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If you have psoriasis, rheumatoid arthritis, or cancer, your healthcare provider may recommend a drug called Trexall. This product is similar to Rheumatrex and other medications used for these conditions, except it comes in higher strengths. The medicine comes in the form of a tablet that is taken by mouth. Possible side effects include mouth sores, nausea, and low white blood cell counts.

What Is Trexall?

Trexall™ (methotrexate) is a prescription medication approved to treat rheumatoid arthritis, various types of cancer, and psoriasis. It is different from Rheumatrex® and generic forms of methotrexate in that it comes in higher strengths, which are convenient for people who would otherwise need to take several Rheumatrex or generic methotrexate tablets for a single dose.
(Click Trexall Uses for more information on this topic, including possible off-label uses.)

Who Makes It?

Currently, brand-name Trexall is made by Teva Pharmaceuticals, Inc.

How Does Trexall Work?

It works by inhibiting an enzyme known as dihydrofolic acid reductase (also known as dihydrofolate reductase). This enzyme is important for transforming an inactive form of folic acid into the active form, which is necessary to make some of the building blocks required for DNA production. By inhibiting this enzyme, Trexall interferes with a cell's ability to repair and replicate (copy) itself.
Although Trexall can damage healthy cells as well as unhealthy cells, it tends to target rapidly replicating cells, such as cancer cells and bone marrow cells.
It is not entirely clear how this medication works to treat rheumatoid arthritis, although it is thought to work by affecting the immune system.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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