Trexor Drug Interactions

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Although ibuprofen (400 mg four times a day) can decrease the clearance of pemetrexed, it can be administered with Pemetrexed in patients with normal renal function (creatinine clearance ≥80 mL/min). No dose adjustment of Pemetrexed is needed with concomitant NSAIDs in patients with normal renal function.
Caution should be used when administering NSAIDs concurrently with Pemetrexed to patients with mild to moderate renal insufficiency (creatinine clearance from 45 to 79 mL/min). NSAIDs with short elimination half-lives (e.g., diclofenac, indomethacin) should be avoided for a period of 2 days before, the day of, and 2 days following administration of Pemetrexed.
In the absence of data regarding potential interaction between Pemetrexed and NSAIDs with longer half-lives (e.g., meloxicam, nabumetone), patients taking these NSAIDs should interrupt dosing for at least 5 days before, the day of, and 2 days following Pemetrexed administration. If concomitant administration of NSAIDs is necessary, patients should be monitored closely for toxicity, especially myelosuppression, renal, and gastrointestinal toxicity.
Nephrotoxic Drugs: 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 (e.g., probenecid) could potentially result in delayed clearance of Pemetrexed.