Raltitrexed

Raltitrexed is a folate analog transported into cells primarily via the reduced folate transporter. Once inside, it undergoes polyglutamation. This polyglutamated form exhibits increased inhibitory potency against folate-dependent enzymes required for purine and thymidylate synthesis, thereby interfering with DNA synthesis and cellular proliferation.

Renal adjustment

Avoid if creatinine clearance less than 30 mL/minute. Reduce dose in mild to moderate impairment (consult product literature).

Hepatic adjustment

Manufacturer advises caution (increased risk of accumulation).

• Creatinine clearance less than 30 mL/minute
• Pregnancy
• Breast-feeding