Pemetrexed

Pemetrexed in Kenya: Pemetrexed chemical Structure

Pemetrexed Mode of Action:

Pemetrexed is a multi-targeted anti-cancer antifolate agent that exerts its action by disrupting crucial folate-dependent metabolic processes essential for cell replication.

Drug Label Information | Brands:

Brands of Pemetrexed in Kenya:

Pemita® ,Atlanta Biologicals Pvt Ltd
Alimta® , Eli Lilly and Company

INDICATIONS:

Malignant pleural mesothelioma

Pemetrexed in combination with cisplatin is indicated for the treatment of chemotherapy naïve patients with unresectable malignant pleural mesothelioma.

Non-small cell lung cancer

Pemetrexed in combination with cisplatin is indicated for the first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology

Pemetrexed is indicated as monotherapy for the maintenance treatment 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

Pemetrexed is indicated as monotherapy for the second-line treatment of patients with locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology.

CONTRAINDICATIONS:

Pemetrexed is contraindicated in patients who have a history of severe hypersensitivity reaction to pemetrexed.

ADVERSE DRUG REACTIONS:

  • Pemetrexed, whether used alone or in combination with cisplatin, has these side effects:
  • Low blood cell counts, as measured by a complete blood count. This is a dose-limiting toxicity.
  • Mental fatigue and sleepiness. Fatigue can be reduced through an off-label prescription of modafinil
  • Nausea and vomiting. Pemetrexed’s emetogenic effects are managed with prophylactic antiemetics.
  • Diarrhea
  • Oral mucositis (mouth, throat, or lip sores). Oral ulcers can be mitigated by proper oral hygiene, including rinsing of the mouth with salt water following consumption of food or drink.
  • Loss of appetite
  • Skin rash. Physician-prescribed glucocorticoids administered on the day prior, day of, and day after infusion typically avoid skin rashes.
  • Constipation

DRUG INTERACTIONS:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Although ibuprofen (400 mg four times a day) can decrease the clearance of pemetrexed, it can be administered with Pemetrexed in patients with normal renal function (creatinine clearance ≥80 mL/min). No dose adjustment of Pemetrexed is needed with concomitant NSAIDs in patients with normal renal function .

Caution should be used when administering NSAIDs concurrently with Pemetrexed for Injection to patients with mild to moderate renal insufficiency (creatinine clearance from 45 to 79 mL/min). NSAIDs with short elimination half-lives (e.g., diclofenac, indomethacin) should be avoided for a period of 2 days before, the day of, and 2 days following administration of Pemetrexed .

In the absence of data regarding potential interaction between Pemetrexed  and NSAIDs with longer half-lives (e.g., meloxicam, nabumetone), patients taking these NSAIDs should interrupt dosing for at least 5 days before, the day of, and 2 days following Pemetrexed  administration. If concomitant administration of NSAIDs is necessary, patients should be monitored closely for toxicity, especially myelosuppression, renal, and gastrointestinal toxicity.

Nephrotoxic Drugs

Pemetrexed is primarily eliminated unchanged renally as a result of glomerular filtration and tubular secretion. Concomitant administration of nephrotoxic drugs could result in delayed clearance of Pemetrexed . Concomitant administration of substances that are also tubularly secreted (e.g., probenecid) could potentially result in delayed clearance of Pemetrexed .


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References/ Citation:

Prescription Category:
DDA Schedule:
Dosage Forms:
Routes of Administration:
Protein Binding:
Metabolosim:
Bioavailability:
Elimination Half life:
Drug Indentifiers:

References/ Citation: