Drug interactions
Flurbiprofen + Pemetrexed
Severity: Major
Flurbiprofen and Pemetrexed: major interaction.
Last updated Sources: US FDA label
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 raise pemetrexed exposure and increase its toxicity, including bone marrow suppression, kidney injury and gastrointestinal toxicity. The risk is greatest in patients with reduced renal function.
What this interaction means in plain words
Flurbiprofen 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.
Flurbiprofen belongs to Musculoskeletal; Pemetrexed belongs to Oncology.
Why it happens
NSAID-induced reduction in renal blood flow and glomerular filtration decreases renal clearance of pemetrexed, which is mainly eliminated unchanged by the kidney.
What to do
In patients with normal renal function, flurbiprofen (a shorter half-life NSAID) should be withheld for about 2 days before, the day of, and 2 days after pemetrexed. Avoid it in patients with mild to moderate renal impairment and monitor blood counts and renal function.
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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References
Other interactions of Flurbiprofen
- Flurbiprofen + Ketorolac Contraindicated
- Flurbiprofen + Ketorolac intranasal Contraindicated
- Aceclofenac + Flurbiprofen Major
- Acemetacin + Flurbiprofen Major
- Acetylsalicylic acid + Flurbiprofen Major
- Alteplase + Flurbiprofen Major
Other interactions of Pemetrexed
Frequently asked questions
Can I take Flurbiprofen with Pemetrexed?
MediHelp rates the interaction as major. Flurbiprofen 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 raise pemetrexed exposure and increase its toxicity, including bone marrow suppression, kidney injury and gastrointestinal toxicity. The risk is greatest in patients with reduced renal function.
How serious is the interaction between Flurbiprofen 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: In patients with normal renal function, flurbiprofen (a shorter half-life NSAID) should be withheld for about 2 days before, the day of, and 2 days after pemetrexed. Avoid it in patients with mild to moderate renal impairment and monitor blood counts and renal function.
What other medicines interact with Flurbiprofen?
MediHelp also lists interactions of Flurbiprofen with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Flurbiprofen page.
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