CLINICAL USE
Treatment of chemotherapy naive patients with unresectable malignant pleural mesothelioma in combination with cisplatinMonotherapy for non-small cell lung cancer
DOSE IN NORMAL RENAL FUNCTION
500 mg/m2 on the first day of each 21 day cycle
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
45–50 Dose as in normal renal function20–45 Use with caution, at a lower dose. See ‘Other Information’<20 Use with caution, at a lower dose. See ‘Other Information’
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsNephrotoxic agents: may reduce clearance of pemetrexed – use with cautionLive vaccines: avoid use; YELLOW FEVER VACCINE ABSOLUTELY CONTRAINDICATED
ADMINISTRATION
Reconstition
20 mL sodium chloride 0.9% per 500 mg vial
Route
IV infusion
Rate of Administration
Over 10 minutes
Comments
Dilute in 100 mL preservative-free sodium chloride 0.9%Incompatible with calcium containing fluids
OTHER INFORMATION
To reduce the incidence and severity of skin reactions, a steroid (equivalent to 4 mg of dexamethasone) should be given the day before, the day of, and the day after pemetrexed therapy. Patients should also take a vitamin preparation containing folic acid and IM vitamin B1225% of patients get reversible mild renal dysfunctionThere has been a case report of a patient having severe rhabdomyolysis with pemetrexed in combination treatment with carboplatin.