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Pemetrexed

Generic Name: pemetrexed (PEM-e-TREX-ed)
Brand Name: Alimta

Pemetrexed is used for:

Treating malignant pleural mesothelioma and certain types of non-small cell lung cancer in certain patients. It may be used alone or in combination with cisplatin (another anticancer medicine).

Pemetrexed is an antifolate antineoplastic agent. It works by decreasing tumor cell growth.

Do NOT use pemetrexed if:

  • you are allergic to any ingredient in pemetrexed
  • you have severe kidney problems
  • you have taken or will be taking palifermin within 24 hours before or after using pemetrexed

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using pemetrexed:

Some medical conditions may interact with pemetrexed. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are able to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have liver or kidney problems, bone marrow problems, diarrhea, an infection, or blood problems (eg, low platelets, low white blood cell count)
  • if you have a history of radiation treatment
  • if you have recently received or are scheduled to receive a vaccine

Some MEDICINES MAY INTERACT with pemetrexed. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Palifermin because if mouth or tongue sores develop, they may be more severe or last longer
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), probenecid, or medicines that may harm the kidney (eg, aminoglycoside antibiotics [gentamicin], amphotericin B, cyclosporine, tacrolimus, vancomycin) because they may increase the risk of pemetrexed's side effects. Ask your doctor if you are unsure if any of your medicines might harm the kidney

This may not be a complete list of all interactions that may occur. Ask your health care provider if pemetrexed may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use pemetrexed:

Use pemetrexed as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with pemetrexed. Talk to your pharmacist if you have questions about this information.
  • Pemetrexed is usually given as an injection at your doctor's office, hospital, or clinic. Contact your health care provider if you have any questions.
  • Do not use pemetrexed if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of pemetrexed, contact your doctor right away.

Ask your health care provider any questions you may have about how to use pemetrexed.

Important safety information:

  • Pemetrexed may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • If you also take an NSAID (eg, naproxen), you may need to stop taking it for a period of time before you receive pemetrexed. You will also need to wait for 2 days after you receive pemetrexed before you begin to take the NSAID again. Check with your doctor for instructions.
  • If you are unsure if any of your medicines are NSAIDs, ask your doctor or pharmacist.
  • If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does.
  • Your doctor will instruct you to take other medicines, such as folic acid, vitamin B12 injections, and corticosteroids (eg, dexamethasone) before using pemetrexed as well as while you are using it. This may help to decrease the risk of certain serious side effects (eg, blood problems, mouth sores or inflammation). Follow the instructions for taking these medicines closely.
  • If diarrhea, nausea, vomiting, or appetite loss occurs, contact your doctor or pharmacist for ways to lessen these effects.
  • You may get redness or sores in your mouth, throat, or on your lips a few days after treatment with pemetrexed. Contact your doctor if this happens or if you have pain or trouble drinking or swallowing food.
  • Pemetrexed may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Do not receive a live vaccine (eg, measles, mumps) while you are taking pemetrexed. Talk with your doctor before you receive any vaccine.
  • Do not get pemetrexed on your skin. If pemetrexed spills on your skin, wash immediately with soap and water. Clean any areas (tables, counters) where pemetrexed may have spilled or sprayed.
  • Tell your doctor or dentist that you use pemetrexed before you receive any medical or dental care, emergency care, or surgery.
  • If you are able to become pregnant, be sure to use an effective form of birth control while using pemetrexed. Contact your doctor or pharmacist if you have any questions about effective birth control.
  • Lab tests, including complete blood cell counts and kidney and liver function, may be performed while you use pemetrexed. These tests may be used to monitor your progress or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use pemetrexed with caution in the ELDERLY; they may be more sensitive to its effects.
  • Pemetrexed should be used with extreme caution in CHILDREN; safety and effectiveness have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Pemetrexed may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using pemetrexed while you are pregnant. It is not known if pemetrexed is found in breast milk. Do not breast-feed while taking pemetrexed.

Possible side effects of pemetrexed:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; hair loss; indigestion; loss of appetite; mild sore throat; nausea; pain, swelling, or redness at the injection site; taste changes; tiredness or weakness; vomiting; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); burning, numbness, or tingling; chest pain; decreased amount of urine produced; fever, chills, or persistent cough or sore throat; irregular heartbeat; mood or mental changes; red, swollen, blistered, or peeling skin; redness or sores in your mouth, throat, or on your lips; severe or persistent diarrhea, nausea, vomiting, or stomach pain; severe or persistent tiredness or weakness; shortness of breath; swelling of the hands, ankles, or feet; symptoms of dehydration (eg, sluggishness, very dry mouth or eyes); trouble swallowing; unusual bruising or bleeding; unusually pale skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms of overdose may include diarrhea; infection with or without fever; inflammation or sores in the mouth or throat; rash; severe tiredness or weakness; unusual bruising or bleeding.

Proper storage of pemetrexed:

Pemetrexed is usually handled and stored by a health care provider. Keep pemetrexed out of the reach of children and away from pets.

General information:

  • If you have any questions about pemetrexed, please talk with your doctor, pharmacist, or other health care provider.
  • Pemetrexed is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take pemetrexed or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about pemetrexed. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to pemetrexed. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using pemetrexed.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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