Generic Name: pemetrexed (pem e TREX ed)
Brand Name: Alimta

What is pemetrexed?

Pemetrexed is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Pemetrexed is used to treat non-small cell lung cancer after other cancer medications have been tried without successful treatment.

Pemetrexed is also used with another medication called cisplatin to treat mesothelioma, a form of lung cancer associated with exposure to asbestos.

Pemetrexed may also be used for purposes not listed in this medication guide.

What is the most important information I should know about pemetrexed?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Slideshow: Flashback: FDA Drug Approvals 2013

What should I discuss with my healthcare provider before receiving pemetrexed?

You should not receive this medication if you are allergic to pemetrexed.

To make sure pemetrexed is safe for you, tell your doctor if you have:

  • kidney disease (especially if you take ibuprofen (Advil, Motrin) or other nonsteroidal anti-inflammatory drugs, or NSAIDs);

  • liver disease;

  • 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. Do not use pemetrexed if you are pregnant. It could harm the unborn baby. Use effective birth control to avoid pregnancy during your treatment with pemetrexed. Follow your doctor's instructions about how long to prevent pregnancy after your treatment ends.

It is not known whether pemetrexed passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using pemetrexed.

How is pemetrexed given?

Pemetrexed is injected into a vein through an IV. A healthcare provider will give you this injection.

Pemetrexed is usually given every 3 weeks. Your doctor will determine how many treatment cycles you should receive.

To prevent certain side effects of pemetrexed, you will need to take folic acid supplements and receive vitamin B12 injections (starting 7 days before your first dose of pemetrexed). Take only the amount of folic acid that your doctor has prescribed.

Your doctor may also prescribe steroid medication to reduce certain side effects of pemetrexed. Follow your doctor's dosing instructions very carefully.

Pemetrexed can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your pemetrexed injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving pemetrexed?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using pemetrexed, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Pemetrexed side effects

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

Call your doctor at once if you have:

  • severe ongoing vomiting or diarrhea;

  • bone marrow suppression--fever, swollen gums, painful mouth sores, cold or flu symptoms, sore throat, pale skin, easy bruising or bleeding, skin sores, red or pink urine, rapid heart rate, feeling light-headed or short of breath,

  • kidney problems--swelling, rapid weight gain, little or no urinating;

  • signs of dehydration--feeling very thirsty or hot, being unable to urinate, heavy sweating, hot and dry skin; or

  • 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:

  • tired feeling, loss of appetite, weight loss;

  • upset stomach, nausea, vomiting, diarrhea;

  • mild rash; or

  • hair loss.

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.

See also: Side effects (in more detail)

What other drugs will affect pemetrexed?

Pemetrexed can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

This list is not complete. Other drugs may interact with pemetrexed, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about pemetrexed.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2013-08-13, 2:27:04 PM.

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