Pemirex

Pemirex

pemetrexed

Manufacturer:

Korea United Pharm

Distributor:

Masu
Concise Prescribing Info
Contents
Pemetrexed (equiv to pemetrexed disodium hemipentahydrate)
Indications/Uses
In combination w/ cisplatin: Chemotherapy naive patients w/ unresectable malignant pleural mesothelioma & 1st-line treatment of patients w/ locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology. Monotherapy: Maintenance of locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology in patients on platinum-based chemotherapy w/ no disease progression & 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
Combination use w/cisplatin 500 mg/m2 IV infusion over 10 min on Day 1 of each 21-day cycle + cisplatin 75 mg/m2 infused over 2 hr approx 30 min after the end of pemetrexed administration. Monotherapy: Non-small cell lung cancer 500 mg/m2 IV infusion over 10 min on Day 1 of each 21-day cycle. Premed regimen Corticosteroid equiv to 4 mg oral dexamethasone bid given the day prior to, on the day of, & the day after pemetrexed administration. Oral folic acid at least 5 doses during the 7 days preceding the 1st dose of pemetrexed & must continue during the full course of therapy & for 21 days after the last dose of pemetrexed or multivit containing folic acid (350-1,000 mcg) daily. Vit B12 (1,000 mcg) IM inj in the wk preceding the 1st dose of pemetrexed & once every 3 cycles thereafter. Subsequent doses may be given the same day as pemetrexed.
Contraindications
Hypersensitivity. Concomitant use w/ yellow fever vaccine.
Special Precautions
Monitor patients for myelosuppression during therapy & should not give to patients until absolute neutrophil count (ANC) returns to ≥1,500 cells/mm3 & platelet count returns to ≥100,000 cells/mm3. Take folic acid & vit B12, & dexamethasone as pre-treatment. Not recommended to patients w/ CrCl <45 mL/min & concomitant use w/ live attenuated vaccines. Patients w/ mild & moderate renal insufficiency should avoid taking NSAIDs eg, ibuprofen, & aspirin (>1.3 g once daily) for 2 days before, on the day, & 2 days following pemetrexed administration. Risk factors for serious renal events including dehydration or preexisting HTN or diabetes. Adequate anti-emetic treatment & appropriate hydration prior to &/or after receiving treatment. Serious CV event in combination w/ another cytotoxic agent who had preexisting CV risk factors. Males are advised not to father a child during & up to 6 mth thereafter. Caution in use of other radiosensitising agents. May affect ability to drive & use machines. Hepatic impairment. Women of childbearing potential must use effective contraception during treatment. Pregnancy. Discontinue breastfeeding during therapy.
Adverse Reactions
Decreased neutrophils/granulocytes, leucocytes, Hb, platelets; nausea, vomiting, stomatitis/pharyngitis/mucositis, anorexia, diarrhoea, constipation; fatigue; neuropathy-sensory; creatinine elevation, decreased CrCl; rash, desquamation, alopecia. Conjunctivitis; dyspepsia; heartburn; fever; dehydration; taste disturbance; pruritus; sepsis; SGPT & SGOT elevation; pain.
Drug Interactions
Potentially result in delayed clearance w/ nephrotoxic drugs eg, aminoglycosides, loop diuretics, platinum compd, cyclosporin; substances that are tubularly secreted eg, probenecid, penicillin. May decrease elimination w/ high-doses of NSAIDs eg, ibuprofen & aspirin. Myelosuppression & GI toxicity w/ NSAIDs eg, piroxicam & rofecoxib. Concomitant use w/ anticoagulants. Risk of fatal generalised vaccinale disease w/ yellow fever vaccine. 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.
Presentation/Packing
Form
Pemirex powd for inj 100 mg
Packing/Price
1's
Form
Pemirex powd for inj 500 mg
Packing/Price
1's
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