Pemetrexed MOA is:

Ref: Goodman & Gillman's 13th ed. P 1179* Pemetrexed is a most recent folate analogue which is avidly transported into cells via the reduced folate carrier and is converted to its metabolite (PGs- Polyglutamate) that inhibit Thymidylate synthase and glycine amide ribonucleotide transformylase, as well as DHFR. (Dihydrofolate Reductase)* It is even more potent than methotrexate.* Like MTX, it induces p53 and cell-cycle arrest, but this effect does not depend on induction of p21.* Use: It has activity against ovarian cancer, mesothelioma, and adenocarcinomas of the lung.* Other effects and side effects are similar to methotrexate like myelosuppression, GI toxicity. The toxicity can be attenuated with folate and vitamin B12 supplementation.* A newer congener, pralatrexate, is more effectively taken up and polyglutamated than MTX and is approved for treatment of CTCL peripheral T cell lymphoma.* Pramipexole is an antiparkinsonism drug which is a dopamine agonist.