Drug General Information (ID: DDI5871XNP)
Drug Name			Pemetrexed		Drug Info		Pralatrexate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Antimetabolites
Structure

Mechanism of Pemetrexed-Pralatrexate Interaction (Severity Level: Moderate)
Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph
Drug Name		Pemetrexed				Pralatrexate
Mechanism		Pemetrexed				Competitive inhibition of renal tubular secretion of pemetrexed
Key Mechanism Factor 1
		Factor Name		Renal tubular secretion
		Factor Description		Renal tubular secretion allows selective transfer of substances from the blood around the capillaries into the renal tubules via filtrate. Drug excretion may be reduced when two drugs compete for renal tubular secretion.
Mechanism Description		Decreased elimination of Pemetrexed caused by Pralatrexate mediated competitive inhibition of renal tubular secretion

Recommended Action
Management		Patients receiving pemetrexed in combination with other drugs that undergo active tubular secretion should be monitored for excessive pharmacologic effects of one or both drugs, and the dosages of the drugs adjusted if necessary. The potential for increased toxicity of pemetrexed such as bone marrow suppression should be considered. Renal function should be closely monitored during therapy.

References
1	Product Information. Alimta (pemetrexed). Lilly, Eli and Company, Indianapolis, IN.