1 What is Alimta?

Brand: Alimta

Generic: Pemetrexed (Intravenous Route)

Alimta treats lung cancer and belongs to a group of medications called antineoplastics. It is used with Cisplatin (cancer medication) to treat a type of cancer called malignant pleural mesothelioma (MPM).

This cancer affects the inside lining of the chest cavity. Pemetrexed injection may also be used alone or together with Cisplatin to treat a type of lung cancer called nonsquamous non-small cell lung cancer.

To lower you chances of side effects from this medication, you must take folic acid and vitamin B12 prior to and during your treatment. Your doctor will prescribe a medication called a Corticosteroid to take for 3 days during your treatment.

Corticosteroids lower your chances of skin reactions with this medication.

This medication is only available with your doctor’s prescription.

This medication is available in the following forms:

  • Powder for Solution

2 What To Know Before Using

As with all medicines, the risks of using Alimta must be compared to how much this medication will help you. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

  • Allergies - Inform your doctor if you have ever had an allergic reaction to Doxorubicin or to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
  • Pediatric - Up-to-date Pediatric Appropriate studies have been performed on the relationship of age to the effects of this medication in the pediatric population. However, efficacy has not been established.
  • Geriatric - Up-to-date studies have not shown any problems specific to the elderly that would limit the use of this medication in the elderly population.
  • Pregnancy - This medication is listed as Pregnancy Category D. This means that studies in pregnant women have demonstrated a risk to the unborn child. However, the benefits of this medication in a life-threatening situation or serious disease may outweigh the potential risk.
  • Breastfeeding - There are no up-to-date studies in women for determining infant risk when using this medication while breastfeeding. Weigh the potential risks with the benefits before taking this medication while breastfeeding.
  • Drug Interactions - Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions. When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive.Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:
    • Aceclofenac
    • Acemetacin
    • Amtolmetin Guacil
    • Aspirin
    • Bromfenac
    • Bufexamac
    • Celecoxib
    • Choline Salicylate
    • Clonixin
    • Dexibuprofen
    • Dexketoprofen
    • Diclofenac
    • Diflunisal
    • Dipyrone
    • Droxicam
    • Etodolac
    • Etofenamate
    • Etoricoxib
    • Felbinac
    • Fenoprofen
    • Fepradinol
    • Feprazone
    • Floctafenine
    • Flufenamic Acid
    • Flurbiprofen
    • Ibuprofen
    • Ibuprofen Lysine
    • Indomethacin
    • Ketoprofen
    • Ketorolac
    • Lornoxicam
    • Loxoprofen
    • Lumiracoxib
    • Meclofenamate
    • Mefenamic Acid
    • Meloxicam
    • Morniflumate
    • Nabumetone
    • Naproxen
    • Nepafenac
    • Niflumic Acid
    • Nimesulide
    • Oxaprozin
    • Oxyphenbutazone
    • Parecoxib
    • Phenylbutazone
    • Piketoprofen
    • Piroxicam
    • Proglumetacin
    • Propionic Acid
    • Propyphenazone
    • Proquazone
    • Rofecoxib
    • Salicylic Acid
    • Salsalate
    • Sodium Salicylate
    • Sulindac
    • Tenoxicam
    • Tiaprofenic Acid
    • Tolfenamic Acid
    • Tolmetin
    • Valdecoxib
  • Other Interactions - Certain medications should not be used while eating, or while eating certain foods in case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.
  • Other Medical Problems - Pre-existing medical problems may affect the use of this medication. Be sure to tell your doctor if you have any other medical problems, especially:
    • Anemia (low iron in the blood)
    • Bone marrow issues
    • Neutropenia (low white blood cells)
    • Throbocytopenia (low platelets in the blood) - Use with caution. May make these conditions worse.
    • Kidney disease - Use with caution. The effects may be increased because of slower removal of the medication from the body.

3 Proper Usage

Alimta comes with a patient information brochure. It is very important that your read this information. Ask your doctor if you have any questions.

It is very important to take Folic acid and B12 during your treatment to lower your chances of harmful side effects. You must take 400-1,000 micrograms (mcg) of folic acid every day for at least 5 out of the 7 days before your first dose of this medication.

You must keep taking folic acid every day during the time of treatment and for 21 days after your last treatment. You can get folic acid supplements over the counter. Folic acid is also found in many multivitamins.

Ask your doctor or pharmacist for help if you are unsure how to choose a folic acid product.

Your doctor will give you vitamin B12 injections while you are getting your treatment. You will receive your first vitamin B12 injection during the week before your first dose of this medication, then every 9 weeks during treatment.

You will receive this medication while you are in a hospital or cancer treatment center. A trained health professional will give you this medication. It is given through a needle placed in one of your veins (intravenous).

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

Your doctor will prescribe a Corticosteroid to take for 3 days during your treatment. Corticosteroids lower you chances of getting skin reactions while taking Pemetrexed.

4 Precautions To Take

It is very important that your doctor checks in with you often while you are receiving Alimta to make sure that it is working properly. Blood tests may be needed to check for unwanted effects.

Do not take other prescription or over-the-counter medications without asking your doctor.

Be sure your doctor knows if you are pregnant before you receive this medication. Using this medication while pregnant can harm your unborn child. If you are a woman of childbearing age, you should use two forms of birth control together to avoid becoming pregnant while receiving this medication.

If you think you may have become pregnant during your treatment, inform your doctor immediately.

It is important to tell your doctor immediately if you have fever or chills, diarrhea or mouth sores. These may be signs of an infection.

You may feel tired or weak for a few days after your treatment. If you have severe weakness or fatigue, inform your doctor.

You may get redness or sores in your mouth, throat or lips. These symptoms may happen a few days after treatment.

You may get a rash or itching during treatment. These normally appear between treatments and normally go away before the next treatment. Inform your doctor if you get a severe rash or itching.

Pemetrexed and Cisplatin can sometimes cause nausea and vomiting. It is very important that you continue to receive this medication, even if you feel ill. You can take other medications to help control the nausea and vomiting. Talk with your doctor if you get any of these symptoms.

You may lose your appetite and some weight during treatment. Talk to your doctor if this is a problem for you.

This medication can temporarily affect your blood counts and your doctor will perform blood tests to check blood counts before and during treatment. Low red blood cells may make you feel tired, become tired easily, appear pale and become short of breath. Low white blood cells may give you a greater chance of infection.

If you have a fever or other signs of infection, call your doctor immediately.

Low platelets can give you a greater chance of bleeding. If this occurs, there are certain precautions you can take to reduce the risk of infection or bleeding, especially when your blood count is low.

  • Take steps to avoid people with infections. Inform your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Inform your doctor immediately if you notice any unusual bleeding or bruising, black or tarry stool, blood in the urine or stool or red spots on your skin.
  • Be careful when using a toothbrush, dental floss or toothpick. Your doctor, dentist or nurse may recommend other ways to clean your teeth and gums. Ask your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when using sharp objects such as a shaving razor or fingernail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

If you have kidney problems, be sure to inform your doctor if you are using an NSAID medication for pain or arthritis.

5 Potential Side Effects

Alimta may produce unwanted affects along with the intended effects. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

More Common

  • Black, tarry stools
  • Bleeding gums
  • Chest pain (angina)
  • Chills
  • Cough
  • Fever
  • Loss of coordination
  • Lower back or side pain
  • Painful or difficult urination
  • Pains in the chest, groin, or legs, especially calves of the legs
  • Pale skin
  • Pinpoint red spots on the skin
  • Severe headaches of sudden onset
  • Shortness of breath
  • Sore throat
  • Sudden onset of slurred speech
  • Sudden vision changes
  • Swollen glands
  • Troubled breathing
  • Ulcers, sores, or white spots in the mouth
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness

Less Common

  • Bloody urine or bloody stools
  • Decreased frequency or amount of urine
  • Fainting (syncope)
  • Fast or irregular breathing
  • Increased blood pressure
  • Increased thirst (polydipsia)
  • Itching
  • Loss of appetite
  • Nausea
  • Skin rash
  • Swelling of the eyes or eyelids
  • Swelling of the face, fingers, or lower legs
  • Tightness in the chest or wheezing
  • Vomiting
  • Weight gain

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

More Common

  • Burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  • Confusion
  • Cough or hoarseness
  • Decreased urination
  • Diarrhea
  • Difficulty having a bowel movement (stool)
  • Difficulty moving
  • Difficulty swallowing
  • Discouragement
  • Dizziness
  • Dry mouth
  • Fatigue
  • Feeling sad or empty
  • Hair loss
  • Headache
  • Heartburn
  • Increase in heart rate
  • Irritability
  • Lightheadedness
  • Loss of interest or pleasure
  • Mood changes
  • Muscle aches or cramping
  • Muscle stiffness
  • Pain or burning in the throat
  • Pain produced by swallowing
  • Rapid breathing
  • Sensation of pins and needles
  • Stabbing pain
  • Stuffy or runny nose
  • Sunken eyes
  • Swelling
  • Swelling or inflammation of the mouth
  • Swollen joints
  • Thinning of the hair
  • Thirst
  • Trouble concentrating
  • Trouble sleeping (insomnia)
  • Weight loss
  • Wheezing
  • Wrinkled skin

Some patients may experience other side effects that are not listed.

Check with your doctor if you notice any other side effects.

Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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