Drug interactions
Naproxen + Pemetrexed
Severity: Major
Naproxen 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
Naproxen can reduce the renal clearance of pemetrexed, raising exposure and the risk of myelosuppression, renal toxicity and gastrointestinal toxicity. The risk is greatest in patients with mild to moderate renal impairment.
What this interaction means in plain words
Naproxen 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.
Naproxen 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
Because naproxen has a long half-life, withhold it for about 2 days before, the day of, and 2 days after pemetrexed, as labeling advises for longer-acting NSAIDs. If it cannot be stopped, 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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen Major
Other interactions of Pemetrexed
Frequently asked questions
Can I take Naproxen with Pemetrexed?
MediHelp rates the interaction as major. Naproxen 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. Naproxen can reduce the renal clearance of pemetrexed, raising exposure and the risk of myelosuppression, renal toxicity and gastrointestinal toxicity. The risk is greatest in patients with mild to moderate renal impairment.
How serious is the interaction between Naproxen 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: Because naproxen has a long half-life, withhold it for about 2 days before, the day of, and 2 days after pemetrexed, as labeling advises for longer-acting NSAIDs. If it cannot be stopped, monitor blood counts and renal function closely.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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