Drug interactions
Diclofenac + Pemetrexed
Severity: Major
Diclofenac and Pemetrexed: major 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 can reduce the renal clearance of pemetrexed, leading to higher exposure and increased myelosuppression, renal and gastrointestinal toxicity. The risk is greatest in patients with mild to moderate renal impairment.
What this interaction means in plain words
Diclofenac and Pemetrexed can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Diclofenac belongs to Musculoskeletal; Pemetrexed belongs to Oncology.
Why it happens
Reduced renal elimination of pemetrexed, likely through NSAID effects on renal perfusion and tubular handling.
What to do
Avoid diclofenac around pemetrexed dosing, following labeling guidance on NSAID interruption. If it must be used, monitor blood counts and renal function closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Other interactions of Pemetrexed
Frequently asked questions
Can I take Diclofenac with Pemetrexed?
MediHelp rates the interaction as major. Diclofenac and Pemetrexed can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. NSAIDs can reduce the renal clearance of pemetrexed, leading to higher exposure and increased myelosuppression, renal and gastrointestinal toxicity. The risk is greatest in patients with mild to moderate renal impairment.
How serious is the interaction between Diclofenac and Pemetrexed?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid diclofenac around pemetrexed dosing, following labeling guidance on NSAID interruption. If it must be used, monitor blood counts and renal function closely.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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