Trimetrexate is a quinazoline derivative. It is a dihydrofolate reductase inhibitor. Trimetrexate is a quinazoline derivative. It is a dihydrofolate reductase inhibitor. It has been used with leucovorin in treating pneumocystis pneumonia. It has been investigated for use in treating leiomyosarcoma.It is a methotrexate (MTX) analog that is active against transport-deficient MTX-resistant tumor cells that overcome the acquired and natural resistance to methotrexate. Other uses include skin lymphoma.