Pralatrexate
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alberto Plate [2]
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Overview
Pralatrexate is an antimetabolite, antineoplastic agent that is FDA approved for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). Common adverse reactions include edema, constipation, nausea, anemia, neutropenia, thrombocytenia, cough and fatigue.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
There is limited information regarding Pralatrexate FDA-Labeled Indications and Dosage (Adult) in the drug label.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Pralatrexate in adult patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Pralatrexate in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
There is limited information regarding Pralatrexate FDA-Labeled Indications and Dosage (Pediatric) in the drug label.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Pralatrexate in pediatric patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Pralatrexate in pediatric patients.
Contraindications
None
Warnings
Bone Marrow Suppression
- FOLOTYN can cause bone marrow suppression, manifested by thrombocytopenia, neutropenia, and/or anemia. Monitor complete blood counts and omit and/or reduce the dose based on ANC and platelet count prior to each dose as outlined in Section 2.2 TABLE 2. Administer vitamin B12 and instruct patients to take folic acid to reduce the risk of treatment-related hematological toxicity.
Mucositis
- FOLOTYN can cause mucositis. Monitor for mucositis weekly and if ≥ Grade 2 mucositis is observed, omit and/or reduce the dose as outlined in Section 2.2 TABLE 1. Administer vitamin B12 and instruct patients to take folic acid to reduce the risk of mucositis.
Dermatologic Reactions
- FOLOTYN can cause severe dermatologic reactions, which may result in death. These dermatologic reactions have been reported in clinical studies (14/663 patients [2.1%]) and post marketing experience, and have included skin exfoliation, ulceration, and toxic epidermal necrolysis (TEN). They may be progressive and increase in severity with further treatment, and may involve skin and subcutaneous sites of known lymphoma. Monitor patients with dermatologic reactions closely, and if severe, withhold or discontinue FOLOTYN.
Tumor Lysis Syndrome
- FOLOTYN can cause tumor lysis syndrome (TLS). Monitor patients who are at increased risk of TLS and treat promptly.
Hepatic Toxicity
- FOLOTYN can cause hepatic toxicity and liver function test abnormalities. Persistent liver function test abnormalities may be indicators of hepatic toxicity and require dose modification or discontinuation. Monitor liver function tests. Omit dose until recovery, adjust or discontinue therapy based on the severity of the hepatic toxicity.
Risk of Increased Toxicity in the Presence of Impaired Renal Function
- Patients with moderate to severe renal function impairment may be at greater risk for increased exposure and toxicity. Monitor patients for renal function and systemic toxicity and adjust dosing accordingly.
- Serious adverse drug reactions including toxic epidermal necrolysis and mucositis were reported in patients with end stage renal disease (ESRD) undergoing dialysis who were administered FOLOTYN therapy. Avoid FOLOTYN use in patients with end stage renal disease including those undergoing dialysis unless the potential benefit justifies the potential risk.
Embryo-Fetal Toxicity
- FOLOTYN can cause fetal harm when administered to a pregnant woman. FOLOTYN was embryotoxic and fetotoxic in rats and rabbits. 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.
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Pralatrexate Clinical Trials Experience in the drug label.
Postmarketing Experience
There is limited information regarding Pralatrexate Postmarketing Experience in the drug label.
Drug Interactions
There is limited information regarding Pralatrexate Drug Interactions in the drug label.
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
There is no FDA guidance on usage of Pralatrexate in women who are pregnant.
Pregnancy Category (AUS):
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Pralatrexate in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Pralatrexate during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Pralatrexate in women who are nursing.
Pediatric Use
There is no FDA guidance on the use of Pralatrexate in pediatric settings.
Geriatic Use
There is no FDA guidance on the use of Pralatrexate in geriatric settings.
Gender
There is no FDA guidance on the use of Pralatrexate with respect to specific gender populations.
Race
There is no FDA guidance on the use of Pralatrexate with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Pralatrexate in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Pralatrexate in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Pralatrexate in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Pralatrexate in patients who are immunocompromised.
Administration and Monitoring
Administration
There is limited information regarding Pralatrexate Administration in the drug label.
Monitoring
There is limited information regarding Pralatrexate Monitoring in the drug label.
IV Compatibility
There is limited information regarding the compatibility of Pralatrexate and IV administrations.
Overdosage
There is limited information regarding Pralatrexate overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.
Pharmacology
There is limited information regarding Pralatrexate Pharmacology in the drug label.
Mechanism of Action
There is limited information regarding Pralatrexate Mechanism of Action in the drug label.
Structure
There is limited information regarding Pralatrexate Structure in the drug label.
Pharmacodynamics
There is limited information regarding Pralatrexate Pharmacodynamics in the drug label.
Pharmacokinetics
There is limited information regarding Pralatrexate Pharmacokinetics in the drug label.
Nonclinical Toxicology
There is limited information regarding Pralatrexate Nonclinical Toxicology in the drug label.
Clinical Studies
There is limited information regarding Pralatrexate Clinical Studies in the drug label.
How Supplied
There is limited information regarding Pralatrexate How Supplied in the drug label.
Storage
There is limited information regarding Pralatrexate Storage in the drug label.
Images
Drug Images
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Package and Label Display Panel
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Patient Counseling Information
There is limited information regarding Pralatrexate Patient Counseling Information in the drug label.
Precautions with Alcohol
Alcohol-Pralatrexate interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
There is limited information regarding Pralatrexate Brand Names in the drug label.
Look-Alike Drug Names
There is limited information regarding Pralatrexate Look-Alike Drug Names in the drug label.
Drug Shortage Status
Price
References
The contents of this FDA label are provided by the National Library of Medicine.
This article needs additional citations for verification. (June 2007) (Learn how and when to remove this template message) |
File:Pralatrexate.png | |
Identifiers | |
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CAS Number | |
PubChem CID | |
E number | {{#property:P628}} |
ECHA InfoCard | {{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value). |
Chemical and physical data | |
Formula | C23H23N7O5 |
Molar mass | 477.47 g/mol |
Pralatrexate (rINN), also known as 10-propargyl-10-deazaaminopterin, common name PDX, is a drug candidate being studied for the treatment of cancer. PDX is a folate analog inhibitor of dihydrofolate reductase. As of July 2005, it is undergoing Phase 1 and Phase 2 clinical trials for treatment of non-Hodgkin lymphoma and non-small cell lung cancer.
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- Dihydrofolate reductase inhibitors