PEMETREXED (pem-a-trex-ed

)

Trade names: Alimta® Alimta is the trade name for the generic drug name Pemetrexed Drug type: Pemetrexed is an anti-cancer (!antineoplastic! or !c"totoxic!) chemotherap" drug Pemetrexed is classified as an !antimeta#olite! ($or more detail% see !&o' this drug 'or(s! section #elo' ) What Pemetrexed is used for: • Pemetrexed is used in the treatment of malignant mesothelioma • )ocall" ad*anced or metastatic nons+uamous nonsmall cell lung cancer ,ote- .f a drug has #een appro*ed for one use% ph"sicians ma" elect to use this same drug for other pro#lems if the" #elie*e it ma" #e helpful • How Pemetrexed is given: • Premetrexed is gi*en as an infusion into the *ein (intra*enous% ./) • Patients treated 'ith premetrexed 'ill usuall" re+uire folic acid and *itamin 012 supplementation to reduce treatment related side effects • The amount of premetrexed that "ou 'ill recei*e depends on man" factors% including "our height and 'eight% "our general health or other health pro#lems% and the t"pe of cancer or condition #eing treated 3our doctor 'ill determine "our dose and schedule Side effects of Pemetrexed: .mportant things to remem#er a#out the side effects of premetrexed• Most people do not experience all of the side effects listed • 4ide effects are often predicta#le in terms of their onset and duration • 4ide effects are almost al'a"s re*ersi#le and 'ill go a'a" after treatment is complete • There are man" options to help minimi5e or pre*ent side effects • There is no relationship #et'een the presence or se*erit" of side effects and the effecti*eness of the medication

The follo'ing side effects are common (occurring in greater than 678) for patients ta(ing pemetrexed-

ncrease in #lood test creatinine • $e*er • $lu-li(e s"mptoms.um#ness or tingling of hands or feet • Depression • Rash% s(in irritation When to contact your doctor or health care provider: 9ontact "our health care pro*ider immediatel"% da" or night% if "ou should experience an" of the follo'ing s"mptoms• $e*er of 177 .• )o' 'hite #lood cell count (This can put "ou at increased ris( for infection ) • )o' red #lood cell count (Anemia) • $atigue • . times in a 2> hour period) • ?nusual #leeding or #ruising • 0lac( or tarr" stools% or #lood in "our stools • 0lood in the urine • Pain or #urning 'ith urination .< $ (6=< 9) or higher% chills (possi#le signs of infection) The follo'ing s"mptoms re+uire medical attention% #ut are not an emergenc" 9ontact "our health care pro*ider 'ithin 2> hours of noticing an" of the follo'ing• .ausea (interferes 'ith a#ilit" to eat and unrelie*ed 'ith prescri#ed medication) • /omiting (*omiting more than >-.ausea and *omiting • 9onstipation • Poor appetite • 4hortness of #reath • 9hest pain These side effects are less common side effects (occurring in a#out 172:8) of patients recei*ing pemetrexed• )o' platelet count (This can put "ou at increased ris( for #leeding ) • .$e*er% chills% generali5ed aches and pains% headache% poor appetite • Mouth sores • .

4A.D4) such as i#uprophen unless "our doctor specificall" permits this • Do not recei*e an" (ind of immuni5ation or *accination 'ithout "our doctor@s appro*al 'hile ta(ing premetrexed Self-care tips: • Drin( at least t'o to three +uarts of fluid e*er" 2> hours% unless "ou are instructed other'ise • 3ou ma" #e at ris( of infection so tr" to a*oid cro'ds or people 'ith colds and those not feeling 'ell% and report fe*er or an" other signs of infection immediatel" to "our health care pro*ider • Aash "our hands often • 3ou ma" #e at ris( of infection report fe*er or an" other signs of infection immediatel" to "our health care pro*ider • ?se an electric ra5or and a soft tooth#rush to minimi5e #leeding • A*oid contact sports or acti*ities that could cause inBur" • To reduce nausea% ta(e anti-nausea medications as prescri#ed #" .• Extreme fatigue (una#le to carr" on self-care acti*ities) • 9onstipation unrelie*ed #" laxati*e use • 4igns of infection such as redness or s'elling% pain on s'allo'ing% coughing up mucous% or painful urination • ?na#le to eat or drin( for 2> hours or ha*e signs of deh"drationtiredness% thirst% dr" mouth% dar( and decrease amount of urine% or di55iness • Depressed (interfering 'ith "our a#ilit" to carr" on "our regular acti*ities) Al'a"s inform "our health care pro*ider if "ou experience an" unusual s"mptoms Precautions: • 0efore starting premetrexed treatment% ma(e sure "ou tell "our doctor a#out an" other medications "ou are ta(ing (including prescription% o*er-the-counter% *itamins% her#al remedies% etc ) Do not ta(e aspirin% or products containing aspirin unless "our doctor specificall" permits this • Do not ta(e non-steroidal anti-inflammator" drugs (.

n general% drin(ing alcoholic #e*erages should #e (ept to a minimum or a*oided completel" 3ou should discuss this 'ith "our doctor Cet plent" of rest Maintain good nutrition Deep "our #o'els mo*ing 3our health care pro*ider ma" prescri#e a stool softener to help pre*ent constipation that ma" #e caused #" this medicine $or flu-li(e s"mptoms% (eep 'arm 'ith #lan(ets and drin( plent" of li+uids There are medications that can help reduce the discomfort caused #" chills Acetaminophen ma" help relie*e discomfort from fe*er% headache andEor generali5ed aches and pains &o'e*er% #e sure to tal( 'ith "our doctor #efore ta(ing it .• • • • • • • • "our doctor% and eat small% fre+uent meals A*oid sun exposure Aear 4P$ 1.f "ou experience s"mptoms or side effects% #e sure to discuss them 'ith "our health care team The" can prescri#e medications andEor offer other suggestions that are effecti*e in managing such pro#lems Monitoring and testing: 3ou 'ill #e chec(ed regularl" #" "our health care professional 'hile "ou are ta(ing premetrexed to monitor side effects and chec( "our response to therap" Periodic #lood 'or( to monitor "our complete #lood count (909) as 'ell as the function of other organs (such as "our (idne"s and li*er) 'ill also #e ordered #" "our doctor How Pemetrexed wor s: 9ancerous tumors are characteri5ed #" cell di*ision% 'hich is no longer controlled as it is in normal tissue !.ormal! cells stop di*iding 'hen the" come into contact 'ith li(e cells% a mechanism (no'n as contact inhi#ition 9ancerous cells lose this a#ilit" 9ancer cells no longer ha*e the normal chec(s and #alances in place that control and limit cell di*ision The process of cell di*ision% 'hether normal or cancerous cells% is through the cell c"cle The cell c"cle goes from the resting phase% through acti*e gro'ing phases% and then to mitosis (di*ision) . (or higher) sun#loc( and protecti*e clothing .

Methotrexate • P"rimidine antagonist.The a#ilit" of chemotherap" to (ill cancer cells depends on its a#ilit" to halt cell di*ision ?suall"% the drugs 'or( #" damaging the R.9ladri#ine% $ludara#ine and Pentostatin .-$luorouracil% $oxuridine% 9"tara#ine% 9apecita#ine% and Cemcita#ine • Purine antagonist.A that tells the cell ho' to cop" itself in di*ision .Premetrexed • $olic acid antagonist.f the cells are una#le to di*ide% the" die The faster the cells are di*iding% the more li(el" it is that chemotherap" 'ill (ill the cells% causing the tumor to shrin( The" also induce cell suicide (self-death or apoptosis) 9hemotherap" drugs that affect cells onl" 'hen the" are di*iding are called cell-c"cle specific 9hemotherap" drugs that affect cells 'hen the" are at rest are called cell-c"cle non-specific The scheduling of chemotherap" is set #ased on the t"pe of cells% rate at 'hich the" di*ide% and the time at 'hich a gi*en drug is li(el" to #e effecti*e This is 'h" chemotherap" is t"picall" gi*en in c"cles 9hemotherap" is most effecti*e at (illing cells that are rapidl" di*iding ?nfortunatel"% chemotherap" does not (no' the difference #et'een the cancerous cells and the normal cells The !normal! cells 'ill gro' #ac( and #e health" #ut in the meantime% side effects occur The !normal! cells most commonl" affected #" chemotherap" are the #lood cells% the cells in the mouth% stomach and #o'el% and the hair folliclesF resulting in lo' #lood counts% mouth sores% nausea% diarrhea% andEor hair loss Different drugs ma" affect different parts of the #od" Premetrexed #elongs to the class of chemotherap" drugs called antimeta#olites Antimeta#olites are *er" similar to normal su#stances 'ithin the cell Ahen the cells incorporate these su#stances into the cellular meta#olism% the" are una#le to di*ide Antimeta#olites are cellc"cle specific The" attac( cells at *er" specific phases in the c"cle Antimeta#olites are classified according to the su#stances 'ith 'hich the" interfere • Antifolate.A or D..G-Mercaptopurine and G-Thioguanine • Adenosine deaminase inhi#itor.

lo' 'hite% red and platelet #lood cell counts% nausea and *omiting These complications and side effects of premetrexed can #e reduced #" using folic acid and *itamin 0-12 supplementation .Ae strongl" encourage "ou to tal( 'ith "our health care professional a#out "our specific medical condition and treatments The information contained in this 'e#site is meant to #e helpful and educational% #ut is not a su#stitute for medical ad*ice .Premetrexed exerts its chemotherapeutic effect #" disrupting folatedependent meta#olic processes essential for cell replication This action also effects normal cells 'hich can cause significant side effects in the #od"% such as.ote.

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