Trexate® 1000mg/40ml Injection (Methotrexate) – Chemotherapy (Rx)

Quick answer: Trexate 1000mg (methotrexate) is a large 40ml vial used mainly for high-dose chemotherapy in osteosarcoma, acute lymphoblastic leukaemia and some lymphomas. It runs as a drip into a vein during a hospital stay. MedHub supplies it on prescription and delivers to hospitals and families anywhere in Pakistan.

For patients and families

What is Trexate 1000mg?

Trexate 1000mg holds one gram of methotrexate in 40ml of solution. Pharmasol makes it in Pakistan. Methotrexate starves dividing cells of the folate they need to build new DNA. This big vial lets hospital pharmacies prepare the very large doses that some cancer protocols call for, without opening dozens of small vials.

What is it used for?

Oncologists and haematologists use high-dose methotrexate in:

• Osteosarcoma, a bone cancer most common in teenagers and young adults, usually after or around surgery
• Acute lymphoblastic leukaemia, in children and adults, including treatment aimed at the brain and spinal fluid
• Non-Hodgkin lymphoma, particularly types with a high risk of spreading to the brain

Lower-dose methotrexate also treats other cancers, but those regimens normally use smaller vials.

How is it given?

Trexate 1000mg goes into a vein as a drip, usually over several hours, while you stay on the ward. Before the drip starts, nurses give you extra fluids and a medicine that makes your urine less acidic, which protects the kidneys. About a day later you start folinic acid, often called the rescue, to protect healthy cells. Nurses test your blood each day until the methotrexate level falls low enough for you to go home. Your doctor decides the dose.

Common side effects

• Painful mouth sores and difficulty swallowing
• Feeling sick or vomiting
• Changes in kidney or liver blood tests
• A drop in blood counts a week or so after treatment
• Skin rash or sensitivity to sunlight

Tell the ward team straight away if you pass much less urine, feel very drowsy or confused, have a seizure, or develop fever, bleeding or a cough at home after discharge.

Storage

The vial stays below 25°C inside its carton to keep light out. The hospital pharmacy stores it and prepares each bag under sterile conditions.

How to order from MedHub

1. Send a photo of your prescription on WhatsApp.
2. Our pharmacist confirms the price and stock with you.
3. We deliver the vials directly to the treating hospital or to your home.

Relatives in the UAE, UK and Saudi Arabia often organize Trexate 1000mg for a young family member in Pakistan through MedHub. Small top-up amounts come from Trexate 50mg/2ml vials. Osteosarcoma protocols commonly add Cispatin 50mg (cisplatin) and Naprodox 50mg (doxorubicin), and our whole range is listed under oncology medicines.

For healthcare professionals

• Composition: methotrexate 1000 mg/40 ml (25 mg/ml) solution for injection
• Drug class: folate antagonist antimetabolite
• Indications: non-metastatic osteosarcoma (high-dose methotrexate with folinic acid rescue, within combination chemotherapy); acute lymphoblastic leukaemia; non-Hodgkin lymphoma; other methotrexate-responsive malignancies per the approved label
• Mechanism: dihydrofolate reductase inhibition leading to depletion of tetrahydrofolate and arrest of DNA synthesis
• Label dose: osteosarcoma 12 g/m² as a 4-hour IV infusion, increased to 15 g/m² if the target peak level is not reached, with folinic acid rescue starting 24 hours after the start of the infusion; other indications per protocol. Not for intrathecal use
• Monitoring / key precautions: pre-hydration and urine alkalinization (urine pH 7 or above); serum methotrexate levels at set time points until below the protocol threshold; daily creatinine; adjust folinic acid for delayed clearance; glucarpidase for toxic levels with renal impairment; avoid NSAIDs, PPIs, penicillins and co-trimoxazole; drain third-space fluid collections; contraindicated in pregnancy
• Storage: below 25°C, protected from light
• Manufactured and marketed in Pakistan by: Pharmasol (Pvt) Ltd
• Pack: 1 vial

Frequently asked questions

What is Trexate 1000mg used for?

Trexate 1000mg is used for high-dose chemotherapy in osteosarcoma, acute lymphoblastic leukaemia and certain non-Hodgkin lymphomas. It is a hospital-only treatment.

What is the Trexate 1000mg price in Pakistan?

Trexate 1000mg costs Rs 3,800 per vial. Prices can change with supply, so message us on WhatsApp for today’s price before you order.

Can MedHub deliver Trexate 1000mg in Lahore, Karachi or Peshawar?

Yes. We supply hospitals and patients in Islamabad, Rawalpindi, Lahore, Karachi, Peshawar, Multan, Faisalabad and other cities.

Is Trexate 1000mg sold without a prescription?

No. High-dose methotrexate needs an oncologist’s prescription and hospital monitoring. Send the prescription on WhatsApp and our pharmacist checks it first.

Why must I stay in hospital for Trexate 1000mg?

High-dose methotrexate needs fluids, urine checks and daily blood levels for two to three days or more. The team can act quickly if your kidneys clear the medicine too slowly.

What is folinic acid rescue after Trexate 1000mg?

Folinic acid is a form of the vitamin folate that the team gives on a fixed schedule after the drip. It protects healthy cells in the mouth, gut and bone marrow, and you must not miss a dose.

How is Trexate 1000mg stored?

Keep it below 25°C in the original carton to protect it from light. Hand it to the hospital pharmacy promptly after delivery.

Can I order Trexate 1000mg from abroad for family in Pakistan?

Yes. Families in the UAE, UK and Saudi Arabia order through us for relatives in Pakistan. Send the prescription on WhatsApp and we coordinate payment and delivery to the hospital.

Last updated: 3 October 2026

This information is for general awareness only and is not medical advice. Always consult your doctor before starting, stopping or changing any medicine.