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Pemetrexed (Alimta®)

About This Drug

Pemetrexed is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Tiredness
  • Decreased appetite (decreased hunger)
  • Nausea

Note: Each of the side effects above was reported in 20% or greater of patients treated with pemetrexed. Not all possible side effects are included above. You may have different side effects if you are receiving premetrexed in combination with other chemotherapy agents.

Warnings and Precautions

  • Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Changes in your kidney function, which can be life-threatening
  • Severe allergic skin reaction, which can be life-threatening. You may develop a rash with fluid-filled bumps/blisters, and/or a red skin rash which sometimes can be weeping (peeling off).
  • Inflammation (swelling) of the lungs. You may have a dry cough or trouble breathing.
  • If you have received radiation treatments, your skin may become red after receving pemetrexed. This reaction is called “radiation recall.” Your body is recalling, or remembering, that it had radiation therapy.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with nausea, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • To help with decreased appetite, eat small, frequent meals. Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • Avoid sun exposure and apply sunscreen routinely when outdoors.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you received radiation, and your skin becomes red or irritated again, follow the same care instructions you did during radiation treatment. Be sure to tell the nurse or doctor administering your chemotherapy about your skin changes.

Food and Drug Interactions

  • There are no known interactions of pemetrexed with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with pemetrexed. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • There are known interactions of pemetrexed with other medicines and products like aspirin, ibuprofen. Ask your doctor what over-the-counter (OTC) medicines you can take for fever, headache and muscle and joint pain.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Decreased or very dark urine
  • A new rash or a rash that is not relieved by prescribed medicines
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • If you think you may be pregnant or may have impregnated your partner 

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for 6 months after treatment. Males with female partners of childbearing potential should use effective contraception during treatment and for 3 months after treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breast feeding warning: It is not known if this drug passes into breast milk. Women should not breastfeed during treatment and for 1 week after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

Revised August 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.