Pemetrexed

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.
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.
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.

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.

Pemetrexed Interactions

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 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.

Pemetrexed Dosage

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.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Call your doctor for instructions if you miss an appointment for your pemetrexed injection.