pemetrexed

What is the most important information I should know about pemetrexed?

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.

What is pemetrexed?

Pemetrexed is used to treat adults with non-squamous non-small cell lung cancer when the cancer has returned or spread after chemotherapy.

Pemetrexed is also used to treat adults with malignant pleural mesothelioma (a form of lung cancer associated with exposure to asbestos) that cannot be removed by surgery or people are not able to have surgery.

Pemetrexed is sometimes used in combination with other cancer medicines.

Pemetrexed may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving pemetrexed?

Tell your doctor if you have ever had:

• kidney disease; or
• radiation treatment.

You may need to have a negative pregnancy test before starting this treatment.

• If you are a woman, do not use pemetrexed if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.
• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using pemetrexed.

This medicine may affect fertility (ability to have children) in men. However, it is important to use birth control to prevent pregnancy because pemetrexed can harm an unborn baby.

How is pemetrexed given?

Pemetrexed is given as an infusion into a vein. 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.

What happens if I miss a dose?

What happens if I overdose?

What should I avoid while receiving pemetrexed?

If you have kidney disease, avoid taking ibuprofen (Advil, Motrin) for 2 days before or 2 days after you are treated with pemetrexed.

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.

What are the possible side effects of pemetrexed?

• little or no urination;
• new or worsening cough, fever, trouble breathing;
• swelling, redness, or blistering of skin that was treated with radiation in the past; or
• low blood cell counts --fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.

Common side effects may include:

• tiredness, feeling short of breath, cough;
• swelling or sores in mouth, sore throat;
• fever, rash;
• low blood cell count;
• loss of appetite; or
• nausea, vomiting, diarrhea, constipation.

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.

What other drugs will affect pemetrexed?

Pemetrexed can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve).

Other drugs may affect pemetrexed, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about pemetrexed.