Health Alert:

COVID-19: The Latest Information from UPMC

Pralatrexate (Folotyn®)

About This Drug

Pralatrexate is used to treat cancer. It is given in your vein (IV).

Possible Side Effects

  • Decreased in the number of platelets. This may raise your risk of bleeding.
  • Nausea
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores in your mouth that hurt.
  • Tiredness

Note: Each of the side effects above was reported in 35% or greater of patients treated with pralatrexate. Not all possible side effects are included above.

Warnings and Precautions

  • Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Severe soreness of the mouth and throat
  • Changes in your liver function
  • Severe skin reactions, which can be life-threatening. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.
  • Tumor lysis syndrome - this drug may act on the cancer cells very quickly. This may affect how your kidneys work.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • You may also receive vitamin B12 and folic acid as part of your treatment, which helps decrease the side effects of pralatrexate. Please follow the administration instructions from your medical team very closely.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with nausea, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • There are no known interactions of pralatrexate with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with pralatrexate. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • There are known interactions of pralatrexate with other medicines and products like aspirin, naproxen, and ibuprofen. Ask your doctor what over-the-counter (OTC) medicines you can take for fever, headache and muscle and joint pain.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Easy bleeding or bruising
  • Feeling dizzy or lightheaded
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
  • New rash or a rash that is not relieved by prescribed medicines
  • If you think you are pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. It is recommended that effective methods of birth control should be used by women of childbearing age during cancer treatment. Let your doctor know right away if you think you may be pregnant.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.

Revised August 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.