Pralatrexato
Pralatrexato Uses, Dosage, Side Effects, Food Interaction and all others data.
Pralatrexato is an antimetabolite for the treatment of relapsed or refractory peripheral T-cell lymphoma. It is more efficiently retained in cancer cells than methotrexate. FDA approved on September 24, 2009.
Pralatrexato is a 10-deazaaminopterin analogue of methotrexate. Compared to methotrexate, pralatrexate binds to RTC-1 with 10-times the affinity and is a more potent substrate for FPGS. As a result, pralatrexate is better internalized and retained in cancer cells and is more cytotoxic.Km, pralatrexate = 0.3 μmol/L;Km, methotrexate = 4.8 μmol/L;Vmax/Km (rate of intracellular transport), pralatrexate = 12.6Vmax/Km (rate of intracellular transport), methotrexate = 0.9
Trade Name | Pralatrexato |
Availability | Prescription only |
Generic | Pralatrexate |
Pralatrexate Other Names | Pralatrexate, Pralatrexato, Pralatrexatum |
Related Drugs | prednisone, methotrexate, dexamethasone, rituximab, Rituxan, Revlimid, cyclophosphamide, vincristine, Imbruvica, Velcade |
Type | |
Formula | C23H23N7O5 |
Weight | Average: 477.4726 Monoisotopic: 477.176066881 |
Protein binding | 67 - 86% bound to plasma protein, albumin is the major binder. Does not significantly displace substrates from proteins. |
Groups | Approved, Investigational |
Therapeutic Class | |
Manufacturer | |
Available Country | |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Pralatrexato is an antineoplastic agent used for the treatment of relapsed or refractory peripheral T-cell lymphoma.
Treatment of relapsed or refractory peripheral T-cell lymphoma.
Pralatrexato is also used to associated treatment for these conditions: Cutaneous T-Cell Lymphoma (CTCL), Relapsed Peripheral T-Cell Lymphoma, Refractory Peripheral T-cell Lymphoma Unspecified
How Pralatrexato works
The selectivity of pralatrexate for cancer cells is based upon the observation that cancer cells generally have an overexpression of reduced folate carrier protein-1 (RTC-1) compared to normal somatic cells. This carrier protein allows the entrance of pralatrexate into the cell. Upon entering the cell, folypolyglutamate synthase FPGS catalyzes the polyglutamination of pralatrexate so that it is retained inside the cell.
Once inside, pralatrexate competitively inhibits dihydrofolate reductase (DHFR) and thymidylate synthase. Subsequent depletion of thymidine monophosphate (TMP) occurs so that the cancer cell is unable to synthesize DNA and RNA. As a result, the cancer cell cannot proliferate and is forced to undergo apoptosis. Pralatrexato is more effective against cells that are actively dividing.
Toxicity
Mucositis is the dose-limiting toxicity. Folic acid and vitamin B12 supplements do not prevent mucositis from happening.
Food Interaction
No interactions found.Pralatrexato Drug Interaction
Moderate: ibuprofen / pseudoephedrine, filgrastim, bifidobacterium infantis / lactobacillus acidophilus / streptococcus thermophilus, denosumabUnknown: fexofenadine / pseudoephedrine, diphenhydramine, menthol topical, fulvestrant, ginger, palbociclib, dextromethorphan / guaifenesin, esomeprazole, lansoprazole, chondroitin / glucosamine, levothyroxine, riboflavin, ascorbic acid, ergocalciferol, zinc sulfate, cetirizine
Pralatrexato Disease Interaction
Volume of Distribution
Vss, R-pralatrexate = 37 L Vss, S-pralatrexate = 105 L
Elimination Route
Pralatrexato demonstrates linear pharmacokinetics with a multiphasic decline with both diasteromers over dose range of 30-325 mg/m^2. Bioavailability, nonformulated preparation = 13 - 20%
Half Life
12-18 hours
Clearance
R- pralatrexate = 191 mL/min S- pralatrexate = 417 mL/min Mean clearance of both enantiomers is 220 mL/min.
Elimination Route
35% of drug is excreted unchanged in the urine (no difference between R- and S- pralatrexate). May be some net renal tubular excretion.
Innovators Monograph
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