Generic Name: pemetrexed (pem e TREX ed)
Brand Names: Alimta
What is pemetrexed?
Pemetrexed is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.
Pemetrexed is used to treat mesothelioma, a form of lung cancer associated with exposure to asbestos. Pemetrexed is also used to treat non-small cell lung cancer that has already been treated with other cancer medications.
Pemetrexed may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about pemetrexed?
Before receiving pemetrexed, tell your doctor if you are allergic to any drugs, or if you have kidney or liver disease, bone marrow suppression, a weak immune system, or excess fluid in the space around your lung, liver, or other internal organs.
Throughout your treatment with pemetrexed, you will need to take folic acid and vitamin B-12 to protect your stomach, blood cells, and bone marrow from the side effects of pemetrexed. You will need to start taking these supplements a week before receiving your first pemetrexed infusion, and will keep taking them for 3 weeks after your treatment ends.
Vitamin B-12 and folic acid are available over the counter. Be sure to take only the forms and strengths of these supplements that your doctor has recommended.
Pemetrexed is usually given every 3 weeks. Your doctor will determine how many treatment cycles you should receive.
Pemetrexed can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your cancer treatments may be delayed based on the results of these tests. Do not miss any scheduled visits to your doctor.
Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.
Before you receive pemetrexed, tell your doctor if you are taking an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), indomethacin (Indocin), ketoprofen (Orudis), and others.
What should I discuss with my healthcare provider before receiving pemetrexed?
You should not receive this medication if you are allergic to pemetrexed.
If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you receive pemetrexed, tell your doctor if you are allergic to any drugs, or if you have:
kidney disease;
liver disease;
bone marrow suppression;
a weak immune system; or
excess fluid in the space around your lung, liver, or other internal organs, including pleural effusion (fluid around the lungs) or ascites (fluid around the liver).
FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not receive pemetrexed without telling your doctor if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. It is not known whether pemetrexed passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.
How is pemetrexed given?
Pemetrexed is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and can take up to 10 minutes to complete.
Throughout your treatment with pemetrexed, you will need to take folic acid and vitamin B-12 to protect your stomach, blood cells, and bone marrow from the side effects of pemetrexed. You will need to start taking these supplements a week before receiving your first pemetrexed infusion, and will keep taking them for 3 weeks after your treatment ends.
Vitamin B-12 and folic acid are available over the counter. Be sure to take only the forms and strengths of these supplements that your doctor has recommended.
Your doctor may also prescribe steroid medications to reduce certain side effects of pemetrexed.
To treat mesothelioma, the pemetrexed injection is usually followed by infusion of cisplatin (Platinol) 30 minutes later. Cisplatin must be given very slowly, and is usually infused over 2 hours.
Pemetrexed is usually given every 3 weeks. Your doctor will determine how many treatment cycles you should receive.
Pemetrexed can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your cancer treatments may be delayed based on the results of these tests. Do not miss any scheduled visits to your doctor.
What happens if I miss a dose?
Contact your doctor if you miss an appointment to have your pemetrexed injection.
What happens if I overdose?
Seek emergency medical attention if you think you have received too much of this medicine.
Overdose may cause fever, chills, body aches, flu symptoms, mouth sores or white patches, and severe diarrhea.
What should I avoid while receiving pemetrexed?
Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.
Pemetrexed side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
pale skin, easy bruising or bleeding, unusual weakness;
fever, chills, body aches, flu symptoms;
white patches or sores inside your mouth or on your lips;
urinating less than usual, or not at all;
chest pain, trouble breathing;
swelling, rapid weight gain.
Less serious side effects may include:
skin rash;
numbness or tingling;
depressed mood;
sore throat;
tired feeling;
nausea, vomiting, diarrhea, constipation, indigestion, loss of appetite; or
muscle pain.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Pemetrexed Dosing Information
Usual Adult Dose for Malignant Pleural Mesothelioma:
Initial Dose:
500 mg/m2 of pemetrexed administered as an intravenous infusion over 10 minutes on day 1 of each 21 day cycle along with cisplatin.
Cisplatin 75 mg/m2 infused over 2 hours beginning approximately 30 minutes after the end of the pemetrexed administration. Patients should receive hydration consistent with local practice prior to and/or after receiving cisplatin.
Pretreatment with dexamethasone (or equivalent) reduces the incidence and severity of cutaneous reactions. In clinical trials, dexamethasone 4 mg was given orally twice a day, on the day before, the day of, and the day after pemetrexed administration.
To reduce toxicity, patients treated with pemetrexed must be instructed to take a low-dose oral folic acid preparation or a multivitamin with folic acid on a daily basis. The most commonly used dose of oral folic acid in clinical trials was 400 mcg. At least 5 daily doses of folic acid must be taken during the 7 day period preceding the first dose of pemetrexed and the dosing should continue during the full course of therapy and for 21 days after the last dose of pemetrexed.
Patients must also receive one intramuscular injection of vitamin B12 during the week preceding the first dose of pemetrexed and every 3 cycles thereafter. Subsequent vitamin B12 injections may be given on the same day as pemetrexed.
Usual Adult Dose for Non-Small Cell Lung Cancer:
Initial Dose:
500 mg/m2 of pemetrexed administered as an intravenous infusion over 10 minutes on day 1 of each 21 day cycle.
Pretreatment with dexamethasone (or equivalent) reduces the incidence and severity of cutaneous reactions. In clinical trials, dexamethasone 4 mg was given orally twice a day, on the day before, the day of, and the day after pemetrexed administration.
To reduce toxicity, patients treated with pemetrexed must be instructed to take a low-dose oral folic acid preparation or a multivitamin with folic acid on a daily basis. The most commonly used dose of oral folic acid in clinical trials was 400 mcg. At least 5 daily doses of folic acid must be taken during the 7 day period preceding the first dose of pemetrexed and the dosing should continue during the full course of therapy and for 21 days after the last dose of pemetrexed.
Patients must also receive one intramuscular injection of vitamin B12 during the week preceding the first dose of pemetrexed and every 3 cycles thereafter. Subsequent vitamin B12 injections may be given on the same day as pemetrexed.
What other drugs will affect pemetrexed?
Before receiving pemetrexed, tell your doctor if you are using any of the following drugs:
probenecid (Benemid);
an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.
This list is not complete and there may be other drugs that can interact with pemetrexed. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
More pemetrexed resources
- Pemetrexed Side Effects (in more detail)
- Pemetrexed Dosage
- Pemetrexed Use in Pregnancy & Breastfeeding
- Pemetrexed Drug Interactions
- Pemetrexed Support Group
- 0 Reviews for Pemetrexed - Add your own review/rating
- pemetrexed Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information
- Alimta Prescribing Information (FDA)
- Alimta Monograph (AHFS DI)
- Alimta Consumer Overview
- Pemetrexed Professional Patient Advice (Wolters Kluwer)
- Pemetrexed MedFacts Consumer Leaflet (Wolters Kluwer)
Compare pemetrexed with other medications
- Malignant Pleural Mesothelioma
- Non-Small Cell Lung Cancer
Where can I get more information?
- Your pharmacist can provide more information about pemetrexed.
See also: pemetrexed side effects (in more detail)
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