Dr. Reddy's Lab


Concise Prescribing Info
Pemetrexed disodium
Malignant pleural mesothelioma: In combination w/ cisplatin for chemotherapy-naive patients w/ unresectable malignant pleural mesothelioma. Non-small cell lung cancer: In combination w/ cisplatin as 1st-line treatment or monotherapy for 2nd-line treatment of patients w/ locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology. Monotherapy for maintenance 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.
Dosage/Direction for Use
In combination w/ cisplatin 500 mg/m2 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). Monotherapy 500 mg/m2 IV infusion over 10 min on 1st day of each 21-day cycle. Premed Oral dexamethasone 4 mg bd given the day prior to, on the day of & day after treatment. Oral folic acid 350-1,000 mcg daily at least 5 doses during the 7 days preceding 1st dose of pemetrexed, continued during the full course of therapy & for 21 days after last dose of pemetrexed. Vit B12 1,000 mcg IM inj in the wk preceding 1st dose of pemetrexed & once every 3 cycles thereafter.
Hypersensitivity. Concomitant use w/ yellow fever vaccine. Lactation.
Special Precautions
Discontinue use if Grade 3 or 4 haematologic or non-haematologic toxicity is observed. Serious CV events eg, MI & cerebrovascular events; serious renal events; dehydration, preexisting HTN or diabetes. Effect of 3rd-space fluid eg, pleural effusion or ascites. Monitor for myelosuppression, complete blood & platelet counts during therapy. Not recommended in immunodepressed status & concomitant use w/ live attenuated vaccines. GI toxicity when given in combination w/ cisplatin, ensure adequate antiemetic treatment & appropriate hydration prior to &/or after therapy. Concomitant use w/ other radiosensitising agents. Interrupt NSAIDs w/ long t½ for at least 5 days prior to, on the day of & at least 2 days after administration. May affect ability to drive & use machines. Avoid NSAIDs for 2 days prior to, on the day of & 2 days following administration in patients w/ mild to moderate renal impairment (CrCl 45-79 mL/min). Not recommended in patients w/ CrCl <45 mL/min. Males should not father a child during & up to 6 mth after treatment. Women of childbearing potential should use effective contraception. Not to be used during pregnancy. 500 mg: Controlled Na diet.
Adverse Reactions
Decreased neutrophils/granulocytes, leukocytes, Hb, platelets; sensory neuropathy; diarrhoea, vomiting, stomatitis/pharyngitis, nausea, anorexia, constipation; rash, alopecia; elevated creatinine, decreased CrCl; fatigue. Dehydration; taste disturbance; conjunctivitis; dyspepsia.
Drug Interactions
Delayed clearance w/ nephrotoxic drugs (eg, aminoglycoside, loop diuretics, platinum compd, cyclosporin), probenecid, penicillin. Decreased elimination & increased occurrence of adverse events w/ high-dose NSAIDs, acetylsalicylic acid. Monitor increased INR frequency w/ oral anticoagulants. Risk of fatal generalised vaccinale disease w/ yellow fever vaccine. Increased risk of systemic, possibly fatal disease w/ live attenuated vaccines.
MIMS Class
Cytotoxic Chemotherapy
ATC Classification
L01BA04 - pemetrexed ; Belongs to the class of antimetabolites, folic acid analogues. Used in the treatment of cancer.
Podoxred powd for inj 100 mg
Podoxred powd for inj 500 mg
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