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The distribution of 4-HNE and similar alkenals has pharmaco-toxicological relevance: owing to the intrinsic toxicity of aldehydes, it is important to know their metabolism and fate: Alary et al

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[35] Although the mechanism is not very clear, the polyglutamylation of methotrexate and dihydrofolate in malignant cells is considered to play an important role in the selective reactivation of dihydrofolate reductase by folinic acid in normal cells

In patients with renal, cardiac or hepatic impairment, caution is required since the use of NSAIDs may result in deterioration of renal function

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