Pemxcel Drug Interactions

Pemetrexed is primarily eliminated unchanged renally as a result of glomerular filtration and tubular secretion. Concomitant administration of nephrotoxic drugs could result in delayed clearance of pemetrexed. Concomitant administration of substances that are also tubularly secreted (eg, probenecid) could potentially result in delayed clearance of pemetrexed.
Although ibuprofen (400 mg four times daily) can be administered with pemetrexed in patients with normal renal function (CrCl ≥80 mL/min), caution should be used when administering ibuprofen concurrently with pemetrexed to patients with mild to moderate renal insufficiency (CrCl 45-79 mL/min). Patients with mild to moderate renal insufficiency should avoid taking NSAIDs with short elimination t_½ for a period of 2 days before, the day of, and 2 days following administration of pemetrexed.
Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Patients with mild to moderate renal insufficiency should avoid taking NSAIDs with short elimination t_½ for a period of 306 of 2 days before, the day of, and 2 days following administration of Pemxcel injection. In the absence of data regarding potential interaction between Pemxcel injection and NSAIDs with longer t_½, all patients taking these NSAIDs should interrupt dosing for at least 5 days before, the day of, 2 days following Pemxcel injection administration. If concomitant administration of an NSAID is necessary, patients should be monitored closely for toxicity, especially myelosuppression, renal and gastrointestinal toxicity.
Nephrotoxic Drugs: Pemxcel injection is primarily eliminated unchanged renally as a result of glomerular filtration and tubular secretion. Concomitant administration of nephrotoxic drugs could result in delayed clearance of Pemxcel injection. Concomitant administration of substances that are also tubularly secreted (eg, probenecid) could potentially result in delayed clearance of Pemxcel injection.