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Pralatrexate is a folate analog inhibitor of dihydrofolate reductase (DHFR) exhibiting a high affinity for reduced folate carrier-1 (RFC-1) with antineoplastic and immunosuppressive activities. Pralatrexate selectively enters cells expressing RFC-1; intracellularly, this agent is highly polyglutamylation and competes for the folate binding site of DHFR, blocking tetrahydrofolate synthesis, which may result in depletion of nucleotide precursors; inhibition of DNA, RNA and protein synthesis; and apoptotic tumor cell death. Efficient intracellular polyglutamylation of pralatrexate results in higher intracellular concentrations compared to non-polyglutamylation pralatrexate, which is more readily affixed by the MRP (multidrug resistance protein) drug efflux pump. RFC-1, an oncofetal protein expressed at the highest levels during embryonic development, may be over-expressed on the cell surfaces of various cancer cell types.
Pralatrexate is a parenterally administered folate antagonist and antineoplastic agent, used in the treatment of peripheral T-cell lymphomas. Pralatrexate has been associated with a modest rate of serum enzyme elevations during therapy but has not been convincingly linked to instances of acute, clinically apparent liver injury.
Pralatrexate is a pteridine that is the N-4-[1-(2,4-diaminopteridin-6-yl)pent-4-yn-2-yl]benzoyl derivative of L-glutamic acid. Used for treatment of Peripheral T-Cell Lymphoma, an aggressive form of non-Hodgkins lymphoma. It has a role as an antineoplastic agent, an antimetabolite, and an EC 1.5.1.3 (dihydrofolate reductase) inhibitor. It is an N-acyl-L-glutamic acid, a member of pteridines, and a terminal acetylenic compound.
Pralatrexate is an antifolate for the treatment of relapsed or refractory peripheral T-cell lymphoma. Pralatrexate was developed in response due to the inferior responses of patients using the standard therapy for their B-cell counterparts Compared to methotrexate, pralatrexate has better accumulation in cancer cells Pralatrexate is designed to have a higher affinity for the reduced folate carrier, a protein that is overexpressed in malignant cells and is upregulated by oncogenes As such, pralatrexate is thought to have a better therapeutic window compared to other antifolate analogs due to the novel target of RFC.[rx] Pralatrexate was approved by the FDA on September 24, 2009. It is also being studied for other types of lymphoma and solid malignancy such as non-small-cell lung cancer, breast cancer, and bladder cancer.[rx]
Mechanism of Action
The selectivity of pralatrexate for cancer cells is based upon the observation that cancer cells generally have overexpression of reduced folate carrier protein-1 (RTC-1) compared to normal somatic cells. This carrier protein allows the entrance of pralatrexate into the cell. Upon entering the cell, folypolyglutamate synthase FPGS catalyzes the polyglutamylation of pralatrexate so that it is retained inside the cell. Once inside, pralatrexate competitively inhibits dihydrofolate reductase (DHFR) and thymidylate synthase. Subsequent depletion of thymidine monophosphate (TMP) occurs so that the cancer cell is unable to synthesize DNA and RNA. As a result, the cancer cell cannot proliferate and is forced to undergo apoptosis. Pralatrexate is more effective against cells that are actively dividing.
Pralatrexate is a folate analog metabolic inhibitor that competitively inhibits dihydrofolate reductase. It is also a competitive inhibitor for polyglutamylation by the enzyme folylpolyglutamyl synthetase. This inhibition results in the depletion of thymidine and other biological molecules the synthesis of which depends on single carbon transfer.
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This study evaluated mechanistic differences between pralatrexate, methotrexate, and pemetrexed. Inhibition of dihydrofolate reductase (DHFR) was quantified using recombinant human DHFR. Cellular uptake and folylpolyglutamate synthetase (FPGS) activity were determined using radiolabeled pralatrexate, methotrexate, and pemetrexed in NCI-H460 non-small cell lung cancer (NSCLC) cells. The tumor growth inhibition (TGI) was assessed using MV522 and NCI-H460 human NSCLC xenografts. Apparent K ( i ) values for DHFR inhibition were 45, 26, and >200 nM for pralatrexate, methotrexate, and pemetrexed, respectively. A significantly greater percentage of radiolabeled pralatrexate entered the cells and was polyglutamylatated relative to methotrexate or pemetrexed. In vivo, pralatrexate showed superior anti-tumor activity in both NSCLC models, with more effective dose-dependent TGI in the more rapidly growing NCI-H460 xenografts. Pralatrexate demonstrated a distinct mechanistic and anti-tumor activity profile relative to methotrexate and pemetrexed. Pralatrexate exhibited enhanced cellular uptake and increased polyglutamylation, which correlated with increased TGI in NSCLC xenograft models.
Indications
- Treatment of relapsed or refractory peripheral T-cell lymphoma.
- Treatment of peripheral T-cell lymphoma,
- Pralatrexate is a parenterally administered folate antagonist and antineoplastic agent, used in the treatment of peripheral T-cell lymphomas.
- Pralatrexate is approved to treat: Peripheral T-cell lymphoma in patients whose disease is refractory (does not respond to treatment) or has recurred (come back).
- Pralatrexate is indicated for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). This indication is based on the overall response rate.
- Cutaneous T Cell Lymphomas (CTCL)
- Relapsed Peripheral T-Cell Lymphoma
- Refractory Peripheral T-cell Lymphoma Unspecified
Use in Cancer
Pralatrexate is approved to treat:
- Peripheral T-cell lymphoma in patients whose disease is refractory (does not respond to treatment) or has recurred (come back).
This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, confirmatory trial(s) must show that pralatrexate provides a clinical benefit in these patients.
Pralatrexate is also being studied in the treatment of other types of cancer.
Contraindications
- Anemia, neutropenia, thrombocytopenia. Hematologic toxicity (e.g., thrombocytopenia, neutropenia, and anemia) has been reported with pralatrexate therapy
- Renal disease, renal impairment
- Hepatic disease
- Oral ulceration
- Tumor lysis syndrome (TLS)
- Serious rash.
- Geriatric.
- Pregnancy.
- anemia
- decreased blood platelets
- low levels of a type of white blood cell called neutrophils
- stomatitis, is a condition with painful swelling and sores inside the mouth
- abnormal liver function tests
- pregnancy
- a patient who is producing milk and breastfeeding
- moderate to severe kidney impairment
Dosage
Strengths: 20 mg/mL
Lymphoma
- Usual Adult Dose: 30 mg/m2 via intravenous push over 3 to 5 minutes once weekly for 6 weeks in 7-week cycles.
- Duration: Until disease progression or unacceptable toxicity.
- Patients should take low doses (1 mg to 1.25 mg) of oral folic acid daily.
- Folic acid should start 10 days before the first dose of pralatrexate and continue for 30 days after the last dose.
- Patients should also receive a B12 (1 mg) injection within 10 weeks before the first dose of pralatrexate and every 8 to 10 weeks thereafter.
- Subsequent B12 injections may be given the same day as treatment with pralatrexate
Dose Adjustments
- Management of severe or intolerable adverse reactions may require dose omission, reduction, or interruption of pralatrexate therapy.
- Doses may be omitted or reduced based on patient tolerance. Omitted doses will not be made up at the end of the cycle. Once a dose reduction occurs for toxicity, do not re-escalate.
Dose Modifications for Mucositis:
- A) If mucositis is grade 2 on the day of treatment, omit the dose. Upon recovery to grade 1 or less, continue the prior dose.
- B) If mucositis is a recurrence of grade 2 on the day of treatment, omit the dose. Upon recovery to grade 1 or less, treatment may be resumed at 20 mg/m2.
- C) If mucositis is grade 3 on the day of treatment, omit the dose. Upon recovery to grade 1 or less, treatment may be resumed at 20 mg/m2.
- D) If mucositis is grade 4 on the day of treatment, therapy should be discontinued.
Dose Modifications for Hematologic Toxicities:
1) Blood count on day of treatment reveals a platelet less than 50,000/mcL:
- A) If the duration of the toxicity is 1 week, omit the dose. Upon restart, continue the prior dose.
- B) If the duration of the toxicity is 2 weeks, omit the dose. Upon restart, treatment may be resumed at 20 mg/m2.
- C) If the duration of the toxicity is 3 weeks, therapy should be discontinued.
2) ANC is 500 to 1,000/mcL and no fever:
- If the duration of the toxicity is 1 week, omit the dose. Upon restart, continue the prior dose.
3) ANC 500 to 1,000/mcL with fever or ANC less than 500/mcL:
- A) If the duration of the toxicity is 1 week, omit the dose and give G-CSF or GM-CSF support. Upon restart, continue the prior dose with G-CSF or GM-CSF support.
- B) If the duration of the toxicity is 2 weeks or a recurrence, omit the dose and give G-CSF or GM-CSF support. Upon restart, treatment may be resumed at 20 mg/m2 with G-CSF or GM-CSF support.
- C) If the duration of the toxicity is 3 weeks or a second recurrence, therapy should be discontinued.
4) Dose modifications for all other treatment-related toxicities:
- A) If the toxicity is grade 3, omit the dose. Upon restart, treatment may be resumed at 20 mg/m2.
- B) If toxicity is grade 4, therapy should be discontinued.
Administration advice:
Prior to administering any dose of pralatrexate:
- 1) Mucositis should be grade 1 or less.
- 2) The platelet count should be greater than or equal to 100,000/mcL for the first dose and greater than or equal to 50,000/mcL for all subsequent doses.
- 3) The absolute neutrophil count (ANC) should be greater than or equal to 1,000/mcL.
Side Effects
The Most Common
- nausea
- vomiting
- diarrhea
- constipation
- decreased appetite
- tiredness
- weakness
- rash
- itching
- night sweats
- stomach, back, arm, or leg pain
- swelling of the hands, feet, ankles, or lower legs
- white patches or sores on the lips or in the mouth and throat
- fever, sore throat, cough, chills, or other signs of infection
- unusual bleeding or bruising
- bleeding gums
- nosebleeds
- small red or purple dots on the skin
- blood in the urine or stool
- shortness of breath
- chest pain
- fast or irregular heartbeat
- pale skin
- cold hands and feet
- extreme thirst
- dry, sticky mouth
- sunken eyes
- decreased urination
- dizziness or lightheadedness
More common
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- body aches or pain
- chills
- convulsions
- cough
- cracked lips
- decreased urine
- diarrhea
- difficult or labored breathing
- difficulty with swallowing
- dry mouth
- ear congestion
- fast, pounding, or irregular heartbeat or pulse
- fever
- headache
- increased thirst
- loss of appetite
- loss of voice
- lower back or side pain
- mood changes
- muscle pain or cramps
- nasal congestion
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- runny nose
- shortness of breath
- sneezing
- sore throat
- sores, ulcers, or white spots on the lips, tongue, or inside the mouth
- swelling
- tightness in the chest
- troubled breathing with exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
- Abdominal or stomach pain
- back pain
- bloody nose
- constipation
- itching skin
- lack or loss of strength
- night sweats
- pain in the arms or legs
- rash
- weight loss
Drug Interactions
| DRUG | INTERACTION |
|---|---|
| Abacavir | Abacavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Abatacept | The risk or severity of adverse effects can be increased when Abatacept is combined with Pralatrexate. |
| Abemaciclib | Abemaciclib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Aceclofenac | Aceclofenac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Acemetacin | Acemetacin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Acetaminophen | Acetaminophen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Acetazolamide | The therapeutic efficacy of Pralatrexate can be increased when used in combination with Acetazolamide. |
| Acetylsalicylic acid | The serum concentration of Pralatrexate can be increased when it is combined with Acetylsalicylic acid. |
| Aclidinium | Pralatrexate may decrease the excretion rate of Aclidinium which could result in a higher serum level. |
| Acrivastine | Pralatrexate may decrease the excretion rate of Acrivastine which could result in a higher serum level. |
| Acyclovir | Acyclovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Adalimumab | The risk or severity of adverse effects can be increased when Adalimumab is combined with Pralatrexate. |
| Adefovir dipivoxil | Adefovir dipivoxil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Adenovirus | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Pralatrexate. |
| Afatinib | Afatinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Albutrepenonacog | Pralatrexate may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level. |
| Alclofenac | Alclofenac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Pralatrexate. |
| Alectinib | Alectinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Pralatrexate. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pralatrexate. |
| Allogeneic | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Pralatrexate. |
| Allopurinol | Allopurinol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Almasilate | Pralatrexate may decrease the excretion rate of Almasilate which could result in a higher serum level. |
| Almotriptan | Almotriptan may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Alogliptin | Alogliptin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Alprazolam | Alprazolam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Pralatrexate. |
| Amantadine | Amantadine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amikacin | Pralatrexate may decrease the excretion rate of Amikacin which could result in a higher serum level. |
| Amiloride | Amiloride may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Aminophenazone | Aminophenazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Aminosalicylic acid | The serum concentration of Pralatrexate can be increased when it is combined with Aminosalicylic acid. |
| Amitriptyline | Amitriptyline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ammonium c | Ammonium chloride may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amoxicillin | Amoxicillin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amphetamine | Amphetamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amphotericin B | Amphotericin B may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ampicillin | Ampicillin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amrinone | Amrinone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Pralatrexate. |
| Anakinra | The risk or severity of adverse effects can be increased when Anakinra is combined with Pralatrexate. |
| Ancestim | Pralatrexate may decrease the excretion rate of Ancestim which could result in a higher serum level. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Anifrolumab. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Pralatrexate. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Pralatrexate. |
| Antihemophilic | Pralatrexate may decrease the excretion rate of Antihemophilic factor (recombinant), PEGylated which could result in a higher serum level. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | Antipyrine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Antithrombin | Pralatrexate may decrease the excretion rate of Antithrombin III human which could result in a higher serum level. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Pralatrexate. |
| Antrafenine | Antrafenine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Apalutamide | Apalutamide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Apremilast | The risk or severity of adverse effects can be increased when Apremilast is combined with Pralatrexate. |
| Arformoterol | Arformoterol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Pralatrexate. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Articaine. |
| COVID-19 Vacci | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Pralatrexate. |
| Atazanavir | Atazanavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Atomoxetine | Atomoxetine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Auranofin | Auranofin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Aurothioglucose | Pralatrexate may decrease the excretion rate of Aurothioglucose which could result in a higher serum level. |
| Avanafil | Avanafil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Avatrombopag | Avatrombopag may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Pralatrexate. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Pralatrexate. |
| Azelaic acid | Azelaic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Aztreonam | Aztreonam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Bacillus calmett | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Pralatrexate. |
| Bacillus liv antigen | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Pralatrexate. |
| Bacillus antigen | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Pralatrexate. |
| Bacitracin | Bacitracin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Baclofen | Baclofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Balsalazide | The serum concentration of Pralatrexate can be increased when it is combined with Balsalazide. |
| Baricitinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Pralatrexate. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Pralatrexate. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Pralatrexate. |
| Belatacept | The risk or severity of adverse effects can be increased when Belatacept is combined with Pralatrexate. |
| Belimumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Belinostat is combined with Pralatrexate. |
| Belumosudil | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Belumosudil. |
| Bendamustine | The risk or severity of adverse effects can be increased when Bendamustine is combined with Pralatrexate. |
| Bendroflumethia | Bendroflumethiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Benorilate | Benorilate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Benoxaprofen | Benoxaprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Benserazide | Pralatrexate may decrease the excretion rate of Benserazide which could result in a higher serum level. |
| Benzatropine | Benzatropine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Benznidazole | Pralatrexate may decrease the excretion rate of Benznidazole which could result in a higher serum level. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Benzocaine. |
| Benzthiazide | Benzthiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Benzydamine | Benzydamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Benzyl alcohol. |
| Bepotastine | Bepotastine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Pralatrexate. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Pralatrexate. |
| Bicisate | Pralatrexate may decrease the excretion rate of Bicisate which could result in a higher serum level. |
| Bimekizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Bimekizumab. |
| Bismuth subgallate | Pralatrexate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level. |
| Bismuth subsalicylate | The serum concentration of Pralatrexate can be increased when it is combined with Bismuth subsalicylate. |
| Bisoprolol | Bisoprolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Bisoxatin | Pralatrexate may decrease the excretion rate of Bisoxatin which could result in a higher serum level. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pralatrexate. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Blinatumomab. |
| Bordetella pertussis | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Pralatrexate. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Pralatrexate. |
| Bosutinib | The risk or severity of adverse effects can be increased when Bosutinib is combined with Pralatrexate. |
| Brentuximab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Brentuximab vedotin. |
| Brigatinib | Brigatinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Brivaracetam | Brivaracetam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Brodalumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Brodalumab. |
| Bromazepam | Bromazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Bromotheophylline | Bromotheophylline may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Budesonide | The risk or severity of adverse effects can be increased when Budesonide is combined with Pralatrexate. |
| Bumadizone | Bumadizone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Bumetanide | Bumetanide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Bupivacaine. |
| Buprenorphine | Buprenorphine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Bupropion | Bupropion may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Buspirone | Buspirone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Busulfan | The risk or severity of adverse effects can be increased when Busulfan is combined with Pralatrexate. |
| Butabarbital | Butabarbital may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Cabazitaxel is combined with Pralatrexate. |
| Caffeine | Caffeine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Canagliflozin | Canagliflozin may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Canakinumab | The risk or severity of adverse effects can be increased when Canakinumab is combined with Pralatrexate. |
| Cannabidiol | Cannabidiol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Canrenoic acid | Canrenoic acid may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Capecitabine | The risk or severity of adverse effects can be increased when Capecitabine is combined with Pralatrexate. |
| Capmatinib | The serum concentration of Pralatrexate can be increased when it is combined with Capmatinib. |
| Capreomycin | Pralatrexate may decrease the excretion rate of Capreomycin which could result in a higher serum level. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Carbamazepine is combined with Pralatrexate. |
| Carbidopa | Carbidopa may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Pralatrexate. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Pralatrexate. |
| Carprofen | Carprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefaclor | Cefaclor may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefadroxil | Cefadroxil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefalotin | Cefalotin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefamandole | Cefamandole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefapirin | Cefapirin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefazolin | Cefazolin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefdinir | Cefdinir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefditoren | Cefditoren may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefepime | Cefepime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefmenoxime | Cefmenoxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefmetazole | Cefmetazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefonicid | Cefonicid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefoperazone | Cefoperazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceforanide | Ceforanide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefotaxime | Cefotaxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefotetan | Cefotetan may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefotiam | Cefotiam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefoxitin | Cefoxitin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefpiramide | Cefpiramide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefpirome | Cefpirome may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefpodoxime | Cefpodoxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefprozil | Cefprozil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefradine | Cefradine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftaroline | Ceftaroline fosamil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftazidime | Ceftazidime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftibuten | Ceftibuten may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftizoxime | Ceftizoxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftobiprole | Ceftobiprole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ceftolozane | Pralatrexate may decrease the excretion rate of Ceftolozane which could result in a higher serum level. |
| Ceftriaxone | Ceftriaxone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cefuroxime | Cefuroxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Celecoxib | Celecoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cephalexin | Cephalexin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cephaloglycin | Cephaloglycin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Certolizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Certolizumab pegol. |
| Cetirizine | Cetirizine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cevimeline | Cevimeline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Chloral hydrate | Chloral hydrate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Chlorambucil is combined with Pralatrexate. |
| Chloramphenicol | The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Pralatrexate. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Chloroprocaine. |
| Chloroquine | Chloroquine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Chlorothiazide | Chlorothiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Chloroxylenol | Pralatrexate may decrease the excretion rate of Chloroxylenol which could result in a higher serum level. |
| Chlorpromazine | Chlorpromazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Chlorpropamide | Chlorpropamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Chlorthalidone | Chlorthalidone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Chlorzoxazone | Chlorzoxazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cholesterol | Cholesterol may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Choline C 11 | Pralatrexate may decrease the excretion rate of Choline C 11 which could result in a higher serum level. |
| Choline magnesium | Choline magnesium trisalicylate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Choline salicylate | The serum concentration of Pralatrexate can be increased when it is combined with Choline salicylate. |
| Chondroitin sulfate | Pralatrexate may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level. |
| Chromic chloride | Pralatrexate may decrease the excretion rate of Chromic chloride which could result in a higher serum level. |
| Chromic nitrate | Pralatrexate may decrease the excretion rate of Chromic nitrate which could result in a higher serum level. |
| Chromium | Pralatrexate may decrease the excretion rate of Chromium which could result in a higher serum level. |
| Chromium gluconate | Pralatrexate may decrease the excretion rate of Chromium gluconate which could result in a higher serum level. |
| Chromium nicotinate | Pralatrexate may decrease the excretion rate of Chromium nicotinate which could result in a higher serum level. |
| Chromous sulfate | Pralatrexate may decrease the excretion rate of Chromous sulfate which could result in a higher serum level. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Ciclesonide is combined with Pralatrexate. |
| Cidofovir | Cidofovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cilostazol | Cilostazol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cimetidine | Cimetidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Cinchocaine. |
| Ciprofloxacin | Ciprofloxacin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Pralatrexate. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Pralatrexate. |
| Clevidipine | Clevidipine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clobazam | Clobazam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clobetasol | The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Pralatrexate. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Pralatrexate. |
| Clofazimine | Clofazimine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clomipramine | Clomipramine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clonazepam | Clonazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clorazepic acid | Clorazepic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Clostridium | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Pralatrexate. |
| Clove oil | Pralatrexate may decrease the excretion rate of Clove oil which could result in a higher serum level. |
| Clozapine | Clozapine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cobicistat | Cobicistat may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Cocaine. |
| Colchicine | Colchicine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Colistimethate | Colistimethate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Colistin | Pralatrexate may decrease the excretion rate of Colistin which could result in a higher serum level. |
| Conivaptan | Conivaptan may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| C estrogens | Conjugated estrogens may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Corifollitropin alfa | Pralatrexate may decrease the excretion rate of Corifollitropin alfa which could result in a higher serum level. |
| Corticotropin | The risk or severity of adverse effects can be increased when Corticotropin is combined with Pralatrexate. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Pralatrexate. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Pralatrexate. |
| Cyanocobalamin | Cyanocobalamin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Cyclopenthiazide | Cyclopenthiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Pralatrexate. |
| Cyclosporine | Pralatrexate may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | Cyclothiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Pralatrexate. |
| Dabigatran | Dabigatran etexilate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dabrafenib | Dabrafenib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Pralatrexate. |
| Daclatasvir | Daclatasvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dacomitinib | Dacomitinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Pralatrexate. |
| Dalfampridine | Dalfampridine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dapagliflozin | Dapagliflozin may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Daptomycin | Daptomycin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Pralatrexate. |
| Darolutamide | Darolutamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dasabuvir | Dasabuvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dasatinib | The risk or severity of adverse effects can be increased when Dasatinib is combined with Pralatrexate. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Pralatrexate. |
| Decitabine | The risk or severity of adverse effects can be increased when Decitabine is combined with Pralatrexate. |
| Deferiprone | Pralatrexate may decrease the excretion rate of Deferiprone which could result in a higher serum level. |
| Deflazacort | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Deflazacort. |
| Delafloxacin | Pralatrexate may decrease the excretion rate of Delafloxacin which could result in a higher serum level. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Pralatrexate. |
| Desipramine | Desipramine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Desmopressin | Desmopressin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Pralatrexate. |
| Desvenlafaxine | Desvenlafaxine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Deucravacitinib. |
| Deutetrabenazine | Pralatrexate may decrease the excretion rate of Deutetrabenazine which could result in a higher serum level. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Dexamethasone is combined with Pralatrexate. |
| Dexamethasone | Dexamethasone acetate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dexibuprofen | Dexibuprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dexketoprofen | Dexketoprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dexmedetomidine | Dexmedetomidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dexpanthenol | Pralatrexate may decrease the excretion rate of Dexpanthenol which could result in a higher serum level. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Pralatrexate. |
| Dextran | Pralatrexate may decrease the excretion rate of Dextran which could result in a higher serum level. |
| Diatrizoate | Diatrizoate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Diazepam | Diazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dichlorobenzyl | Pralatrexate may decrease the excretion rate of Dichlorobenzyl alcohol which could result in a higher serum level. |
| Diclofenac | Diclofenac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Diclofenamide | Diclofenamide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Dicyclomine | Dicyclomine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Didanosine | Didanosine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dienogest | Pralatrexate may decrease the excretion rate of Dienogest which could result in a higher serum level. |
| Diethylstilbestrol | Diethylstilbestrol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Diflunisal | The serum concentration of Pralatrexate can be increased when it is combined with Diflunisal. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Difluocortolone. |
| Digoxin | Pralatrexate may decrease the excretion rate of Digoxin which could result in a higher serum level. |
| Dihydrostreptomycin | Dihydrostreptomycin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dimercaprol | Dimercaprol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Dimethyl fumarate. |
| Dimethyl sulfoxide | Dimethyl sulfoxide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Diphenhydramine. |
| Diroximel fumarate | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Diroximel fumarate. |
| Disopyramide | Disopyramide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| DL-Methylephedrine | Pralatrexate may decrease the excretion rate of DL-Methylephedrine which could result in a higher serum level. |
| Dobutamine | Dobutamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Docetaxel | The risk or severity of adverse effects can be increased when Docetaxel is combined with Pralatrexate. |
| Dopamine | Dopamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Doripenem | Doripenem may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Doxacurium | Doxacurium may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Doxepin | Doxepin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Doxorubicin | The risk or severity of adverse effects can be increased when Doxorubicin is combined with Pralatrexate. |
| Doxycycline | Doxycycline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Drospirenone | Drospirenone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Droxidopa | Droxidopa may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Duloxetine | Duloxetine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Dyclonine. |
| Dyphylline | Dyphylline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ebola Zaire vaccine | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Pralatrexate. |
| Eculizumab | The risk or severity of adverse effects can be increased when Eculizumab is combined with Pralatrexate. |
| Edoxaban | Pralatrexate may decrease the excretion rate of Edoxaban which could result in a higher serum level. |
| Edrophonium | Edrophonium may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Pralatrexate. |
| Elbasvir | Elbasvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Eltrombopag | Eltrombopag may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Emapalumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Emapalumab. |
| Enalaprilat | Pralatrexate may decrease the excretion rate of Enalaprilat which could result in a higher serum level. |
| Enasidenib | Enasidenib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Enzalutamide | Pralatrexate may decrease the excretion rate of Enzalutamide which could result in a higher serum level. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Pralatrexate. |
| Eplerenone | Eplerenone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Epoprostenol | Epoprostenol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Eribulin | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Eribulin. |
| Erlotinib | Erlotinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ertapenem | Ertapenem may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ertugliflozin | Ertugliflozin may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Pralatrexate. |
| Estazolam | Estazolam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol | Estradiol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol acetate | Estradiol acetate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol benzoate | Estradiol benzoate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol cypionate | Estradiol cypionate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol dienanthate | Estradiol dienanthate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estradiol valerate | Estradiol valerate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Estramustine | The risk or severity of adverse effects can be increased when Estramustine is combined with Pralatrexate. |
| Estrone sulfate | Estrone sulfate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Eszopiclone | Eszopiclone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Etacrynic acid | Etacrynic acid may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Etafedrine | Pralatrexate may decrease the excretion rate of Etafedrine which could result in a higher serum level. |
| Etanercept | The risk or severity of adverse effects can be increased when Etanercept is combined with Pralatrexate. |
| Ethambutol | Ethambutol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Etidocaine. |
| Etodolac | Etodolac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Etomidate | Etomidate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Etonogestrel | Etonogestrel may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Pralatrexate. |
| Etoricoxib | Etoricoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Eucalyptus oil | Pralatrexate may decrease the excretion rate of Eucalyptus oil which could result in a higher serum level. |
| Everolimus | The risk or severity of adverse effects can be increased when Everolimus is combined with Pralatrexate. |
| Ezogabine | Ezogabine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Famtozinameran | The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Pralatrexate. |
| Febuxostat | The excretion of Pralatrexate can be decreased when combined with Febuxostat. |
| Fedratinib | Fedratinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fenbufen | Fenbufen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fenofibrate | Fenofibrate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fenofibric acid | Pralatrexate may decrease the excretion rate of Fenofibric acid which could result in a higher serum level. |
| Fenoldopam | Fenoldopam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fenoprofen | Fenoprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fentanyl | Fentanyl may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fesoterodine | Fesoterodine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Filgotinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Filgotinib. |
| Finerenone | Finerenone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Fingolimod | Pralatrexate may increase the immunosuppressive activities of Fingolimod. |
| Flavoxate | Flavoxate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Floctafenine | Floctafenine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Florbetaben | Pralatrexate may decrease the excretion rate of Florbetaben (18F) which could result in a higher serum level. |
| Florbetapir | Pralatrexate may decrease the excretion rate of Florbetapir (18F) which could result in a higher serum level. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Pralatrexate. |
| Fluconazole | Fluconazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Flucytosine | The risk or severity of adverse effects can be increased when Flucytosine is combined with Pralatrexate. |
| Fludarabine | The risk or severity of adverse effects can be increased when Fludarabine is combined with Pralatrexate. |
| Fludeoxyglucose | Pralatrexate may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Pralatrexate. |
| Flumazenil | Flumazenil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Pralatrexate. |
| Fluocinolone | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Pralatrexate. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Fluocinonide is combined with Pralatrexate. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Fluocortolone. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Pralatrexate. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Pralatrexate. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Fluprednisolone. |
| Flurazepam | Flurazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Flurbiprofen | Flurbiprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Flutamide | Flutamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fluticasone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Fluticasone. |
| Fluticasone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Fluticasone furoate. |
| Fluticasone | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Pralatrexate. |
| Fluvoxamine | Fluvoxamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Folic acid | The therapeutic efficacy of Pralatrexate can be decreased when used in combination with Folic acid. |
| Fomepizole | Fomepizole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fondaparinux | Fondaparinux may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Formestane | Pralatrexate may decrease the excretion rate of Formestane which could result in a higher serum level. |
| Foscarnet | Foscarnet may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fosfomycin | Fosfomycin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fosinopril | Fosinopril may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fostamatinib | Fostamatinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Fostemsavir | Fostemsavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Framycetin | Framycetin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Furosemide | Furosemide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Fusidic acid | Fusidic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gabapentin | Pralatrexate may decrease the excretion rate of Gabapentin enacarbil which could result in a higher serum level. |
| Gadobenic acid | Gadobenic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gadodiamide | Gadodiamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gadofosveset | Gadofosveset trisodium may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gadopentetic acid | Gadopentetic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gadoteric acid | Pralatrexate may decrease the excretion rate of Gadoteric acid which could result in a higher serum level. |
| Gadoteridol | Gadoteridol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Pralatrexate. |
| Ganciclovir | Ganciclovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gefitinib | Gefitinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Pralatrexate. |
| Gemfibrozil | Gemfibrozil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gemtuzumab | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Pralatrexate. |
| Gentamicin | Pralatrexate may decrease the excretion rate of Gentamicin which could result in a higher serum level. |
| Gilteritinib | Gilteritinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Gimeracil | Pralatrexate may decrease the excretion rate of Gimeracil which could result in a higher serum level. |
| Givosiran | Givosiran may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Glasdegib | Glasdegib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Glatiramer | The risk or severity of adverse effects can be increased when Glatiramer is combined with Pralatrexate. |
| Glecaprevir | Glecaprevir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Glipizide | Glipizide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Glucarpidase | The serum concentration of the active metabolites of Pralatrexate can be reduced when Pralatrexate is used in combination with Glucarpidase resulting in a loss in efficacy. |
| Glycerol | Pralatrexate may decrease the excretion rate of Glycerol phenylbutyrate which could result in a higher serum level. |
| Glycol salicylate | Glycol salicylate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Golimumab | The risk or severity of adverse effects can be increased when Golimumab is combined with Pralatrexate. |
| Golodirsen | Pralatrexate may decrease the excretion rate of Golodirsen which could result in a higher serum level. |
| Goserelin | Goserelin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Grazoprevir | Grazoprevir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Guanethidine | Guanethidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Guanfacine | Guanfacine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Guselkumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Guselkumab. |
| Haemophilus | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Pralatrexate. |
| Haloperidol | Haloperidol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Hepatitis A Vaccine | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Pralatrexate. |
| Hepatitis B | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Pralatrexate. |
| Human adenovirus | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Pralatrexate. |
| Hydralazine | Hydralazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Hydrochlorothiazide | Hydrochlorothiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydrocortisone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Hydrocortisone acetate. |
| Hydrocortisone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Hydrocortisone butyrate. |
| Hydrocortisone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Hydrocortisone succinate. |
| Hydroflumethiazide | Hydroflumethiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydromorphone | Hydromorphone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Hydroxocobalamin | Hydroxocobalamin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Hydroxychloroquine | The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Pralatrexate. |
| Hydroxyethyl Starch | Pralatrexate may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level. |
| Hydroxyurea | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pralatrexate. |
| Ibritumomab | The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Pralatrexate. |
| Ibrutinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ibrutinib. |
| Ibuprofen | Ibuprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ibutilide | Ibutilide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Icatibant | Icatibant may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Icosapent | Icosapent may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Idarubicin | The risk or severity of adverse effects can be increased when Idarubicin is combined with Pralatrexate. |
| Idarucizumab | Pralatrexate may decrease the excretion rate of Idarucizumab which could result in a higher serum level. |
| Idebenone | Pralatrexate may decrease the excretion rate of Idebenone which could result in a higher serum level. |
| Idelalisib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Idelalisib. |
| Ifosfamide | The risk or severity of adverse effects can be increased when Ifosfamide is combined with Pralatrexate. |
| Imatinib | The risk or severity of adverse effects can be increased when Imatinib is combined with Pralatrexate. |
| Imipramine | Imipramine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Indapamide | Indapamide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Indigotindisulfonic | Pralatrexate may decrease the excretion rate of Indigotindisulfonic acid which could result in a higher serum level. |
| Indomethacin | Indomethacin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Inebilizumab | The risk or severity of infection can be increased when Pralatrexate is combined with Inebilizumab. |
| Infliximab | The risk or severity of adverse effects can be increased when Infliximab is combined with Pralatrexate. |
| Isradipine | Isradipine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Istradefylline | Istradefylline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Itraconazole | Itraconazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ixabepilone | The risk or severity of adverse effects can be increased when Ixabepilone is combined with Pralatrexate. |
| Ixazomib | Pralatrexate may decrease the excretion rate of Ixazomib which could result in a higher serum level. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ixekizumab. |
| COVID-19 Vaccine | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Pralatrexate. |
| J encephalitis | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Pralatrexate. |
| Kanamycin | Pralatrexate may decrease the excretion rate of Kanamycin which could result in a higher serum level. |
| Ketamine | Ketamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ketazolam | Ketazolam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ketoprofen | Ketoprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ketorolac | Ketorolac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Labetalol | Labetalol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lamivudine | Lamivudine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lamotrigine | Lamotrigine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lansoprazole | Lansoprazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lasmiditan | The serum concentration of Pralatrexate can be increased when it is combined with Lasmiditan. |
| Latamoxef | Latamoxef may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ledipasvir | Ledipasvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Leflunomide | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Leflunomide. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Pralatrexate. |
| Lesinurad | Pralatrexate may decrease the excretion rate of Lesinurad which could result in a higher serum level. |
| Letermovir | Letermovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Leucovorin | The therapeutic efficacy of Pralatrexate can be decreased when used in combination with Leucovorin. |
| Leuprolide | Leuprolide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Levobupivacaine. |
| Levocarnitine | Levocarnitine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Levocetirizine | Levocetirizine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Levofloxacin | Levofloxacin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Levoleucovorin | The therapeutic efficacy of Pralatrexate can be decreased when used in combination with Levoleucovorin. |
| Levomilnacipran | Pralatrexate may decrease the excretion rate of Levomilnacipran which could result in a higher serum level. |
| Levosalbutamol | Pralatrexate may decrease the excretion rate of Levosalbutamol which could result in a higher serum level. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Lidocaine. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Pralatrexate. |
| Liothyronine | Liothyronine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lisinopril | Lisinopril may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lithium carbonate | Pralatrexate may decrease the excretion rate of Lithium carbonate which could result in a higher serum level. |
| Lithium citrate | Lithium citrate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lixisenatide | Pralatrexate may decrease the excretion rate of Lixisenatide which could result in a higher serum level. |
| Lofexidine | Lofexidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lomustine | The risk or severity of adverse effects can be increased when Lomustine is combined with Pralatrexate. |
| Lopinavir | The serum concentration of Pralatrexate can be increased when it is combined with Lopinavir. |
| Loracarbef | Loracarbef may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lorazepam | Lorazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lorcaserin | Lorcaserin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lornoxicam | Lornoxicam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lorpiprazole | Pralatrexate may decrease the excretion rate of Lorpiprazole which could result in a higher serum level. |
| Loxoprofen | Loxoprofen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lubiprostone | Lubiprostone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Lumiracoxib | Lumiracoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Macitentan | Pralatrexate may decrease the excretion rate of Macitentan which could result in a higher serum level. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Pralatrexate. |
| Magnesium | Pralatrexate may decrease the excretion rate of Magnesium carbonate which could result in a higher serum level. |
| Magnesium chlo | Pralatrexate may decrease the excretion rate of Magnesium chloride which could result in a higher serum level. |
| Magnesium | Pralatrexate may decrease the excretion rate of Magnesium hydroxide which could result in a higher serum level. |
| Magnesium tris | Pralatrexate may decrease the excretion rate of Magnesium trisilicate which could result in a higher serum level. |
| Mangafodipir | Mangafodipir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mannitol | Mannitol may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Maprotiline | Maprotiline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Maribavir | Maribavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Measles virus | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Pralatrexate. |
| Mecamylamine | Mecamylamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Pralatrexate. |
| Meclofenamic acid | Meclofenamic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Medroxyprogeste | Medroxyprogesterone acetate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mefenamic acid | Mefenamic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Megestrol acetate | Megestrol acetate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Meloxicam | Meloxicam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Pralatrexate. |
| Memantine | Memantine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Pralatrexate. |
| Menthyl salicylate | Menthyl salicylate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Meperidine | Meperidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Mepolizumab is combined with Pralatrexate. |
| Meprednisone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Pralatrexate. |
| Meropenem | Meropenem may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mesalazine | The serum concentration of Pralatrexate can be increased when it is combined with Mesalazine. |
| Metamfetamine | Metamfetamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Metamizole | Metamizole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Metaxalone | Metaxalone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Metformin | Metformin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Methadone | Methadone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Methazolamide | Methazolamide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Pralatrexate. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Pralatrexate. |
| Methoxsalen | Methoxsalen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Methoxy | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Pralatrexate. |
| Methyl salicylate | The serum concentration of Pralatrexate can be increased when it is combined with Methyl salicylate. |
| Methyldopa | Methyldopa may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Methylene blue | Pralatrexate may decrease the excretion rate of Methylene blue which could result in a higher serum level. |
| Methylnaltrexone | Methylnaltrexone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Pralatrexate. |
| Methyltestosterone | Methyltestosterone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Meticrane | Meticrane may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoclopramide | Metoclopramide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Metolazone | Metolazone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoprolol | Metoprolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Metyrapone | Metyrapone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Midazolam | Midazolam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Migalastat | Migalastat may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Milnacipran | Milnacipran may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Milrinone | Milrinone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Mirabegron | Pralatrexate may decrease the excretion rate of Mirabegron which could result in a higher serum level. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Pralatrexate. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pralatrexate. |
| COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Pralatrexate. |
| accinia ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Pralatrexate. |
| Mometasone | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Mometasone furoate. |
| Monomethyl | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Mosunetuzumab. |
| Moxisylyte | Pralatrexate may decrease the excretion rate of Moxisylyte which could result in a higher serum level. |
| Mumps virus | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Pralatrexate. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Pralatrexate. |
| Muzolimine | Muzolimine may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Mycophenolate | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Pralatrexate. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Pralatrexate. |
| N-acetyltyrosine | Pralatrexate may decrease the excretion rate of N-acetyltyrosine which could result in a higher serum level. |
| Nabumetone | Nabumetone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nadolol | Nadolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Naldemedine | Pralatrexate may decrease the excretion rate of Naldemedine which could result in a higher serum level. |
| Nalmefene | Nalmefene may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Naloxone | Naloxone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Naproxen | Naproxen may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Natalizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Natalizumab. |
| Nateglinide | Nateglinide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nedaplatin | Pralatrexate may decrease the excretion rate of Nedaplatin which could result in a higher serum level. |
| Nedocromil | Nedocromil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nefazodone | Nefazodone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nelarabine | The risk or severity of adverse effects can be increased when Nelarabine is combined with Pralatrexate. |
| Nelfinavir | Nelfinavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Neomycin | Pralatrexate may decrease the excretion rate of Neomycin which could result in a higher serum level. |
| Netilmicin | Pralatrexate may decrease the excretion rate of Netilmicin which could result in a higher serum level. |
| Nicorandil | Pralatrexate may decrease the excretion rate of Nicorandil which could result in a higher serum level. |
| Nifedipine | Nifedipine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nilotinib | The risk or severity of adverse effects can be increased when Nilotinib is combined with Pralatrexate. |
| Nilutamide | Nilutamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nimesulide | Nimesulide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nisoldipine | Nisoldipine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nitric Oxide | Nitric Oxide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nitrofurantoin | Nitrofurantoin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nitroprusside | Nitroprusside may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Novobiocin | Novobiocin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Pralatrexate. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Obinutuzumab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Pralatrexate. |
| Octinoxate | Pralatrexate may decrease the excretion rate of Octinoxate which could result in a higher serum level. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Ofatumumab is combined with Pralatrexate. |
| Olaparib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Olaparib. |
| Olsalazine | The serum concentration of Pralatrexate can be increased when it is combined with Olsalazine. |
| Omeprazole | Omeprazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Opium | Pralatrexate may decrease the excretion rate of Opium which could result in a higher serum level. |
| Oseltamivir | Oseltamivir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Osimertinib | Osimertinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oteseconazole | The serum concentration of Pralatrexate can be increased when it is combined with Oteseconazole. |
| Oxacillin | Oxacillin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Pralatrexate. |
| Oxaprozin | Oxaprozin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oxazepam | Oxazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Oxetacaine. |
| Oxybenzone | Oxybenzone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Oxybuprocaine. |
| Oxyphenbutazone | Oxyphenbutazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Oxyquinoline | Pralatrexate may decrease the excretion rate of Oxyquinoline which could result in a higher serum level. |
| Ozanimod | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Paclitaxel is combined with Pralatrexate. |
| Pacritinib | The serum concentration of Pralatrexate can be increased when it is combined with Pacritinib. |
| Palbociclib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Palbociclib. |
| Paliperidone | Paliperidone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Palonosetron | Palonosetron may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pamidronic acid | Pamidronic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Panobinostat | The risk or severity of adverse effects can be increased when Panobinostat is combined with Pralatrexate. |
| Pantoprazole | Pantoprazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Parecoxib | Parecoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Paritaprevir | Paritaprevir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Paromomycin | Paromomycin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Patent Blue | Pralatrexate may decrease the excretion rate of Patent Blue which could result in a higher serum level. |
| Pazopanib | The risk or severity of adverse effects can be increased when Pazopanib is combined with Pralatrexate. |
| Pegaptanib | Pegaptanib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Pralatrexate. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Pralatrexate. |
| Peginterferon alfa | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Pralatrexate. |
| Peginterferon alfa | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Pralatrexate. |
| Peginterferon beta | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Pemetrexed is combined with Pralatrexate. |
| Penbutolol | Penbutolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Penicillamine | The risk or severity of adverse effects can be increased when Penicillamine is combined with Pralatrexate. |
| Pentaerythritol | Pentaerythritol tetranitrate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pentamidine | Pentamidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pentastar | Pralatrexate may decrease the excretion rate of Pentastarch which could result in a higher serum level. |
| Pentetic acid | Pralatrexate may decrease the excretion rate of Pentetic acid which could result in a higher serum level. |
| Pentobarbital | Pentobarbital may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pentostatin | The risk or severity of adverse effects can be increased when Pentostatin is combined with Pralatrexate. |
| Pentoxifylline | Pentoxifylline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Perindopril | Perindopril may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Permethrin | Permethrin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Pralatrexate. |
| Phenelzine | Phenelzine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Phenol. |
| Phentolamine | Phentolamine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Phenyl aminosalicy | The serum concentration of Pralatrexate can be increased when it is combined with Phenyl aminosalicylate. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Pralatrexate. |
| Phenylbutazone | Phenylbutazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pholcodine | Pralatrexate may decrease the excretion rate of Pholcodine which could result in a higher serum level. |
| Phosphoric acid | Pralatrexate may decrease the excretion rate of Phosphoric acid which could result in a higher serum level. |
| Phylloquinone | Phylloquinone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pibrentasvir | Pibrentasvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Picosulfuric acid | Pralatrexate may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Pralatrexate. |
| Pindolol | Pindolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Piperacillin | Piperacillin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Piracetam | Pralatrexate may decrease the excretion rate of Piracetam which could result in a higher serum level. |
| Piretanide | Piretanide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Pirfenidone is combined with Pralatrexate. |
| Piroxicam | Piroxicam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pitolisant | Pralatrexate may decrease the excretion rate of Pitolisant which could result in a higher serum level. |
| Plazomicin | Pralatrexate may decrease the excretion rate of Plazomicin which could result in a higher serum level. |
| Plerixafor | Plerixafor may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Polythiazide | Polythiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Pomalidomide. |
| Ponatinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ponatinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ponesimod. |
| Potassium | Potassium may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium acetate | Pralatrexate may decrease the excretion rate of Potassium acetate which could result in a higher serum level. |
| Potassium | Pralatrexate may decrease the excretion rate of Potassium bicarbonate which could result in a higher serum level. |
| Potassium cation | Potassium cation may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium chloride | Potassium chloride may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Potassium citrate | Potassium citrate may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium nitrate | Pralatrexate may decrease the excretion rate of Potassium nitrate which could result in a higher serum level. |
| Potassium | Pralatrexate may decrease the excretion rate of Potassium perchlorate which could result in a higher serum level. |
| Potassium sulfate | Pralatrexate may decrease the excretion rate of Potassium sulfate which could result in a higher serum level. |
| Pralidoxime | Pralidoxime may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pralsetinib | Pralsetinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pramipexole | Pramipexole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Pramocaine. |
| Prasugrel | Prasugrel may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pravastatin | Pravastatin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Pralatrexate. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Pralatrexate. |
| Pregabalin | Pregabalin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Prilocaine. |
| Probenecid | The serum concentration of Pralatrexate can be increased when it is combined with Probenecid. |
| Procainamide | Pralatrexate may decrease the excretion rate of Procainamide which could result in a higher serum level. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Procaine. |
| Procaine | Pralatrexate may decrease the excretion rate of Procaine benzylpenicillin which could result in a higher serum level. |
| Procarbazine | The risk or severity of adverse effects can be increased when Procarbazine is combined with Pralatrexate. |
| Progesterone | Progesterone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Promethazine | Promethazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Propantheline | Propantheline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Proparacaine. |
| Propiverine | Pralatrexate may decrease the excretion rate of Propiverine which could result in a higher serum level. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Propoxycaine. |
| Propranolol | Propranolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Pralatrexate. |
| Prucalopride | Prucalopride may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pyrantel | Pralatrexate may decrease the excretion rate of Pyrantel which could result in a higher serum level. |
| Pyrazinamide | Pyrazinamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pyridoxine | Pyridoxine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pyrithione | Pralatrexate may decrease the excretion rate of Pyrithione which could result in a higher serum level. |
| Quetiapine | Quetiapine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Quinethazone | Quinethazone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Quinidine | Pralatrexate may decrease the excretion rate of Quinidine which could result in a higher serum level. |
| Rabeprazole | Rabeprazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rabies i | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Pralatrexate. |
| Rabies antigen, A | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Pralatrexate. |
| Rabies antigen, B | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Pralatrexate. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Pralatrexate. |
| Ramelteon | Ramelteon may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ranitidine | Ranitidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ranolazine | Ranolazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rasagiline | Rasagiline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ravulizumab. |
| Regorafenib | Regorafenib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Reserpine | Reserpine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Resorcinol | Pralatrexate may decrease the excretion rate of Resorcinol which could result in a higher serum level. |
| Ribavirin | Ribavirin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ribostamycin | Pralatrexate may decrease the excretion rate of Ribostamycin which could result in a higher serum level. |
| Rilonacept | The risk or severity of adverse effects can be increased when Rilonacept is combined with Pralatrexate. |
| Rilpivirine | Rilpivirine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ripretinib | Ripretinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Risankizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Risankizumab. |
| Ritonavir | Ritonavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Pralatrexate. |
| Rivaroxaban | Rivaroxaban may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rizatriptan | Rizatriptan may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rofecoxib | Rofecoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Pralatrexate. |
| Rolapitant | Rolapitant may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ropeginterferon | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Ropivacaine. |
| Rosiglitazone | Rosiglitazone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Pralatrexate. |
| Roxadustat | The serum concentration of Pralatrexate can be increased when it is combined with Roxadustat. |
| Rubella virus vaccine | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Pralatrexate. |
| Rucaparib | Rucaparib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ruxolitinib. |
| Sacubitril | Pralatrexate may decrease the excretion rate of Sacubitril which could result in a higher serum level. |
| Safinamide | Safinamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Salbutamol | Salbutamol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Salicylamide | Salicylamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Salicylic acid | The serum concentration of Pralatrexate can be increased when it is combined with Salicylic acid. |
| Salmon calcitonin | Salmon calcitonin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Salsalate | Salsalate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sapropterin | The serum concentration of Sapropterin can be decreased when it is combined with Pralatrexate. |
| Saquinavir | Saquinavir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sarilumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Sarilumab. |
| Satralizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Satralizumab. |
| Saxagliptin | Saxagliptin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Secobarbital | Secobarbital may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Secukinumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Secukinumab. |
| Selenious acid | Pralatrexate may decrease the excretion rate of Selenious acid which could result in a higher serum level. |
| Selenium | Pralatrexate may decrease the excretion rate of Selenium which could result in a higher serum level. |
| Sibutramine | Sibutramine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Siltuximab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Siltuximab. |
| Simeprevir | Simeprevir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Siponimod | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Pralatrexate. |
| Sirolimus | The risk or severity of adverse effects can be increased when Sirolimus is combined with Pralatrexate. |
| Sitagliptin | Sitagliptin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Smallpox | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Pralatrexate. |
| Sodium acetate | Pralatrexate may decrease the excretion rate of Sodium acetate which could result in a higher serum level. |
| Sodium | Pralatrexate may decrease the excretion rate of Sodium aurothiomalate which could result in a higher serum level. |
| Sodium fluoride | Pralatrexate may decrease the excretion rate of Sodium fluoride which could result in a higher serum level. |
| Sodium sulfate | Pralatrexate may decrease the excretion rate of Sodium sulfate which could result in a higher serum level. |
| Sofosbuvir | Pralatrexate may decrease the excretion rate of Sofosbuvir which could result in a higher serum level. |
| Solriamfetol | Pralatrexate may decrease the excretion rate of Solriamfetol which could result in a higher serum level. |
| Sorafenib | The risk or severity of adverse effects can be increased when Sorafenib is combined with Pralatrexate. |
| Sorbitol | Sorbitol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sotagliflozin | Sotagliflozin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sotorasib | The serum concentration of Pralatrexate can be increased when it is combined with Sotorasib. |
| Spesolimab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Spesolimab. |
| Spironolactone | Spironolactone may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Stiripentol | The excretion of Pralatrexate can be decreased when combined with Stiripentol. |
| Streptomycin | Pralatrexate may decrease the excretion rate of Streptomycin which could result in a higher serum level. |
| Streptozocin | The risk or severity of adverse effects can be increased when Streptozocin is combined with Pralatrexate. |
| Strontium chloride | Pralatrexate may decrease the excretion rate of Strontium chloride which could result in a higher serum level. |
| Sucralfate | Sucralfate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sulbactam | Pralatrexate may decrease the excretion rate of Sulbactam which could result in a higher serum level. |
| Sulfadiazine | Sulfadiazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sulfamethoxazole | Pralatrexate may decrease the excretion rate of Sulfamethoxazole which could result in a higher serum level. |
| Sulfasalazine | The serum concentration of Pralatrexate can be increased when it is combined with Sulfasalazine. |
| Sulindac | Sulindac may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sumatriptan | Sumatriptan may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Sunitinib | The risk or severity of adverse effects can be increased when Sunitinib is combined with Pralatrexate. |
| SEstrogens, A | Pralatrexate may decrease the excretion rate of Synthetic Conjugated Estrogens, A which could result in a higher serum level. |
| SEstrogens, B | Pralatrexate may decrease the excretion rate of Synthetic Conjugated Estrogens, B which could result in a higher serum level. |
| Tacrolimus | Tacrolimus may increase the immunosuppressive activities of Pralatrexate. |
| Tadalafil | Tadalafil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tafamidis | The serum concentration of Pralatrexate can be increased when it is combined with Tafamidis. |
| Tamsulosin | Tamsulosin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tasimelteon | Pralatrexate may decrease the excretion rate of Tasimelteon which could result in a higher serum level. |
| Taurocholic acid | Taurocholic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Technetium | Pralatrexate may decrease the excretion rate of Technetium Tc-99m exametazime which could result in a higher serum level. |
| Technetium | Pralatrexate may decrease the excretion rate of Technetium Tc-99m mebrofenin which could result in a higher serum level. |
| Technetium | Pralatrexate may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level. |
| Technetium | Pralatrexate may decrease the excretion rate of Technetium Tc-99m pyrophosphate which could result in a higher serum level. |
| Teduglutide | Pralatrexate may decrease the excretion rate of Teduglutide which could result in a higher serum level. |
| Tegafur | Pralatrexate may decrease the excretion rate of Tegafur which could result in a higher serum level. |
| Telavancin | Telavancin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Telmisartan | Telmisartan may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Temazepam | Temazepam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Temozolomide | The risk or severity of adverse effects can be increased when Temozolomide is combined with Pralatrexate. |
| Temsirolimus | The risk or severity of adverse effects can be increased when Temsirolimus is combined with Pralatrexate. |
| Teniposide | The risk or severity of adverse effects can be increased when Teniposide is combined with Pralatrexate. |
| Tenofovir | The serum concentration of Tenofovir alafenamide can be increased when it is combined with Pralatrexate. |
| Tenofovir disoproxil | Tenofovir disoproxil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tenoxicam | Tenoxicam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tepotinib | Tepotinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Teprotumumab is combined with Pralatrexate. |
| Terbutaline | Terbutaline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Teriflunomide | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Teriflunomide. |
| Testolactone | Testolactone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Testosterone | Testosterone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Testosterone | Pralatrexate may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level. |
| Testosterone | Pralatrexate may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level. |
| Testosterone | Testosterone propionate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Testosterone | Pralatrexate may decrease the excretion rate of Testosterone undecanoate which could result in a higher serum level. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Pralatrexate is combined with Tetracaine. |
| Tetracycline | Tetracycline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tetradecyl | Pralatrexate may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level. |
| Thalidomide | The risk or severity of adverse effects can be increased when Thalidomide is combined with Pralatrexate. |
| Thiabendazole | Thiabendazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Thiethylperazine | Thiethylperazine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Thiotepa | The risk or severity of adverse effects can be increased when Thiotepa is combined with Pralatrexate. |
| Tiaprofenic acid | Tiaprofenic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tick- encephalitis | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Pralatrexate. |
| Ticlopidine | Ticlopidine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tiludronic acid | Tiludronic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Timolol | Timolol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tinidazole | Tinidazole may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Pralatrexate. |
| Tiopronin | Pralatrexate may decrease the excretion rate of Tiopronin which could result in a higher serum level. |
| Tiotropium | Tiotropium may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tirofiban | Tirofiban may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tivozanib | Tivozanib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tixocortol | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Tixocortol. |
| Tobramycin | Pralatrexate may decrease the excretion rate of Tobramycin which could result in a higher serum level. |
| Tocilizumab | The risk or severity of adverse effects can be increased when Tocilizumab is combined with Pralatrexate. |
| Tocopherol | Pralatrexate may decrease the excretion rate of Tocopherol which could result in a higher serum level. |
| Tofacitinib | Pralatrexate may increase the immunosuppressive activities of Tofacitinib. |
| Tolazamide | Tolazamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolbutamide | Tolbutamide may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolcapone | Tolcapone may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolfenamic acid | Tolfenamic acid may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolmetin | Tolmetin may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolterodine | Tolterodine may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tolvaptan | Tolvaptan may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Topiramate | Topiramate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Topotecan | The risk or severity of adverse effects can be increased when Topotecan is combined with Pralatrexate. |
| Torasemide | Torasemide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Pralatrexate. |
| Trabectedin | The risk or severity of adverse effects can be increased when Trabectedin is combined with Pralatrexate. |
| Tramadol | Tramadol may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Trametinib | Pralatrexate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Pralatrexate. |
| Trastuzumab | The risk or severity of adverse effects can be increased when Trastuzumab emtansine is combined with Pralatrexate. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Pralatrexate. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Pralatrexate. |
| Triamterene | Triamterene may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Triazolam | Triazolam may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Trichlormethiazide | Trichlormethiazide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Triethylenetetram | Pralatrexate may decrease the excretion rate of Triethylenetetramine which could result in a higher serum level. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Pralatrexate. |
| Trilostane | The risk or severity of adverse effects can be increased when Trilostane is combined with Pralatrexate. |
| Trimebutine | Pralatrexate may decrease the excretion rate of Trimebutine which could result in a higher serum level. |
| Trimethoprim | Trimethoprim may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Trimetrexate | Trimetrexate may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Tropisetron | Pralatrexate may decrease the excretion rate of Tropisetron which could result in a higher serum level. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Pralatrexate. |
| Typhoid Vaccine | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Pralatrexate. |
| Typhoid Vi | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Pralatrexate. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Upadacitinib. |
| Vaborbactam | Pralatrexate may decrease the excretion rate of Vaborbactam which could result in a higher serum level. |
| Valaciclovir | Valaciclovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Valbenazine | Pralatrexate may decrease the excretion rate of Valbenazine which could result in a higher serum level. |
| Valdecoxib | Valdecoxib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Valganciclovir | Valganciclovir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Vancomycin | Pralatrexate may decrease the excretion rate of Vancomycin which could result in a higher serum level. |
| Vandetanib | Vandetanib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Varenicline | Varenicline may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Varicella zoster | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Pralatrexate. |
| Varicella zoster | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Pralatrexate. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Vedolizumab. |
| Velpatasvir | Velpatasvir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Vemurafenib | Vemurafenib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Venetoclax | Venetoclax may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Venlafaxine | Venlafaxine may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
| Verapamil | Verapamil may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Vibrio antigen | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Pralatrexate. |
| Vilanterol | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Vilanterol. |
| Viloxazine | Pralatrexate may decrease the excretion rate of Viloxazine which could result in a higher serum level. |
| Vinblastine | The risk or severity of adverse effects can be increased when Vinblastine is combined with Pralatrexate. |
| Vincristine | The risk or severity of adverse effects can be increased when Vincristine is combined with Pralatrexate. |
| Vindesine | The risk or severity of adverse effects can be increased when Vindesine is combined with Pralatrexate. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Vinorelbine is combined with Pralatrexate. |
| Vismodegib | Vismodegib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Voclosporin | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Voclosporin. |
| Vorinostat | The risk or severity of adverse effects can be increased when Vorinostat is combined with Pralatrexate. |
| Vortioxetine | Pralatrexate may decrease the excretion rate of Vortioxetine which could result in a higher serum level. |
| Voxilaprevir | Voxilaprevir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Warfarin | Pralatrexate may decrease the excretion rate of Warfarin which could result in a higher serum level. |
| Yellow fever vaccine | The risk or severity of infection can be increased when Yellow fever vaccine is combined with Pralatrexate. |
| Zaleplon | Zaleplon may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Zanamivir | Zanamivir may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Zidovudine | The risk or severity of adverse effects can be increased when Zidovudine is combined with Pralatrexate. |
| Zonisamide | Zonisamide may increase the excretion rate of Pralatrexate which could result in a lower serum level and potentially a reduction in efficacy. |
Pregnancy and Lactation
FDA Pregnancy Category D
Pregnancy
FOLOTYN can cause fetal harm when administered to a pregnant woman. Pralatrexate was embryotoxic and fetotoxic in rats at IV doses of 0.06 mg/kg/day (0.36 mg/m2/day or about 1.2% of the clinical dose on an mg/m2 basis) given on gestation days 7 through 20. Treatment with pralatrexate caused a dose-dependent decrease in fetal viability manifested as an increase in late, early, and total resorptions. There was also a dose-dependent increase in post-implantation loss. In rabbits, IV doses of 0.03 mg/kg/day (0.36 mg/m2 /day) or greater given on
gestation days 8 through 21 also caused abortion and fetal lethality. This toxicity manifested as early and total resorptions, post-implantation loss, and a decrease in the total number of live fetuses. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
Lactation
It is not known whether pralatrexate is excreted in human milk. Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions in nursing infants from this drug, a decision should be made whether to discontinue nursing or to discontinue FOLOTYN, taking into account the importance of FOLOTYN to the mother.
How should this medicine be used?
Pralatrexate injection comes as a solution (liquid) to be injected intravenously (into a vein) by a doctor or nurse in a hospital or clinic. It is usually given over a period of 3 to 5 minutes once a week for 6 weeks as part of a 7-week cycle. Your treatment will probably continue until your condition worsens or you develop serious side effects.
Your doctor may need to adjust your dose, skip a dose, or stop your treatment if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with a pralatrexate injection.
You will need to take folic acid and vitamin B12 during your treatment with pralatrexate injection to help prevent certain side effects. Your doctor will probably tell you to take folic acid by mouth every day beginning 10 days before you start your treatment and for 30 days after your final dose of pralatrexate injection. Your doctor will also probably tell you that you will need to receive a vitamin B12 injection no more than 10 weeks before your first dose of pralatrexate injection and every 8 to 10 weeks for as long as your treatment continues.
What special precautions should I follow?
Before receiving a pralatrexate injection,
- tell your doctor and pharmacist if you are allergic to pralatrexate injection, any other medications, or any of the ingredients in pralatrexate injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); probenecid (Probalan), and trimethoprim/sulfamethoxazole (Bactrim). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had kidney or liver disease.
- tell your doctor if you are pregnant, could be pregnant, or plan to become pregnant. You should not become pregnant while you are receiving pralatrexate injections. Talk to your doctor about birth control methods that you can use during your treatment. If you become pregnant while receiving a pralatrexate injection, call your doctor immediately. Pralatrexate injection may harm the fetus.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving a pralatrexate injection.
References
