Drug interactions
Acetylsalicylic acid + Pemetrexed
Severity: Moderate
Acetylsalicylic acid and Pemetrexed: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
NSAIDs including aspirin at anti-inflammatory doses can reduce pemetrexed clearance and increase its toxicity, including myelosuppression, renal and gastrointestinal effects. The risk is highest in patients with mild to moderate renal impairment.
What this interaction means in plain words
Acetylsalicylic acid and Pemetrexed can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Acetylsalicylic acid belongs to Musculoskeletal; Pemetrexed belongs to Oncology.
Why it happens
NSAID-related reduction in renal blood flow and glomerular filtration, and possible competition for tubular secretion, decreases pemetrexed elimination.
What to do
In patients with creatinine clearance below 80 mL/min avoid NSAIDs including higher-dose aspirin around pemetrexed dosing, following the labeled interruption periods based on half-life. Monitor blood counts and renal function if the combination cannot be avoided.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Pemetrexed
Frequently asked questions
Can I take Acetylsalicylic acid with Pemetrexed?
MediHelp rates the interaction as moderate. Acetylsalicylic acid and Pemetrexed can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. NSAIDs including aspirin at anti-inflammatory doses can reduce pemetrexed clearance and increase its toxicity, including myelosuppression, renal and gastrointestinal effects. The risk is highest in patients with mild to moderate renal impairment.
How serious is the interaction between Acetylsalicylic acid and Pemetrexed?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: In patients with creatinine clearance below 80 mL/min avoid NSAIDs including higher-dose aspirin around pemetrexed dosing, following the labeled interruption periods based on half-life. Monitor blood counts and renal function if the combination cannot be avoided.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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