulties and maintaining weight. The dietitian at the hospital can be very helpful.
Diarrhoea This can usually be easily controlled with medicine, but tell your doctor if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.
Lowered resistance to infection Raltitrexed can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels before your next cycle of chemotherapy is due.
Contact your doctor or the hospital straightaway if:
- Your temperature goes above 38ºC (100.5ºF)
- You suddenly feel unwell (even with a normal temperature).
You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Bruising or bleeding Raltitrexed can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.
Anaemia (low number of red blood cells) While having treatment with raltitrexed you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these are a problem.
Temporary effect on liver function Raltitrexed may cause changes in the way that your liver works, though your liver will return to normal when the treatment is finished. You are very unlikely to notice any problems but your doctor will check your liver is working properly before each treatment.
Skin changes Raltitrexed can cause a rash, which may be itchy. Your doctor can prescribe medication to relieve the symptoms.
Tiredness and weakness Some people feel very tired when having raltitrexed and occasionally a flu-like illness may occur. You may have headaches, aching joints and muscles and a high temperature. It is important to let your doctor know immediately if you get a high temperature.
Less common side effects
Constipation Less commonly, raltitrexed can cause constipation, which is usually relieved by a high fibre diet or simple laxatives. Let your doctor know if you become constipated.
Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Taste change You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes
Hair loss This is rare with raltitrexed, but may occasionally happen. More commonly your hair may just thin. Hair loss is temporary and your hair will regrow once the treatment has finished.
Additional information
Other medicines Some other medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.
Contraception It is not advisable to become pregnant or father a child while taking raltitrexed, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.
