pemetrexed
Other Name: Alimta®
mixed into larger bags of fluids
- For treating certain cancers such as a type of lung cancer called non-small cell lung cancer and a type of cancer inside the lining of the chest cavity called mesothelioma.
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Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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kidney, liver or heart problems
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radiation therapy or
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any allergies.
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To lower the chance of other side effects, your health care team will prescribe oral folic acid and vitamin B12 given by injection. You need to start these at least 5-7 days before your first pemetrexed dose, continue during treatment and until at least 21 days after the last treatment.
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To lower the chances of getting skin reactions, you will be given a corticosteroid (such as dexamethasone) to take for a few days. You need to start this the day before each pemetrexed treatment.
Remember to:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
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The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
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If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
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►Use 2 effective forms of birth control at the same time while taking this drug. Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
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Do not breastfeed while on pemetrexed treatment.
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This medication may affect fertility (ability to have a baby).
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This drug is given through an IV (injected into a vein) . Talk to your health care team about your treatment schedule.
- If you forget to take your premedications (folic acid, vitamin B12 or dexamethasone) or miss your pemetrexed treatment appointment, contact your health care team to find out what to do.
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This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
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Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.
- For mild aches and pain or fever:
- If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever.
- You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you.
- Do not take anti-inflammatory medications (such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®) for 5 days before and 2 days after pemetrexed. They can make your side effects worse. Talk to your health care team before you start or stop these medications.
- Talk to your health care team or go to the closest emergency room right away if you have a fever. See the Fever pamphlet for more information.
- If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever.
- Take your premedications (including folic acid, vitamin B12 and corticosteroids) exactly as directed by your health care team.
- Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
The following table lists side effects that you may have when getting pemetrexed. The table is set up to list the most common side effects first and the least common last.
It is unlikely that you will have all of the side effects listed and you may have some that are not listed. Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on pemetrexed.
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Fatigue (tiredness)
See our Fatigue pamphlet for more information. |
Contact your health care team if no improvement or if severe | ||||
Nausea and vomiting (generally mild) May occur in hours to days after your treatment. If you have nausea or vomiting:
Also see Nausea & Vomiting pamphlet for more information. |
Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours |
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Low appetite
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Contact your health care team if no improvement or if severe | ||||
Mouth sores (may be severe) You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks. To help prevent mouth sores:
If you have mouth sores:
See the Mouth Care pamphlet for more information. |
Contact your health care team as soon as possible | ||||
Low platelets in the blood (may be severe)
See the Low Platelet Count pamphlet for more information. Fever, chills, infection You have a fever if your temperature taken in your mouth (oral temperature) is:
While you are getting treatment:
If you have a fever, talk to your health care team or go to the closest emergency room. |
Get emergency medical help right away | ||||
Rash (in rare cases maybe severe) Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. To prevent and treat dry skin,
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Contact your health care team if no improvement or if severe | ||||
Diarrhea (may be severe) May happen days to weeks after you get your treatment. If you have diarrhea :
See the Diarrhea pamphlet for more information. |
Contact your health care team if no improvement or if severe | ||||
Abnormal liver lab tests
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Contact your health care team as soon as possible |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
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Tingling, numb, pain or trouble moving your fingers or toes; trouble doing up buttons, writing, or picking up small objects
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Dry eyes, redness, irritation, pain, tearing, sensitivity to light or blurred vision
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Lower back pain, body swelling, passing little or no urine, or recent unusual weight gain
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Irregular heartbeat, chest pain, fainting, swelling in legs/ ankles/ belly, shortness of breath
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Pain, swelling and hardening of the vein in an arm or leg
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Feel confused or have a sudden loss of vision, speech or use of your limb(s)
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Severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness
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Redness, rash, blistering or change in skin colour in areas where you’ve previously received radiation
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You may have skin rash, blistering, or changes in skin colour
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Sudden, severe pain in belly or stomach area
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Yellowing of the skin or eyes and/or red-brown urine
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Increased cough, breathing problems, or coughing blood
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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August 2022 Updated fever info
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.