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Trimetrexate glucuronate is a synthetic non-classical folate antagonist that inhibits the enzyme dihydrofolate reductase (DHFR). It is primarily used for the treatment of moderate-to-severe Pneumocystis carinii pneumonia (PCP) in immunocompromised patients, particularly those with AIDS. Due to its potentially serious toxicities, it must be administered with concurrent leucovorin (leucovorin protection) to prevent life-threatening side effects.
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