Drug interactions
Pemetrexed + Salicylates
Severity: Moderate
Pemetrexed and Salicylates: 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
Non-acetylated salicylates behave like NSAIDs and may reduce renal clearance of pemetrexed, increasing exposure. This can heighten myelosuppression, mucositis and renal toxicity, especially with impaired renal function.
What this interaction means in plain words
Pemetrexed and Salicylates 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.
Why it happens
Reduced renal elimination of pemetrexed through effects on renal prostaglandins and possible competition for tubular secretion.
What to do
Avoid or hold the salicylate for several days before, on the day of, and for 2 days after pemetrexed, particularly if creatinine clearance is reduced. Monitor blood counts and renal function if it must be continued.
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 Pemetrexed
Frequently asked questions
Can I take Pemetrexed with Salicylates?
MediHelp rates the interaction as moderate. Pemetrexed and Salicylates 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. Non-acetylated salicylates behave like NSAIDs and may reduce renal clearance of pemetrexed, increasing exposure. This can heighten myelosuppression, mucositis and renal toxicity, especially with impaired renal function.
How serious is the interaction between Pemetrexed and Salicylates?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid or hold the salicylate for several days before, on the day of, and for 2 days after pemetrexed, particularly if creatinine clearance is reduced. Monitor blood counts and renal function if it must be continued.
What other medicines interact with Pemetrexed?
MediHelp also lists interactions of Pemetrexed with, for example, Bacitracin, Brexucabtagene autoleucel, Celecoxib. The full list is on the Pemetrexed page.
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