Brands of Pemetrexed in Kenya:
Pemita® ,Atlanta Biologicals Pvt Ltd
Alimta® , Eli Lilly and Company
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.
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.
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 .
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 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 the 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
Reporting of suspected adverse reactions
The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, pv@pharmacyboardkenya.org or clicking below button:
Pemetrexed in Kenya
Pemetrexed in Kenya
Clinical | Pharmacokinetic data
Pregnancy Category:
Routes of Administration: Intravenous
Bioavailability: Not Available
Protein Binding: 81%
Metabolosim: Negligible
Onset of Action:
Elimination Half life: 3.5 hours
Excretion: Renal
Legal Status | Dosage forms & Strengths
Prescription Category:
Prescription only Medicine (POM) , â„ž-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This Drug is not Subject to DDA drugs Act
Dosage Forms | Strengths:
Injectable
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Drug Images
References/ Citation:
- PPB Retention Register
- National Cancer Institute: FDA Approval for Pemetrexed Disodium
- Mok, Tony S., et al. “Osimertinib or platinum–pemetrexed in EGFR T790M–positive lung cancer.” New England Journal of Medicine 376.7 (2017): 629-640.