Alimta

Name: Alimta

What special precautions should I follow?

Before taking pemetrexed,

  • tell your doctor and pharmacist if you are allergic to pemetrexed, mannitol,or any other medications.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), or probenecid. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have a pleural effusion (excess fluid between the linings around the lung), ascites (excess fluid in the abdomen); or have or have ever had kidney or liver disease.
  • tell your doctor if you are pregnant or plan to become pregnant. You should use birth control to prevent pregnancy during your treatment with pemetrexed. If you become pregnant while using this medication, call your doctor. Pemetrexed may harm the fetus.
  • tell your doctor if you are breast-feeding. You should not breast-feed during your treatment with pemetrexed.

What should I do if I forget a dose?

If you miss an appointment to receive a dose of pemetrexed, call your doctor as soon as possible.

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.

Inform MD

Before taking Alimta, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are allergic to Alimta or to any of its ingredients
  • have kidney problems
  • have blood problems
  • are pregnant or are breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

 

What happens if I miss a dose?

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

Introduction

Antineoplastic agent; a folic acid antagonist.1 3 4 5

Stability

Storage

Parenteral

Powder for Injection

25°C (may be exposed to 15–30°C).1

Store reconstituted solution and infusion solutions at 25°C (may be exposed to 15–30°C) or refrigerate at 2–8°C; use solution within 24 hours of reconstitution; discard unused solution.1

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Use 0.9% sodium chloride injection (without preservatives) to reconstitute and dilute pemetrexed.1

Pemetrexed is not compatible with diluents containing calcium (e.g., Ringer’s injection; Ringer’s injection, lactated).1

Manufacturer recommends that pemetrexed not be administered with other drugs or diluents other than 0.9% sodium chloride injection.1

Proper Use of Alimta

It is very important to take folic acid and vitamin B12 during your treatment with pemetrexed to lower your chances of harmful side effects. You must start taking 400 to 1000 micrograms (mcg) of folic acid every day for at least 5 days out of the 7 days before your first dose of pemetrexed. You must keep taking folic acid every day during the time you are getting treatment with pemetrexed, and for 21 days after your last treatment. You can get folic acid vitamins over-the-counter. Folic acid is also found in many multivitamin pills. Ask your doctor or pharmacist for help if you are not sure how to choose a folic acid product. Your doctor will give you vitamin B12 injections while you are getting treatment with pemetrexed. You will get your first vitamin B12 injection during the week before your first dose of pemetrexed, and then about every 9 weeks during treatment.

You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Pemetrexed is given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your doctor to help you create a plan to take them at the right times.

Your doctor will prescribe a medicine called a corticosteroid (cortisone medicine) to take for 3 days during your treatment with pemetrexed. Corticosteroid medicines lower your chances for getting skin reactions with pemetrexed.

This medicine comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Uses of Alimta

  • It is used to treat lung cancer.
  • It is used to treat mesothelioma.
  • It may be given to you for other reasons. Talk with the doctor.

How do I store and/or throw out Alimta?

  • If you need to store this medicine at home, talk with your doctor, nurse, or pharmacist about how to store it.

What is the most important information i should know about pemetrexed (alimta)?

Do not use pemetrexed if you are pregnant. It could harm the unborn baby.

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

Before you receive pemetrexed, tell your doctor you have kidney or liver disease, bone marrow suppression, a weak immune system, or excess fluid in the space around your lung, liver, or other internal organs.

Tell your doctor about all other medicines you use, especially an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

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.

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. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection.

Call your doctor at once if you have a serious side effect such as fever, flu symptoms, sore throat, mouth sores, pale skin, easy bruising or bleeding, ongoing vomiting or diarrhea, increased thirst, urinating less than usual, pounding heartbeats, and swelling or rapid weight gain.

Alimta side effects

Get emergency medical help if you have any signs of an allergic reaction to Alimta: 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 Alimta 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.

In Summary

Common side effects of Alimta include: anemia, chest pain, constipation, depression, desquamation, diarrhea, dyspnea, fatigue, fever, increased serum creatinine, infection without neutropenia, leukopenia, nausea, neuropathy, neutropenia, pharyngitis, skin rash, stomatitis, thrombocytopenia, vomiting, anorexia, and mood changes. Other side effects include: embolism, thrombosis, dehydration, dysphagia, esophagitis, and odynophagia. See below for a comprehensive list of adverse effects.

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