Common brand names

• Folotyn

How it is administered

Pralatrexate is given as an intravenous (IV) injection. It is supplied as a clear yellow solution in single-dose vials, with each 1 mL containing 20 mg of pralatrexate. The recommended dose is 30 mg/m² administered over 3 to 5 minutes once weekly for 6 weeks in 7-week cycles. For patients with severe renal impairment, the dose is reduced to 15 mg/m². Pralatrexate should not be diluted and is administered undiluted via the side port of a free-flowing IV line.

Patients are also advised to take folic acid by mouth daily and receive vitamin B12 injections every 8-10 weeks to help reduce the risk of side effects.

How it works

Pralatrexate is a type of chemotherapy known as a folate analog metabolic inhibitor. It works by blocking an enzyme called dihydrofolate reductase, which is important for making DNA and other molecules that cells need to grow and divide. By inhibiting this enzyme, pralatrexate interferes with the ability of cancer cells to multiply, leading to their death.

This medication is particularly effective in targeting rapidly dividing cells, such as those found in certain types of blood cancers. Because cancer cells often grow and divide faster than normal cells, they are more affected by pralatrexate’s action. However, some normal cells that divide quickly can also be affected, which accounts for some of the side effects seen with this treatment.

Who should take it

Pralatrexate is indicated for adults with relapsed or refractory peripheral T-cell lymphoma (PTCL), a type of non-Hodgkin lymphoma that affects T-cells. It is used when the disease has returned after previous treatment or has not responded to other therapies.

This medication is typically considered when other standard treatments have not been effective, and it is given under the supervision of a healthcare provider experienced in treating blood cancers. Patients should have regular monitoring during treatment to check for side effects and response to therapy.

Who should not take it

There are no absolute contraindications listed for pralatrexate, but it should be used with caution in certain groups:

• Patients with end-stage renal disease (with or without dialysis) should avoid pralatrexate because of increased risk of serious side effects.
• Pregnant women should not take pralatrexate, as it can cause harm to an unborn baby. Women of childbearing potential and men with female partners should use effective contraception during and after treatment (6 months for women, 3 months for men).
• Patients with severe liver problems or significant ongoing infections should discuss risks with their doctor before starting pralatrexate.

Always inform your healthcare provider about all medical conditions and medications before starting pralatrexate.

Commonly used with

Pralatrexate is often used as a single agent for relapsed or refractory PTCL. However, supportive medications are commonly given alongside pralatrexate to help manage side effects, such as:

• Folic acid (oral)
• Vitamin B12 (injection)
• Growth factors (like G-CSF or GM-CSF) to support blood counts if needed

Patients should inform their healthcare provider about all other medications they are taking, as some drugs (such as probenecid or nonsteroidal anti-inflammatory drugs) can increase the risk of side effects.

Commonly tested with

In clinical studies, pralatrexate has been evaluated primarily as a single agent in patients with relapsed or refractory peripheral T-cell lymphoma. It may be tested with supportive medications like folic acid and vitamin B12 to reduce side effects.

There is no standard combination with other chemotherapy agents for PTCL, but pralatrexate may be studied in combination with other drugs in clinical trials. Always consult with your healthcare provider about ongoing research or combination therapies.