Pemetrexed | Side Effects, Dosage & More
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Generic Name:

pemetrexed, Injectable solution

All Brands

  • Alimta
SECTION 1 of 5

Highlights for pemetrexed

Injectable solution
1

Pemetrexed is used to treat non-squamous non-small cell lung cancer. It’s also used to treat malignant pleural mesothelioma (cancer of the lining of your lungs).

2

This drug comes as a solution that a healthcare provider injects into your vein. You won’t give this drug to yourself at home.

3

Pemetrexed is only available as the brand-name drug Alimta. It isn’t available as a generic drug.

4

The more common side effects of this drug include tiredness, nausea, and loss of appetite.

5

In some cases, pemetrexed can cause serious side effects. These can include dangerously low blood cell counts. This raises your risk of bleeding and infections. Serious side effects are more likely to occur if you receive this drug in combination with the medication cisplatin.

IMPORTANT INFORMATION

Bone marrow suppression

This drug can cause a severe reduction in your red blood cells, white blood cells, and platelets. Red blood cells deliver oxygen throughout your body, and white blood cells help fight off infections. Platelets help your blood to clot. Your doctor will monitor your blood cell counts while you’re receiving this medication. If your blood cell levels drop too low, your doctor may decrease your dosage.

Mouth sores

You may develop painful, red, and swollen sores in your mouth after you receive this drug. Tell your doctor right away if this happens. Your doctor may give you a prescription mouthwash to help treat these sores. You may have to avoid eating hot, spicy, or acidic foods.

What is pemetrexed?

Pemetrexed is a prescription drug. It’s comes as a solution for intravenous injection. A healthcare provider injects it into your vein. You won’t give this drug to yourself at home.

Pemetrexed is only available as the brand-name drug Alimta. It isn’t available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications to treat your condition. It’s often given with the medication cisplatin. You may also have to take folic acid, vitamin B-12, and corticosteroids. You may take these before, during, or after you receive pemetrexed.

Why it's used

Pemetrexed is used to treat non-squamous non-small cell lung cancer. If this is the first treatment for your lung cancer, you may receive this drug alone or with another chemotherapy drug called cisplatin.

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How it works

Pemetrexed belongs to a class of drugs called folate analog metabolic inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

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Why it's used

Pemetrexed is used to treat non-squamous non-small cell lung cancer. If this is the first treatment for your lung cancer, you may receive this drug alone or with another chemotherapy drug called cisplatin. You’ll receive this drug by itself if you’ve already had treatment, if your cancer has come back, or if you had problems with an earlier treatment.

Pemetrexed is also used with cisplatin to treat malignant pleural mesothelioma. This is cancer of the lining of your lungs. This drug is given when surgery isn’t an option.

How it works

Pemetrexed belongs to a class of drugs called folate analog metabolic inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Pemetrexed works by blocking the production of chemicals that help cells grow. This stops tumor cells from growing and multiplying.

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pemetrexed Side Effects

Injectable solution

More common side effects

The more common side effects of pemetrexed include:

  • tiredness

  • nausea

  • vomiting

  • loss of appetite

  • painful, red, swollen sores in your mouth

  • constipation

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Decreased levels of red blood cells. This raises your risk of anemia. Symptoms can include:

    • tiredness
    • weakness
    • shortness of breath
    • dizziness
    • fast heart rate
  • Decreased levels of white blood cells. This raises your risk of infection. Symptoms can include:

    • fever greater than 100.4°F
    • sore throat
    • cuts or wounds that are red, swollen, or draining
    • body aches
    • tiredness
  • Decreased levels of platelets. This raises your risk of bleeding. Symptoms can include:

    • bleeding more often than normal
    • large, red spots on your skin
  • Skin reactions. Symptoms can include:

    • blistering or peeling skin in your mouth or nose
Pharmacist's Advice
Healthline Pharmacist Editorial Team
  • Pemetrexed may cause drowsiness. 
  • This drug can cause nausea and vomiting during the first few hours after you receive it. Your risk is higher if you take this drug with cisplatin.
  • To reduce your risk of side effects, your doctor will give you folic acid and vitamin B-12 before and during your treatment. They’ll also give you a corticosteroid to take the day before, the day of, and the day after your treatment with pemetrexed.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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pemetrexed May Interact with Other Medications

Injectable solution

Pemetrexed can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs, or vitamins you’re taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Important considerations for taking pemetrexed
kidney problem warning
People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects. These effects can be fatal (cause death). You should not receive this drug if you have kidney problems.

bone marrow toxicity
People with bone marrow toxicity

Your doctor may reduce your dosage of this drug if you already have bone marrow problems that have caused low levels of red and white blood cells and platelets. (This can be caused by previous chemotherapy treatment.) They may also delay giving you this drug until your blood cell counts go up.

pregnancy warning
Pregnant women

Pemetrexed is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

Talk to your doctor about birth control options before you start receiving this drug.

breast feeding warning
Women who are breast-feeding

Pemetrexed may pass into breast milk and cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you’re older than 65 years of age, you may be at higher risk of tiredness, reduced number of blood cells, and high blood pressure from this drug.

childrens warning
For children

This drug hasn’t been shown to be effective in children. It shouldn’t be used in people younger than 18 years of age.

allergy warning
Allergies

Pemetrexed can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Taking this drug again if you’ve ever had an allergic reaction to it could be fatal (cause death). Be sure to tell your doctor if you’ve ever had an allergic reaction to this drug.

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How to Take pemetrexed (Dosage)

Injectable solution

Your doctor will determine a dosage that’s right for you based on your individual needs including your height and weight. Your general health may affect your dosage. Tell your doctor about all health conditions you have before your healthcare provider administers the drug to you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Pemetrexed comes with serious risks if you don’t take it as prescribed.

If you stop receiving the drug suddenly or don’t receive it at all

Your cancer won’t be treated. It may continue to spread.

If you miss doses or don’t receive the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at certain times.

What to do if you miss a dose

Call your doctor right away to reschedule your appointment.

How to tell if the drug is working

If your cancer was causing symptoms, the symptoms may improve. Your doctor will also monitor you to check how your cancer is responding to treatment with this drug.

Pemetrexed is used for short-term treatment.

This drug is usually given once every 21 days.

Ask your doctor how often you’ll receive this drug and how long each cycle will last.

How long does it take?

This drug is injected slowly. It will take about 10 minutes to receive your injection.

If you’re receiving cisplatin with this drug, your cisplatin infusion will start 30 minutes after you receive pemetrexed. It will take about 2 hours to receive cisplatin.

Can I drive home after?

This drug may make you sleepy. You may need a friend or loved one to help you get home after your infusion.

You should not drive or use machinery while you’re being treated with this medication until you know you can function normally.

Travel

Talk with your doctor if you plan to travel while receiving this drug. You may need to plan your travel around your treatment schedule.

Clinical monitoring

Your doctor will monitor your progress during treatment with this medication. This monitoring may include:

  • Blood cell count checks. Your doctor will do blood tests to check the levels of your white and red blood cells and platelets. If your blood cell counts are low, your doctor may decrease your dosage. They may also delay giving you this drug until your blood counts go up.
  • Liver function tests. Your doctor will do blood tests to check how well your liver is working. In rare cases, this drug can cause liver problems.
  • Kidney function tests. Your doctor will do blood tests to check how well your kidneys are working before you receive each dose of this drug. You shouldn’t receive this drug if you have kidney problems.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

What does the pill look like?

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How Much Does pemetrexed Cost?

Injectable solution

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These prices represent the lowest priced national pharmacies for pemetrexed on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on February 17, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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