Brand name: Alimta
Eli Lilly and Co
Availability: Pemetrexed is available by
Pemetrexed was approved in February 2004 by the US FDA (Food and Drug Administration) for treatment of malignant
pleural mesothelioma, in combination with cisplatin. Thereafter, in September 2008, the FDA approved the drug as
a first-line treatment, in combination with cisplatin, of locally-advanced and metastatic non-small cell lung
cancer (NSCLC) in patients with non-squamous histology.
Indications: Pemetrexed is used to treat the
mesothelioma that was not previously treated with other chemotherapy drugs. Most of the times, Pemetrexed
is used in combination with another chemotherapy drug called cisplatin.
or metastatic non-small cell lung cancer that was treated with monochemotherapy.
doctor can use Pemetrexed to treat other medical conditions non-mentioned in this article if he believes it may
form: Pemetrexed is taken by injection into
a vein (intravenous, IV), usually associated with cisplatin.
In addition, you can be prescribed folic acid and vitamin B12 to
supplement your diet in order to reduce the development of side effects.
ike any chemotherapy drug, Pemetrexed must be administered only by medical professionals experienced in the use of
anticancer chemotherapy. The instructions recommended should be respected. In other words, PEMETREXED solution must
be prepared and administered according to the FDA approved indications
Pemetrexed is used in combination with cisplatin, the dosage is usually 500 mg / m² Body Surface Area (BSA). The
drug is recommended to be taken by intravenous infusion during a period of 10 minutes, once every 21 days. The
recommended dose of cisplatin is 75 mg / m² body surface area (BSA) injected over 2 hours. It is recommended to start the injection about 30 minutes
after the Pemetrexed injection. To increase the curative effects and decrease the side effects of Pemetrexed,
the therapy must be accompanied by an antiemetic treatment (against vomiting and nausea) and adequate hydration
before and after the injection of cisplatin.
Pemetrexed is given by intravenous injection, usually in combination with other drugs. The drug is given by a
specialist in oncology, hematology, or by a competent physician that has experience in giving chemotherapy
medications; this reduces any chance of overdose. However, in cases of overdose symptoms, your doctor may reduce
the dosage or stopping the treatment completely. Therefore, if you experience signs or symptoms of complications
(see side effects), contact your doctor immediately.
dose: since Pemetrexed is administered in
hospital, missing dose is basically difficult if you are present for your appointment. If for some reasons you
cannot go to the hospital for the treatment, contact your doctor before the date schedule for the injection.
contraindicated in the following conditions:
or adolescent below 18 years
association with vaccine against yellow fever
to mannitol, Pemetrexed or any of its ingredients
or liver disease
- Pemetrexed increased the risk of adverse reactions in breastfed infant; therefore, breastfeeding should
be discontinued during treatment with Pemetrexed;
Pregnancy - Pemetrexed can cause birth defects when administered during pregnancy. It is recommended that all
women of childbearing age, and who are sexually active to follow an effective contraceptive method during
treatment with Pemetrexed to avoid pregnancy. It is also recommended that men do not conceive after 6 months of
Mechanism of Action (MOA)
: Pemetrexed acts by inhibiting several metabolic processes involved in the synthesis of DNA, and therefore
prevents multiplication of
If you are taking Pemetrexed, talk to your doctor before taking any prescription or nonprescription medications:
Advil, Motrin, Aleve, Naprosyn, and others. Other than folic acid and vitamin 12, you should not take vitamins,
nutritional supplements or/and herbal products without the recommendation of your doctor.
effects: to reduce the occurrence and severity
of skin reactions, a corticosteroid is recommended to be administered the day before, the same day and the day
after taking Pemetrexed. In general, the dosage is 4 mg of dexamethasone (Decadron) taken by mouth twice a day.
In addition, your doctor may recommend you to take folic acid or a multivitamin containing folic acid daily. At
least five doses of folic acid must be taken within 7 days before the first dose of Pemetrexed. You should
continue taking the supplement during the duration of the treatment and for 21 days following the last day of
also be prescribed an intramuscular injection of vitamin B12 in the week preceding the first dose of Pemetrexed
and once every three cycles. Subsequent injections of vitamin B12 can take place the same day as the
Pemetrexed tends to damage the bone marrow, which causes a deficiency of white blood cells, red blood cells and
platelets. In addition, the toxicity of the drug may cause adverse reaction in most patients. Most common
Pemetrexed side effects include:
- loss of appetite
- loss of taste
- weight loss
- pale skin or/and skin rashes
- hair loss
- joint or
- Bowel problems
(diarrhea or constipation
your health care provider right away if you experience at least one of the following:
- dizziness or
- chest pain and/or
- unreasonable bleeding or
- difficulty breathing and/or
- weakness or numbness of an arm or
Pain, numbness, or tingling in the hands or feet.