Why is this medication prescribed?

Alimta (generic name pemetrexed) is prescribed primarily for the treatment of certain types of cancer. Alimta is primarily used for treating advanced or metastatic NSCLC, especially when the cancer has not responded to other treatments or if it’s inoperable. Malignant Pleural Mesothelioma is a type of cancer that affects the lining of the lungs, often related to asbestos exposure. Alimta is used to treat this condition, often in combination with cisplatin. The drug works by interfering with the growth of cancer cells, ultimately leading to their destruction. It’s usually given in combination with other chemotherapy agents or treatments.

How should this medicine be used?

Alimta (pemetrexed) is administered as an intravenous (IV) infusion. Here’s a general overview of how it is used:

• Dosage and Schedule: The dosage and schedule depend on the type of cancer being treated, the patient’s overall health, and how well they tolerate the medication. Typically, it’s given once every 21 days.
• Preparation: Pemetrexed is prepared by a healthcare professional in a sterile environment. The drug is diluted in a suitable IV fluid.
• Administration: The infusion is usually given through an IV line inserted into a vein, often in the arm. The infusion can take about 10 minutes.
• Pre-Medication: Patients may receive pre-medication to prevent or reduce side effects. This might include steroids to prevent allergic reactions and medications to manage potential nausea.
• Monitoring: Regular monitoring is essential to assess the response to the medication and to manage any side effects. Blood tests are often performed to check for potential adverse effects, such as changes in blood cell counts or kidney function.

It’s crucial to follow the treatment plan prescribed by your oncologist and report any side effects or unusual symptoms promptly. Your healthcare team will provide detailed instructions and support throughout the treatment process.

Other uses for this medicine

Apart from treating non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma, Alimta (pemetrexed) may also be used for:

• Combination Therapy: It can be used in combination with other chemotherapy drugs for various cancers, as determined by your oncologist.
• Adjuvant Therapy: Sometimes it’s used as part of adjuvant therapy (additional treatment) after initial surgery or radiation therapy to reduce the risk of cancer recurrence.

What special precautions should I follow?

Special Precautions for Alimta:

• Blood Tests: Regular blood tests are needed to monitor for changes in blood cell counts, liver function, and kidney function. Pemetrexed can cause decreases in red blood cells, white blood cells, and platelets, as well as affect liver and kidney function.
• Vitamin Supplementation: To reduce the risk of side effects, particularly from low blood counts, folic acid and vitamin B12 supplements are typically prescribed before and during treatment.
• Hydration: Proper hydration is important. Your healthcare provider may advise you to drink plenty of fluids to help prevent kidney-related side effects.
• Avoiding Certain Medications: Some medications and supplements may interact with pemetrexed. Always inform your healthcare provider about any other medications or supplements you are taking.
• Pregnancy and Breastfeeding: Pemetrexed is not recommended during pregnancy or breastfeeding due to potential harm to the baby. Use effective contraception and discuss options with your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
• Infection Risk: Pemetrexed can increase the risk of infections due to lowered white blood cell counts. Take precautions to avoid infections, such as practicing good hygiene and avoiding exposure to sick individuals.
• Avoid Live Vaccines: Live vaccines should be avoided during treatment with pemetrexed as they may pose a risk to individuals with compromised immune systems.

Always follow your healthcare provider’s advice and report any unusual symptoms or side effects. Your healthcare team will guide you on how to manage these precautions effectively.

What special dietary instructions should I follow?

• Balanced Diet: Maintain a balanced diet to support overall health and manage side effects. Eating a variety of fruits, vegetables, lean proteins, and whole grains can help.
• Hydration: Drink plenty of fluids to stay hydrated and support kidney function. This is particularly important if you experience side effects like nausea or vomiting.
• Avoid Alcohol: Limit or avoid alcohol, as it can interact with medications and exacerbate side effects.

What should I do if I forget a dose?

• Contact Your Healthcare Provider: If you miss a dose of Alimta, contact your healthcare provider or clinic immediately for guidance. They will advise you on whether you should take the missed dose or reschedule your next dose.
• Do Not Double Up: Do not take a double dose to make up for the missed dose. Following the guidance of your healthcare provider is crucial to avoid potential complications or side effects.

What side effects can this medication cause?

Alimta (pemetrexed) can cause a range of side effects. Some of the common and serious side effects include:

Common Side Effects:

• Fatigue: Feeling tired or weak is a frequent side effect.
• Nausea and Vomiting: Gastrointestinal symptoms like nausea and vomiting are common, though anti-nausea medications can help manage these.
• Loss of Appetite: A decrease in appetite can occur.
• Diarrhea or Constipation: Digestive issues may arise.
• Mouth Sores: Mucositis, or sores in the mouth, can develop.
• Skin Rash: Rashes or changes in skin appearance may occur.

Serious Side Effects:

• Low Blood Cell Counts: This can lead to anemia (low red blood cells), increased risk of infections (low white blood cells), or bleeding problems (low platelets). Regular blood tests are necessary to monitor these levels.
• Kidney Problems: Symptoms might include changes in urine output or color, swelling in the legs or ankles, or pain in the lower back.
• Liver Issues: Elevated liver enzymes can be detected through blood tests, potentially leading to jaundice (yellowing of the skin or eyes).
• Allergic Reactions: Severe reactions such as rash, itching, swelling, or difficulty breathing may occur and require immediate medical attention.
• Lung Problems: In rare cases, pemetrexed may cause lung inflammation or fluid accumulation in the lungs, which can lead to difficulty breathing or cough.
• Infections: Due to reduced white blood cell counts, you may be more susceptible to infections. Symptoms such as fever, chills, or persistent sore throat should be reported.

If you experience any severe or persistent side effects, it is crucial to contact your healthcare provider promptly. They can provide guidance on managing side effects and adjust your treatment plan as needed.

What should I know about storage and disposal of this medication?

Storage and Disposal of Alimta:

• Storage:
  • Store the unprepared Alimta vials at room temperature (between 20°C and 25°C or 68°F to 77°F). Keep them in the original package to protect from light.
  • Once prepared for infusion, Alimta should be used immediately. If not used right away, it can be stored in the refrigerator (2°C to 8°C or 36°F to 46°F) for a limited time as specified by the manufacturer, usually up to 24 hours.
• Disposal:
  • Unused or expired Alimta should be disposed of properly. Do not throw it away in household trash or flush it down the toilet.
  • Return unused or expired medication to a pharmacy or designated medication disposal site. Many pharmacies have take-back programs.
  • Dispose of any medication according to local regulations or guidelines to ensure safe and environmentally-friendly disposal.

In case of emergency/overdose

• Seek Medical Attention: If you suspect an overdose or experience severe side effects, seek medical attention immediately.
• Contact Poison Control: In some cases, contacting a poison control center or emergency services for advice can be beneficial.
• Symptoms of Overdose: Symptoms might include severe nausea or vomiting, excessive fatigue, or significant changes in blood counts.
• Medical Intervention: In a medical setting, healthcare providers will assess the situation and provide appropriate treatment, which may include supportive care to manage symptoms and address any complications.

What other information should I know?

• Regular Monitoring: Regular blood tests are crucial for monitoring your response to Alimta and managing side effects. Adherence to scheduled tests and follow-up appointments is important.
• Inform Your Healthcare Provider: Keep your healthcare provider informed about all other medications, supplements, and any changes in your health status.
• Symptoms to Report: Report any unusual or severe symptoms, such as signs of infection (fever, chills), persistent nausea or vomiting, mouth sores, or respiratory issues, to your healthcare provider.
• Patient Education: Understanding your treatment plan, including how to manage side effects and what to expect, can help you feel more in control and improve your overall treatment experience.

Always follow the instructions provided by your healthcare provider and the medication’s labeling to ensure safe and effective use of Alimta.