Drug General Information (ID: DDIJCELGYF)
Drug Name			Phenoxymethylpenicillin		Drug Info		Pemetrexed		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antibiotics				Antineoplastics
Structure

Mechanism of Phenoxymethylpenicillin-Pemetrexed Interaction (Severity Level: Moderate)
Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph
Drug Name		Phenoxymethylpenicillin				Pemetrexed
Mechanism		Competitive inhibition of renal tubular secretion of pemetrexed				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 Phenoxymethylpenicillin 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.