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( rall-tee-TREX-edd )
Other Name(s): Tomudex® (Pfizer)
Apparence: Colourless solution mixed into larger bags of fluids

Medication Information Sheet
raltitrexed (rall-tee-TREX-edd)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Tomudex®

Colourless solution

mixed into larger bags of fluids

What is this medication for?
  • For treating cancer of the colon or rectum, or to treat a type of cancer that affects the inside lining of the chest cavity
What should I do before I have this medication?
  • Tell  your doctor and pharmacist if you have/had significant medical condition(s), especially if you have / had kidney or liver disease, prior radiation treatment, or any allergies.
  • People who have cancer or leukemia are at a higher risk of developing other cancers/leukemias (usually some years later) or blood clots. Some cancer medications may increase these risks, especially if used for a prolonged period of time. You should discuss any concerns with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Raltitrexed can harm the unborn baby and should not be used by pregnant women.
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: ►Use 2 effective forms of birth control at the same time while taking this drug. Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while on raltitrexed treatment.
  • Effects on Fertility: Probable
How is this medication given?
  • This drug is given by injection into a vein.



What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
What are the side effects of this medication?

The following side effects are common or severe. You may not have all of the side effects, while others may occur. Discuss with your doctor if you have any unusual or bothersome symptoms.

Side effects and what to do When to contact doctor?
More Common Side Effects

Nausea and vomiting

  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.  Also see Nausea & Vomiting pamphlet.*




Contact your health care team if no improvement or if severe


  • Rest often; take naps if needed. Move slowly when getting up.
  • Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
  • Do not drive a motor vehicle or operate machinery when feeling tired.
Contact your health care team if no improvement or if severe

Diarrhea (may be severe)

  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Also see Diarrhea pamphlet.*
Contact your health care team if no improvement or if severe

Poor Appetite; don't feel like eating; weight loss

  • Eat foods that you like and try to eat regular small meals.
  • Use meal supplements if possible.  See a dietitian.
Contact your health care team if no improvement or if severe

Abnormal liver lab tests

  • Your doctor will monitor these regularly.  Call your doctor if you have yellowish skin or eyes, or unusual dark urine.
Contact your health care team if no improvement or if severe

Pains or cramps in the belly

  • Treat constipation or diarrhea.
  • May be due to other causes; check with your doctor or nurse if pain is severe, does not go away or worsens.
Contact your health care team if no improvement or if severe


  • Eat a balanced diet with fibres such whole grains, fruit and raw vegetables.
  • Drink plenty of fluids. Try light exercise regularly.
  • Speak to your doctor if no bowel movement for 3 or more days.
  • Also see Constipation Pamphlet.*
Contact your health care team if no improvement or if severe

Rash; itchy skin

  • Stay out of the sun; wear sunblock, a hat and cover exposed skin.
  • Use daily moisturizer.


Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Mouth sores

  • Maintain good mouth hygiene. Regular teeth brushing with a soft toothbrush or Toothette®, and regular use of alcohol-free mouthwashes.
  • Instead, try a homemade mouthwash: 
    Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
  • Avoid hot, spicy, acidic, hard or crunchy foods.
  • Check with your doctor or nurse as soon as you notice sores in mouth/lips or pain with swallowing. Your doctor may prescribe a prescription mouthwash to relieve mouth sores and prevent infection.
  • Also see Mouth Care pamphlet.*
Contact your health care team as soon as possible

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Heart problems
(irregular heartbeat, chest pain, fainting, shortness of breath)

Get emergency medical help right away

For more links on how to manage your symptoms go to

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.