Alimta

Alimta

pemetrexed

Manufacturer:

Eli Lilly

Distributor:

Zuellig
/
Agencia Lei Va Hong
Concise Prescribing Info
Contents
Pemetrexed disodium
Indications/Uses
In combination w/ cisplatin for the treatment of chemotherapy naive patients w/ unresectable malignant pleural mesothelioma. In combination w/ cisplatin for the 1st line treatment of patients w/ locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology. Monotherapy for the maintenance treatment of locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology in patients whose disease has not progressed immediately following platinum-based chemotherapy. Monotherapy for the 2nd line treatment of patients w/ locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology.
Dosage/Direction for Use
In combination w/ cisplatin: 500 mg/m2 by IV infusion over 10 min on 1st day of each 21-day cycle. Cisplatin: 75 mg/m2 infused over 2 hr approx 30 min after completion of pemetrexed infusion. Ensure adequate anti-emetic treatment & appropriate hydration prior to &/or after receiving cisplatin. As monotherapy for non-small cell lung cancer 500 mg/m2 by IV infusion over 10 min on 1st day of each 21-day cycle. Pre-medication regimen: Corticosteroid, equivalent to dexamethasone 4 mg PO bd, given the day prior to, on the day of, & the day after pemetrexed administration.
Contraindications
Hypersensitivity. Concomitant yellow fever vaccine. Lactation.
Special Precautions
Monitor patients for myelosuppression; should not be given in patients w/ absolute neutrophil count (ANC) <1,500 cells/mm3 & platelet count <100,000 cells/mm3. Pre-treatment w/ dexamethasone (or equivalent) & co-administration w/ folic acid & vit B12 as prophylactic measure while under treatment is recommended. Reports of serious renal events (eg, acute renal failure) & CV events (eg, MI & CVA); radiation pneumonitis &/or radiation recall in patients treated w/ radiation or radiotherapy prior, during or subsequent to therapy. Radiosensitising agents must be used w/ caution. 3rd space fluid (eg, pleural effusion or ascites). Ensure adequate anti-emetic therapy & appropriate hydration prior to &/or after receiving treatment. Concomitant use w/ live attenuated vaccine is not recommended. May affect ability to drive & operate machines. Avoid high-dose NSAIDs in patients w/ mild to moderate renal insufficiency (CrCl 45-79 mL/min) 2 days before, during, & 2 days after treatment administration. Not recommended in patients w/ CrCl <45 mL/min. Contraceptive measures or abstinence are recommended in males during treatment & up to 6 mth thereafter; counselling on sperm storage prior to treatment initiation is recommended. Women of childbearing potential must use effective contraception during treatment. Pregnancy. Discontinue breast-feeding while under therapy. 500-mg: May affect patients on controlled Na diet.
Adverse Reactions
Bone marrow suppression (anaemia, neutropenia, leukopenia, thrombocytopenia); GI toxicities (anorexia, nausea, vomiting, diarrhoea, constipation, pharyngitis, mucositis & stomatitis). Renal toxicities; increased aminotransferases; alopecia; fatigue; dehydration; rash; infection/sepsis; neuropathy.
Drug Interactions
Delayed clearance w/ nephrotoxic drugs (eg, aminoglycosides, loop diuretics, platinum compd, cyclosporin); probenecid, penicillin. Decreased elimination w/ high dose NSAIDs (eg, ibuprofen >1,600 mg/day & acetylsalicylic acid ≥1.3 g/day). Possible interaction w/ oral anticoagulants. Risk of fatal generalised vaccinale disease w/ yellow fever vaccine. Risk of systemic, possibly fatal, disease w/ live attenuated vaccine.
ATC Classification
L01BA04 - pemetrexed ; Belongs to the class of antimetabolites, folic acid analogues. Used in the treatment of cancer.
Presentation/Packing
Form
Alimta powd conc for soln for infusion 500 mg
Packing/Price
1's
Form
Alimta powd conc for soln for infusion 100 mg
Packing/Price
1's
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