|Recommended starting dose
||20 mg/m2 given one time weekly.
Instruct patients/caregivers that the recommended dose should
be taken weekly, as directed. Mistaken daily use has resulted
in fatal toxicity.
||Advise patients/caregivers to ask their pharmacist for an accurate (mL)
dosing device. Tell patients/caregivers that a household teaspoon is not
an accurate dosing device.
||After initiating Xatmep, continuation of appropriate dosing requires
periodic monitoring of absolute neutrophil count (ANC) and platelet count
to assure sufficient drug exposure (i.e., to maintain ANC at a desirable
level) and to adjust for excessive hematological toxicity.
Store refrigerated (2°C – 8°C/36°F – 46°F) in a tightly closed container. Patients may store Xatmep either refrigerated (2°C – 8°C/36°F – 46°F) or at room temperature (20°C – 25°C/68°F – 77°F); excursions permitted to 15°C – 30°C/59°F– 86°F. If stored at room temperature, discard after 60 days. Avoid freezing and excessive heat.
|If oral dosing is inappropriate
||Use another formulation of methotrexate.