Pemetrexed
Cytostatic · Antimetabolite
Indications
Malignant Pleural Mesothelioma.
Dosage
Malignant Pleural Mesothelioma: Adults: 500 mg/m² IV over 10 min on Day 1 of each 21-day cycle with cisplatin 75 mg/m² infused over 2 hr beginning 30 min after pemetrexed. Children: Not recommended.
Administration
Administered as an IV infusion over 10 min. Pemetrexed is compatible with standard polyvinyl chloride (PVC) administration sets and IV solution bags. Reconstitution: Reconstitute each 100 mg vial with 4.2 mL of 0.9% NaCl (preservative free). Reconstitute 500 mg vials with 20 mL of 0.9% NaCl (preservative free). Reconstitution of either size vial gives a solution containing pemetrexed 25 mg/mL. Gently swirl each vial until the powder is completely dissolved. Further dilution is required. An appropriate quantity of the reconstituted pemetrexed solution must be further diluted into a solution of 0.9% NaCl (preservative free), so that the total volume of solution is 100 mL. Compatibility: Stable in NS. Incompatible with diluents containing calcium, including Ringer’s lactate injection and Ringer’s injection. Stability: Store at 25°C (77°F); excursions are permitted between 15°C-30°C…
Adverse Effects
Blood dyscrasias, conjunctivitis, GI upset, dehydration, fatigue, skin reactions, alopecia, pyrexia, renal failure, chest pain, allergic reactions, stomatitis, dehydration, sensory neuropathy, motor neuropathy, dysgeusia. Raised serum creatinine and liver enzymes, infection. Reports of nephrogenic diabetes insipidus and renal tubular necrosis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Severe renal insufficiency. Precautions: Renal insufficiency, diabetes, cardiovascular risk factors, pleural effusion, ascites, monitor for myelo suppression. Give folic acid, vit E312 and a corticosteroid before, during and after treatment to reduce toxicity. Ensure adequate anti-emetic therapy and hydration before and after therapy. Mild to moderate renal impairment (CrCl 45-79m1/min), hepatic impairment. Monitor haematology, renal and hepatic function. Radiotherapy.
Interactions
Yellow fever and live attenuated vaccine, NSAIDs, aminoglycosides, loop diuretics, cyclosporin, probenecid, penicillin, anticoagulants, platinum compounds.
Advice to Patient
Contact prescriber if there is any allergic reaction (rash, hives, itching, difficulty in breathing, swelling on face/lips/tongue), nausea, vomiting, loss of appetite, diarrhoea, constipation, headache, mouth sores, body aches, unusual tiredness, dizziness, rapid heartbeat, severe stomach pain, swelling on arms/legs, fever, chills, persistent sore throat, difficulty in swallowing, changes in mood, depression, numbness/tingling of hands/feet, easy bruising or bleeding, chest pain. Do not get vaccinations without consulting prescriber. Avoid contact with people who have recently received oral polio vaccine, people who are sick or have infection. Sharp objects like nail cutters or safety razors should be used with caution. Avoid activities that may cause bruising or bleeding. Be cautious while shaving or brushing teeth. Wash hands regularly to prevent spread of infection. Reduce alcohol…
Pharmacokinetics
Metabolism: Minimal. Half-life elimination: Normal renal function: 3.5 hours. Excretion: Urine (70% to 90% as unchanged drug).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.