Etodolac and Pemetrexed Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 9, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pemetrexed Injection
Etodolac
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased PEMEtrexed exposure and an increased risk of PEMEtrexed toxicity (myelosuppression, renal toxicity, and gastrointestinal toxicity)
Interaction Deep Dive
Concomitant administration of NSAIDs and PEMEtrexed may decrease the clearance of PEMEtrexed1. Use caution when NSAIDs and PEMEtrexed are coadministered to patients with mild to moderate renal insufficiency (CrCl from 45 to 79 mL/min). Avoid NSAIDs with short elimination half-lives (eg, diclofenac, indomethacin) for a period of 2 days before, the day of, and 2 days following administration of PEMEtrexed. Avoid NSAIDs with longer half-lives (eg, nabumetone) for at least 5 days before, the day of, and 2 days following administration of PEMEtrexed 231. Dose adjustment of PEMEtrexed is not required in patients with normal renal function when NSAIDs are used concurrently. When concomitant use of NSAIDs and PEMEtrexed is necessary, monitor for PEMEtrexed-associated toxicity, especially myelosuppression, renal, and gastrointestinal toxicity 1.
Why it happens (mechanism)
Decreased clearance of PEMEtrexed
Literature reports
1 report — tap to read
a) Ibuprofen, an OAT3 inhibitor, administered at 400 mg four times a day decreased the clearance of PEMEtrexed and increased its exposure (AUC) by approximately 20% in patients with normal renal function (CrCl more than 80 mL/min) 1.
Common questions
Can I take Etodolac and Pemetrexed Injection together?
Increased PEMEtrexed exposure and an increased risk of PEMEtrexed toxicity (myelosuppression, renal toxicity, and gastrointestinal toxicity) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Etodolac and Pemetrexed Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Etodolac or Pemetrexed Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: ALIMTA(R) intravenous injection powder, pemetrexed intravenous injection powder. Lilly USA, LLC (per Manufacturer), Indianapolis, IN, 2013. DailyMed
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: TIVORBEX(R) oral capsules, indomethacin oral capsules. Iroko Pharmaceuticals LLC (per FDA), Philadelphia, PA, 2016. DailyMed
Keep reading about Pemetrexed Injection
Keep reading about Etodolac
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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