Details of Drug

Drug General Information (ID: D1323)
Drug Name	Pralatrexate
Drug Type	Small molecule
Drug Synonymous	Folotyn (TN) Click to Show/Hide
Disease Class	2C60-2C6Y: Breast cancer; 2A90: Mature T-cell lymphoma
Therapeutic Class	Antimetabolites
Structure
Structure	3D Structure		2D Structure
Formula	C23H23N7O5
InChI	1S/C23H23N7O5/c1-2-3-14(10-15-11-26-20-18(27-15)19(24)29-23(25)30-20)12-4-6-13(7-5-12)21(33)28-16(22(34)35)8-9-17(31)32/h1,4-7,11,14,16H,3,8-10H2,(H,28,33)(H,31,32)(H,34,35)(H4,24,25,26,29,30)/t14?,16-/m0/s1
InChIKey	OGSBUKJUDHAQEA-WMCAAGNKSA-N
Canonical SMILES	C#CCC(CC1=CN=C2C(=N1)C(=NC(=N2)N)N)C3=CC=C(C=C3)C(=O)NC(CCC(=O)O)C(=O)O
External Link
	Pubchem ID	148121
	CAS Number	146464-95-1
	CHEBI ID	71223
	TTD ID	D02LWU
	INTEDE ID	DR1320
	VARIDT ID	DR00041

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism AM005 Affected excretion pathways AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM026 Increased metabolism (Unspecific) BM028 Competitive inhibition of renal tubular secretion BM032 Decreased renal excretion (Unspecific) BM043 Additive immunosuppressive effects BM044 Additive myelosuppressive effects BM055 Increased risk of hepatotoxicity BM100 Antagonize the effect of vaccine/toxoid BM105 Antagonize the effect of probiotics BM106 Diminish the response to diagnostic skin test antigens BM107 Attenuated pharmacological effects (Unspecific)
Relation Graph

Full list of drugs interacting with Pralatrexate
Affected intra/extra-hepatic metabolism
	Increased metabolism (Unspecific)					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1802		Glucarpidase	Zn4+8	21195079	Moderate		Inter Info	[7], [82]
Affected excretion pathways
	Competitive inhibition of renal tubular secretion					Drug Num: 9
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0489		Diflunisal	C13H8F2O3	3059	Moderate		Inter Info	[31]
D0576		Entecavir	C12H15N5O3	135398508	Moderate		Inter Info	[55]
D0645		Fenoprofen	C15H14O3	3342	Moderate		Inter Info	[31]
D0786		Ibuprofen	C13H18O2	3672	Moderate		Inter Info	[31]
D0881		Ketoprofen	C16H14O3	3825	Moderate		Inter Info	[31]
D0988		Meclofenamic acid	C14H11Cl2NO2	4037	Moderate		Inter Info	[31]
D0995		Meloxicam	C14H13N3O4S2	54677470	Moderate		Inter Info	[31]
D1109		Naproxen	C14H14O3	156391	Moderate		Inter Info	[31]
D1241		Pemetrexed	C20H21N5O6	135410875	Moderate		Inter Info	[72]
	Decreased renal excretion (Unspecific)					Drug Num: 13
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0017		Acetylsalicylic acid	C9H8O4	2244	Moderate		Inter Info	[31]
D0624		Etodolac	C17H21NO3	3308	Moderate		Inter Info	[31]
D0680		Flurbiprofen	C15H13FO2	3394	Moderate		Inter Info	[31]
D0800		Indomethacin	C19H16ClNO4	3715	Moderate		Inter Info	[31]
D0882		Ketorolac	C15H13NO3	3826	Moderate		Inter Info	[31]
D0991		Mefenamic acid	C15H15NO2	4044	Moderate		Inter Info	[31]
D1097		Nabumetone	C15H16O2	4409	Moderate		Inter Info	[31]
D1196		Oxaprozin	C18H15NO3	4614	Moderate		Inter Info	[31]
D0331		Choline salicylate	C12H19NO4	54686350	Moderate		Inter Info	[31]
D1439		Salicylic acid (sodium)	C7H6O3	338	Moderate		Inter Info	[31]
D1442		Salsalate	C14H10O5	5161	Moderate		Inter Info	[31]
D1520		Sulindac	C20H17FO3S	1548887	Moderate		Inter Info	[31]
D1606		Tolmetin	C15H15NO3	5509	Moderate		Inter Info	[31]
Pharmacodynamic additive effects
	Additive immunosuppressive effects					Drug Num: 37
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0023		Adalimumab	NA	NA	Major		Inter Info	[1], [2], [3], [4], [5], [6]
D0348		Cladribine	C10H12ClN5O3	20279	Major		Inter Info	[7], [8]
D0614		Etanercept	NA	NA	Major		Inter Info	[1], [2], [3], [4], [5], [6]
D0736		Golimumab	NA	NA	Major		Inter Info	[1], [2], [3], [4], [5], [6]
D0802		Infliximab	NA	NA	Major		Inter Info	[1], [2], [3], [4], [5], [6]
D1111		Natalizumab	NA	NA	Major		Inter Info	[13]
D0146		Baricitinib	C16H17N7O2S	44205240	Major		Inter Info	[17], [7], [18]
D0304		Certolizumab pegol	NA	NA	Major		Inter Info	[1], [5], [6]
D0661		Fingolimod	C19H33NO2	107970	Major		Inter Info	[21]
D1211		Ozanimod	C23H24N4O3	52938427	Major		Inter Info	[7], [23]
D1474		Siponimod	C29H35F3N2O3	44599207	Major		Inter Info	[17], [25]
D1600		Tofacitinib	C16H20N6O	9926791	Major		Inter Info	[29]
D0032		Alefacept	NA	NA	Moderate		Inter Info	[26], [32], [33]
D0033		Alemtuzumab	NA	NA	Moderate		Inter Info	[34]
D0085		Anakinra	C20H23N5O7S2	146171046	Moderate		Inter Info	[35], [36], [37]
D0136		Azathioprine	C9H7N7O2S	2265	Moderate		Inter Info	[17], [7]
D0246		Canakinumab	NA	NA	Moderate		Inter Info	[35], [36], [37]
D0313		Chloramphenicol	C11H12Cl2N2O5	5959	Moderate		Inter Info	[17], [7], [49]
D0314		Chloramphenicol (ophthalmic)	C11H12Cl2N2O5	5959	Moderate		Inter Info	[17], [7], [49]
D0443		Denosumab	NA	NA	Moderate		Inter Info	[51]
D0553		Efalizumab	NA	NA	Moderate		Inter Info	[52]
D1174		Omacetaxine mepesuccinate	C29H39NO9	285033	Moderate		Inter Info	[68]
D1855		Palifermin	NA	NA	Moderate		Inter Info	[69]
D0499		Dimethyl fumarate	C6H8O4	637568	Moderate		Inter Info	[81]
D0507		Diroximel fumarate	C11H13NO6	73330464	Moderate		Inter Info	[81]
D1085		Monomethyl fumarate	C5H6O4	5369209	Moderate		Inter Info	[81]
D1140		Niraparib	C19H20N4O	24958200	Moderate		Inter Info	[87]
D1162		Ocrelizumab	NA	NA	Moderate		Inter Info	[88]
D1167		Olaparib	C24H23FN4O3	23725625	Moderate		Inter Info	[7], [89]
D1375		Radium Ra 223 dichloride	NA	NA	Moderate		Inter Info	[97]
D1487		Sodium phosphate, monobasic (p32)	NA	NA	Moderate		Inter Info	[101]
D1509		Strontium chloride Sr-89	Cl2Sr	5388879	Moderate		Inter Info	[17], [7], [102]
D1366		Pyrimethamine	C12H13ClN4	4993	Moderate		Inter Info	[7], [102]
D1403		Rilonacept	NA	NA	Moderate		Inter Info	[35], [36], [37]
D1422		Roflumilast	C17H14Cl2F2N2O3	449193	Moderate		Inter Info	[7], [103]
D1671		Ustekinumab	NA	NA	Moderate		Inter Info	[108]
D1720		Zidovudine	C10H13N5O4	35370	Moderate		Inter Info	[17], [7], [109]
	Additive myelosuppressive effects					Drug Num: 5
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0370		Clozapine	C18H19ClN4	135398737	Major		Inter Info	[7], [9], [10]
D0433		Deferiprone	C7H9NO2	2972	Major		Inter Info	[17], [19], [20]
D1443		Samarium (153Sm) lexidronam	Sm	23951	Major		Inter Info	[30]
D0710		Ganciclovir	C9H13N5O4	135398740	Moderate		Inter Info	[17], [7], [59], [60]
D1676		Valganciclovir	C14H22N6O5	135413535	Moderate		Inter Info	[17], [7], [59], [60]
	Increased risk of hepatotoxicity					Drug Num: 23
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0900		Leflunomide	C12H9F3N2O2	3899	Major		Inter Info	[11]
D1073		Mipomersen	C230H324N67O122P19S19	118984467	Major		Inter Info	[12]
D0944		Lomitapide	C39H37F6N3O2	9853053	Major		Inter Info	[22]
D1258		Pexidartinib	C20H15ClF3N5	25151352	Major		Inter Info	[24]
D1556		Teriflunomide	C12H9F3N2O2	54684141	Major		Inter Info	[11]
D0114		Asparaginase Escherichia coli	NA	NA	Moderate		Inter Info	[38], [39], [40], [17], [7], [41], [42], [43], [44], [45], [46], [47], [48]
D0357		Clofarabine	C10H11ClFN5O3	119182	Moderate		Inter Info	[50]
D0554		Efavirenz	C14H9ClF3NO2	64139	Moderate		Inter Info	[53], [54]
D0826		Interferon beta-1a	NA	NA	Moderate		Inter Info	[61], [62], [63], [64]
D0827		Interferon beta-1b	NA	NA	Moderate		Inter Info	[61], [62], [63], [64]
D1025		Methotrexate	C20H22N8O5	126941	Moderate		Inter Info	[7], [66]
D1106		Naltrexone	C20H23NO4	5360515	Moderate		Inter Info	[67]
D1234		Pegaspargase	C14H19NO	436058	Moderate		Inter Info	[38], [39], [40], [17], [7], [41], [42], [43], [44], [45], [46], [47], [48]
D0113		Asparaginase Erwinia chrysanthemi	NA	NA	Moderate		Inter Info	[38], [39], [40], [17], [7], [41], [42], [43], [44], [45], [46], [47], [48]
D0149		Bedaquiline	C32H31BrN2O2	5388906	Moderate		Inter Info	[75]
D0199		Brentuximab vedotin	NA	NA	Moderate		Inter Info	[76]
D0232		Calaspargase pegol	NA	NA	Moderate		Inter Info	[38], [39], [40], [17], [7], [41], [42], [43], [44], [45], [46], [47], [48]
D0248		Cannabidiol	C21H30O2	644019	Moderate		Inter Info	[7], [80]
D0789		Idelalisib	C22H18FN7O	11625818	Moderate		Inter Info	[83]
D1239		Peginterferon beta-1a	NA	NA	Moderate		Inter Info	[61], [62], [63], [64]
D1389		Remdesivir	C27H35N6O8P	121304016	Moderate		Inter Info	[17], [7], [98], [99], [100]
D1589		Tioguanine	C5H5N5S	2723601	Moderate		Inter Info	[105], [106]
D1615		Trabectedin	C39H43N3O11S	108150	Moderate		Inter Info	[7], [107]
Pharmacodynamic antagonistic effects
	Antagonize the effect of vaccine/toxoid					Drug Num: 23
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1744		Bacillus calmette-guerin substrain tice live antigen	NA	NA	Major		Inter Info	[14], [15], [16]
D1839		Measles virus vaccine live attenuated	NA	NA	Major		Inter Info	[14], [15], [16]
D1849		Mumps virus strain B level jeryl lynn live antigen	NA	NA	Major		Inter Info	[14], [15], [16]
D1881		Rotavirus vaccine	NA	NA	Major		Inter Info	[14], [15], [16]
D1882		Rubella virus vaccine	NA	NA	Major		Inter Info	[14], [15], [16]
D1890		Smallpox (Vaccinia) Vaccine, Live	NA	NA	Major		Inter Info	[26], [17], [27]
D1897		Talimogene laherparepvec	NA	NA	Major		Inter Info	[28]
D1914		Typhoid vaccine (live)	NA	NA	Major		Inter Info	[14], [15], [16]
D1920		Varicella Zoster Vaccine (Recombinant)	NA	NA	Major		Inter Info	[14], [15], [16]
D1922		Yellow Fever Vaccine	NA	NA	Major		Inter Info	[14], [15], [16]
D1838		Lyme disease vaccine (recombinant OspA)	NA	NA	Moderate		Inter Info	[65]
D0089		Anthrax vaccine	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0366		Clostridium tetani toxoid antigen (formaldehyde inactivated)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0755		Hepatitis A Vaccine	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0756		Hepatitis B Vaccine (Recombinant)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0767		Human papillomavirus type 11 L1 capsid protein antigen	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0803		Influenza A virus A/California/7/2009 (H1N1)-like antigen (propiolactone inactivated)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0804		Influenza A virus A/Vietnam/1194/2004 (H5N1) antigen (formaldehyde inactivated)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D0999		Meningococcal polysaccharide vaccine group C	NA	NA	Moderate		Inter Info	[26], [73], [74]
D1259		Pfizer-BioNTech Covid-19 Vaccine	NA	NA	Moderate		Inter Info	[90], [26], [17], [91], [92], [93], [73], [94], [95], [96], [74]
D1307		Poliovirus type 1 antigen (formaldehyde inactivated)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D1662		Typhoid vaccine (inactivated)	NA	NA	Moderate		Inter Info	[26], [73], [74]
D1692		Vibrio cholerae CVD 103-HgR strain live antigen	NA	NA	Moderate		Inter Info	[26], [73], [74]
	Antagonize the effect of probiotics					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1827		Lactobacillus acidophilus	NA	NA	Moderate		Inter Info	[84], [85], [86]
	Diminish the response to diagnostic skin test antigens					Drug Num: 4
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1755		Candida albicans	C29H27N2O12P	118855431	Moderate		Inter Info	[77], [78], [79]
D1765		Coccidioides immitis spherule	NA	NA	Moderate		Inter Info	[77], [78], [79]
D1912		Trichophyton mentagrophytes	NA	NA	Moderate		Inter Info	[77], [78], [79]
D1913		Tuberculin purified protein derivative	NA	NA	Moderate		Inter Info	[77], [78], [79]
	Attenuated pharmacological effects (Unspecific)					Drug Num: 4
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0659		Filgrastim	NA	NA	Moderate		Inter Info	[56], [57], [58]
D1235		Pegfilgrastim	C27H46N4O19	70683024	Moderate		Inter Info	[70], [71]
D1884		Sapropterin	C9H15N5O3	135398654	Moderate		Inter Info	[17], [104]
D1446		Sargramostim	NA	NA	Moderate		Inter Info	[56], [57], [58]

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78	Product Information. Candin (candida albicans extract). Nielsen Biosciences Inc, San Diego, CA.
79	Product Information. Spherulin (coccidioidin skin test). ALK Laboratories Inc, Wallingford, CT.
80	Product Information. Epidiolex (cannabidiol). Greenwich Biosciences Inc, Carlsbad, CA.
81	Product Information. Vumerity (diroximel fumarate). Alkermes, Inc, Cambridge, MA.
82	Product Information. Voraxaze (glucarpidase). BTG International Inc, West Conshohocken, PA.
83	Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
84	Borriello SP, Hammes WP, Holzapfel W, et.al "Safety of probiotics that contain lactobacilli or bifidobacteria." Clin Infect Dis 36 (2003): 775-80. [PMID: 12627362]
85	Schlegel L, Lemerle S, Geslin P "Lactobacillus species as opportunistic pathogens in immunocompromised patients." Eur J Clin Microbiol Infect Dis 17 (1998): 887-8. [PMID: 10052559]
86	Salminen MK, Tynkkynen S, Rautelin H, et al. "Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland." Clin Infect Dis 35 (2002): 1155-60. [PMID: 12410474]
87	Product Information. Zejula (niraparib). Tesaro Inc., Waltham, MA.
88	Product Information. Ocrevus (ocrelizumab). Genentech, South San Francisco, CA.
89	Product Information. Lynparza (olaparib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.
90	CDC Centers for Disease Control and Prevention "General Best Practice Guidelines for Immunization: Altered Immunocompetence." .
91	Product Information. Biothrax (anthrax vaccine adsorbed). Emergent BioSolutions Inc., Lansing, MI.
92	Product Information. Fluzone Influenza Vaccine (influenza virus vaccine). Connaught, Swiftwater, PA.
93	Product Information. Havrix (hepatitis A vaccine). SmithKline Beecham, Philadelphia, PA.
94	Product Information. Influenza Virus Vaccine, H5N1, Inactivated (influenza virus vaccine, H5N1, inactivated). GlaxoSmithKline, Research Triangle Park, NC.
95	Product Information. Omnihib (haemophilus b conjugate vaccine). SmithKline Beecham, Philadelphia, PA.
96	CDC Centers for Disease Control and Prevention "Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.".
97	Product Information. Xofigo (radium Ra 223 dichloride). Bayer Pharmaceutical Inc, West Haven, CT.
98	European Medicines Agency "Summary on compassionate use. Remdesivir Gilead.".
99	Gilead Sciences, Inc "About Remdesivir.".
100	US Food and Drug Administration "Fact sheet for health care providers emergency use authorization (EUA) of remdesivir (GS-5734TM)".
101	AnazaoHealth Corporation "P32 Sodium Phosphate."
102	Multum Information Services, Inc. Expert Review Panel.
103	Product Information. Daxas (roflumilast). Nycomed Inc, Princeton, NJ.
104	Product Information. Kuvan (sapropterin). BioMarin Pharmaceutical Inc, Novato, CA.
105	Product Information. Aubagio (teriflunomide). Genzyme Corporation, Cambridge, MA.
106	Product Information. Tabloid (thioguanine). Prasco Laboratories, Cincinnati, OH.
107	Product Information. Yondelis (trabectedin). Janssen Pharmaceuticals, Titusville, NJ.
108	Product Information. Stelara (ustekinumab). Centocor Inc, Malvern, PA.
109	Product Information. Retrovir (zidovudine). Glaxo Wellcome, Research Triangle Park, NC.

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