Description: Antineoplastic Agent, Antimetabolite (Antifolate)
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Pemetrexed, Alimta is an antifolate that disrupts folate-dependent metabolic processes essential for cell replication. Pemetrexed, Alimta inhibits dihydrofolate reductase, glycinamide ribonucleotide formyltransferase, thymidylate synthase, and aminoimidazole carboxamide ribonucleotide formyltransferase. These enzymes are involved in folate metabolism and DNA synthesis and inhibiting them results in inhibition of purine and thymidine nucleotide and protein synthesis.
Indications For Use
Mesothelioma; Non-small cell lung cancer (NSCLC), nonsquamous
Before starting Pemetrexed, Alimta make sure your physician is aware of any allergies or medications you currently take, if you have renal impairment, third space fluid, are pregnant, or breastfeeding. Pemetrexed, Alimta use has been associated with rare but serious adverse events such as bone marrow suppression, cutaneous reactions, gastrointestinal toxicity, hypersensitivity reactions, nephrotoxicity, pulmonary toxicity, and radiation recall.
IV: 500 mg/m2 on day 1 of each 21-day cycle (in combination with cisplatin); continue until disease progression or unacceptable toxicity
Pharmacist Tips On Using
How to Take: Infuse over 10 minutes. When used in combination with platinum-based therapy (cisplatin or carboplatin), administer pemetrexed prior to the platinum. Administer pemetrexed after pembrolizumab if administered on the same day. Initiate folic acid supplementation 1 week before first dose of pemetrexed, continue for full course of therapy, and for 21 days after last pemetrexed dose. Institute vitamin B12 1 week before the first dose; administer every 9 weeks thereafter. Store intact vials at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Reconstituted solution and solution diluted for infusion are stable for 24 hours when refrigerated at 2°C to 8°C (36°F to 46°F).
You Need to Avoid: New treatment cycles should not begin unless ANC ≥1,500/mm3, platelets ≥100,000/mm3, CrCl ≥45 mL/minute, and recovery of nonhematologic toxicity to ≤ grade 2.
Fatigue, desquamation, skin rash, nausea, anorexia, vomiting, stomatitis, diarrhea, anemia, neutropenia, pharyngitis
Note this is not a complete list
Frequently Asked Questions
What do I do if side effects are intolerable?
If side effects are causing a lot of distress speak to your physician as soon as possible to discuss options.
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions and many other factors will further complicate or limit which medications are appropriate. This medication is used for certain forms of cancer and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to avoid many of the serious side effects and will keep you on the lowest effective dosage for the shortest amount of time possible.