Monograph Details
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Neoplasms
> Antimetabolites
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ALIMTA |
| Manufacturer |
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Lilly, Eli and Company |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Antifolate. |
| Generic Name |
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Pemetrexed 100mg/vial, 500mg/vial; pwd for IV inj after reconstitution and dilution; preservative-free. |
| Indications |
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In combination with cisplatin or as a single agent after prior chemotherapy in patients with locally advanced or metastatic nonsquamous non-small cell lung cancer. In combination with cisplatin for treating malignant pleural mesothelioma (MPM) in patients whose disease is either unresectable or who are otherwise not candidates for curative surgery. |
| Children |
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Not recommended. |
| Adults |
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See literature. 500mg/m2 by IV infusion over 10 minutes on Day 1 of each 21-day cycle. Adjust dose if toxicity (esp. myelosuppression) develops. Combination therapy: Give cisplatin beginning 30 minutes after pemetrexed infusion. |
| Precautions |
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See literature. Renal impairment (CrCl <45mL/min): not recommended. Discontinue if Grade 3 or 4 neurotoxicity occurs, or if any Grade 3 or 4 toxicity occurs after two dose reductions. Do not start new cycle if ANC <1500cells/mm3 and platelet count <100,000cells/mm3. Supplement with folic acid and vitamin B12. Hepatic impairment. Ensure adequate hydration. Pretreat with corticosteroid. Monitor CBCs, platelets, renal and hepatic function. Consider draining effusion first. Pregnancy (Cat.D). Nursing mothers: not recommended. |
| Interactions |
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May be potentiated by nephrotoxic agents, drugs eliminated by renal tubular secretion (eg, probenecid), NSAIDs (see literature). |
| Adverse Reactions |
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Fatigue, GI upset, anorexia, stomatitis, pharyngitis, constipation, fever, infection with neutropenia, rash, desquamation, neutropenia, leukopenia, anemia, thrombocytopenia, elevated creatinine, chest pain, neuropathy; rare: renal failure. |
| How Supplied |
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Single-use vial—1 |
| Additional Resources |
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• Related Prescribing Note |
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