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Last reviewed on RxList: 8/17/2017
Folotyn Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 8/17/2017

Folotyn (pralatrexate injection) is an antineoplastic (anti-cancer) drug used to treat T-cell lymphoma that has spread throughout the body. Folotyn is given for relapsed T-cell lymphoma, or after other medications have been tried without successful treatment. Common side effects of Folotyn include:

Serious skin reactions can occur. Tell your doctor if you develop rash, peeling, sores or blisters on the skin while using Folotyn. Tell your doctor if you have unlikely but serious side effects of Folotyn including:

  • signs of infection (such as fever, cough, sore throat, chills),
  • easy bleeding or bruising,
  • dehydration,
  • feeling weak,
  • looking pale, or
  • shortness of breath.

The recommended dose of Folotyn is 30 mg/m² administered as an intravenous push over 3-5 minutes via the side port of a free-flowing 0.9% Sodium Chloride Injection, intravenous line once weekly for 6 weeks in 7-week cycles until progressive disease or unacceptable toxicity. Folotyn may interact with probenecid, trimethoprim, or aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs). Tell your doctor all medications and supplements you use. Folotyn is not recommended for use during pregnancy. It may harm a fetus. If you become pregnant or think you may be pregnant, tell your doctor. It is unknown if this drug passes into breast milk. Because of the potential harm to a nursing infant, breastfeeding while using Folotyn is not recommended.

Our Folotyn (pralatrexate injection) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Folotyn Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • bone marrow suppression--fever, chills, cold or flu symptoms, pale skin, easy bruising or bleeding, red or pink urine, painful mouth sores, cough, trouble breathing, feeling light-headed, rapid heart rate;
  • dehydration--feeling very thirsty or hot, are unable to urinate, and have heavy sweating or hot and dry skin;
  • low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, loss of appetite, diarrhea, constipation;
  • tired feeling;
  • swelling; or
  • mild rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Folotyn (Pralatrexate Solution for Intravenous Injection)

Folotyn Professional Information


The following serious adverse reactions are described below and elsewhere in the labeling:

The most common adverse reactions observed in patients with peripheral T-cell lymphoma (PTCL) treated with FOLOTYN were mucositis, thrombocytopenia, nausea, and fatigue.

Clinical Trials Experience

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.

The safety of FOLOTYN was evaluated in 111 PTCL patients in a single-arm clinical study in which patients received a starting dose of 30 mg/m² once weekly for 6 weeks in 7-week cycles. The median duration of treatment was 70 days (range 1-540 days).

Most Frequent Adverse Reactions

Table 4 summarizes the most frequent adverse reactions, regardless of causality, using the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI CTCAE, version 3.0).

Table 4 : Adverse Reactions Occurring in PTCL Patients (Incidence ≥ 10% of patients )

Preferred Term N=111
Total Grade 3 Grade 4
N % N % N %
Any Adverse Event 111 100 48 43 34 31
  Mucositisa 78 70 19 17 4 4
  Thrombocyto peniab 45 41 15 14 21 19b
  Nausea 44 40 4 4 0 0
  Fatigue 40 36 5 5 2 2
  Anemia 38 34 17 15 2 2
  Constipation 37 33 0 0 0 0
  Pyrexia 36 32 1 1 1 1
  Edema 33 30 1 1 0 0
  Cough 31 28 1 1 0 0
  Epistaxis 29 26 0 0 0 0
  Vomiting 28 25 2 2 0 0
  Neutropenia 27 24 14 13 8 7
  Diasuprrhea 23 21 2 2 0 0
  Dyspnea 21 19 8 7 0 0
  Anorexia 17 15 3 3 0 0
  Hypokalemia   17 15 4 4 1 1
  Rash  17 15 0 0 0 0
  Pruritus 16 14 2 2 0 0
  Pharyngolaryngeal pain 15 14 1 1 0 0
  Liver function test abnormalc 14 13 6 5 0 0
  Abdominal pain 13 12 4 4 0 0
  Pain in extremity 13 12 0 0 0 0
  Back pain 12 11 3 3 0 0
  Leukopenia 12 11 3 3 4 4
  Night sweats 12 11 0 0 0 0
  Asthenia 11 10 1 1 0 0
  Tachycardia 11 10 0 0 0 0
  Upper respiratory tract infection 11 10 1 1 0 0
a Stomatitis or mucosal inflammation of the gastrointestinal and genitourinary tracts.
b Five patients with platelets < 10,000/mcL
c Alanine aminotransferase, aspartate aminotransferase, and transaminases increased

Serious Adverse Events

Forty-four percent of patients (n = 49) experienced a serious adverse event while on study or within 30 days after their last dose of FOLOTYN. The most common serious adverse events ( > 3%), regardless of causality, were pyrexia, mucositis, sepsis, febrile neutropenia, dehydration, dyspnea, and thrombocytopenia. One death from cardiopulmonary arrest in a patient with mucositis and febrile neutropenia was reported in this trial. Deaths from mucositis, febrile neutropenia, sepsis, and pancytopenia occurred in 1.2% of patients treated on all FOLOTYN trials at doses ranging from 30 to 325 mg/m².


Twenty-three percent of patients (n = 25) discontinued treatment with FOLOTYN due to adverse reactions. The adverse reactions reported most frequently as the reason for discontinuation of treatment were mucositis (6%, n = 7) and thrombocytopenia (5%, n = 5).

Dose Modifications

The target dose of FOLOTYN was 30 mg/m² once weekly for 6 weeks in 7-week cycles. The majority of patients (69%, n = 77) remained at the target dose for the duration of treatment. Overall, 85% of scheduled doses were administered.

Post Marketing Experience

Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Dermatologic Reactions

Toxic epidermal necrolysis, sometimes fatal, has been reported during post-marketing use of FOLOTYN. Fatal cases have been reported following the first dose of FOLOTYN, including when a reduced dose is given, and have been reported in patients with end-stage renal disease undergoing dialysis [see WARNINGS AND PRECAUTIONS, Use in Specific Populations, and CLINICAL PHARMACOLOGY].

Read the entire FDA prescribing information for Folotyn (Pralatrexate Solution for Intravenous Injection)

Related Resources for Folotyn

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© Folotyn Patient Information is supplied by Cerner Multum, Inc. and Folotyn Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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