Alimta (Pemetrexed) – effective chemotherapy injection

Alimta(Pemetrexed) belongs to a class of medications called antifolate antineoplastic agents. Pemetrexed (brand name Alimta) is a chemotherapy drug manufactured and marketed by Eli Lilly and Company.

Alimta is used:

• for the treatment of patients with advanced nonsquamous non-small-cell lung cancer (NSCLC), to maintain the effect of initial treatment with chemotherapy and whose disease has not worsened
• with cisplatin for the treatment of malignant pleural mesothelioma (MPM), which is cancer that affects the inside lining of the chest cavity,  who cannot be treated with surgery

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

Available as:

100 mg & 500 mg single dose vial.

Important safety information

Alimta(Pemetrexed) is not indicated for the treatment of patients with squamous cell non-small cell lung cancer.

Alimta(Pemetrexed) may not be appropriate for some patients:

• If you are allergic to Alimta, tell your doctor because you should not receive it.
• If you have liver or kidney problems, be sure to tell your doctor. Your dose of Alimta may have to be changed, or Alimta may not be right for you.

Your doctor will prescribe a medicine called a “corticosteroid” to take for 3 days during each treatment with Alimta. Corticosteroids lower your chances of getting skin reactions with Alimta.

Precautions:

1. Before starting Alimta treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
2. Do not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen unless your doctor specifically permits this.
3. Do not receive any kind of immunization or vaccination without your doctor’s approval while taking Alimta.
4. Inform your health care professional if you are pregnant or may be pregnant before starting this treatment.  Pregnancy category D (Alimta may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
5. For both men and women: Do not conceive a child (get pregnant) while taking Alimta. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
6. Do not breastfeed while taking this medication.

Also, tell your prescriber or health care professional if you are a frequent user of drinks containing caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

How Alimta is given:

• Alimta is given as an infusion into the vein (intravenous). Alimta is slowly infused (injected) into a vein. The injection or infusion will last about 10 minutes. You will usually receive Alimta once every 21 days (3 weeks).
• It is very important to take folic acid and vitamin B12 before and during your treatment with Alimta to lower your chances of harmful side effects.
• The amount of Alimta that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. You will have regular blood tests before and during your treatment with Alimta. Your doctor will determine your dose and schedule.

Missed Dose of Alimta

If your physician has instructed or directed you to receive Alimta injection on a regular schedule and you have missed a dose of this medicine, call your doctor as soon as possible.

Overdose of Alimta

Any medication taken in excess can have serious consequences. If you suspect an overdose of Alimta, seek medical attention immediately.

Side Effects of Alimta

Like other medicines, Alimta can cause some side effects. If they do occur, the side effects of Alimta are most likely to be minor and temporary. However, some may be serious and may require the individual to inform the doctor or visit the nearest hospital immediately.

Alimta when given alone or in combination with cisplatin can cause side effects such as:

• Stomach upset, including nausea, vomiting, diarrhea, or constipation. You can obtain medicines to help control some of these symptoms. Call your doctor if you get any of these symptoms.
• Low blood cell counts:

1. Low red blood cells. Low red blood cells may make you feel tired, get tired easily, appear pale, and become short of breath.
2. Low white blood cells. Low white blood cells may give you a greater chance of infection. If you have a fever (temperature above 100.4°F (38° C)) or other signs of infection, call your doctor right away.
3. Low platelets. Low platelets give you a greater chance of bleeding. Your doctor will do blood tests to check your blood counts before and during treatment with Alimta.

• Tiredness. You may feel tired or weak for a few days after your Alimta treatments. If you have severe weakness or tiredness, call your doctor.
• Mouth, throat, lip, or food pipe sores (stomatitis, pharyngitis, esophagitis). You may get redness or sores in your mouth, throat, or on your lips, or you may feel pain or difficulty when drinking or swallowing food. These symptoms may happen a few days after Alimta treatment. Talk with your doctor if you get any of these symptoms.
• Loss of appetite. You may lose your appetite and lose weight during your treatment. Talk to your doctor if this is a problem for you.
• Rash. You may get a rash or itching during treatment. These reactions usually appear between treatments with Alimta and usually go away before the next treatment. Skin reactions or rashes that include blistering or peeling may be severe and could lead to death. Call your doctor if you have any of these symptoms.

Self-care tips:

• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• You may be at risk of infection report fever or any other signs of infection immediately to your health care provider.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine.
• For flu-like symptoms, keep warm with blankets and drink plenty of liquids. Some medications can help reduce the discomfort caused by chills.
• Acetaminophen may help relieve discomfort from fever, headache, and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.