Yellow fever and live attentenuated vaccine ( potentially fatal ) NSAIDs nephrotoxic agents including aminoglycosides loop diuretics, platinum comps cyclosporine penicillin, anticoagulants drugs eliminated by renal tubular secreation eg. probenecid

In combination with cisplatin for treatment of chemotherapy

Approved US FDA Drugs List- 2008

04-12-2008

Premetrexed disodium 500mg/100mg powder for sol (addl.Indication

As monotherapy for the second-line treatment of patients with locally advanced  or metastic non-small cell lung cancer other than predominently squamous cell histology

Blood dyscrasiasis lymphatic disorders conjunctivitis g- i upset fatigue dehydration dysgeusia sensory neuropathy renal and bladder disorders skin reactions altered blood chemistry and hepatobilliary disorders elevated creatinine

Renal insufficiency pregnancy lactation

Special precautions

Pretreat with foilic acid, vit B and a corticosteroid to reduce toxicity ensure adequate anti-emetic therapy and hydration before to and after therapy mild to moderate renal insufficiency

Monitor for myelosuppression withdraw or reduce susequent dose as necessary discontinue if grade 3 or grade 4 toxicity occurs

Hepatic impairment ensure adequate contraception for women during and for 6 mths after therapy

In combination with cisplatin for treatment of chemotherapy

Dosage-

Infusion over 10 minutes over on day 1 of each 21 day cycle Adjust dose if toxicity develops

Use contraindicated. Observe caution