pemetrexed diarginine at a glance
Medicine class
Cytotoxic antifolate chemotherapy
Main uses
Selected non-squamous non-small-cell lung cancers and unresectable malignant pleural mesothelioma
Administration
Diluted and given into a vein by a specialist cancer team
Supportive treatment
Folic acid, vitamin B12 and corticosteroid premedication help reduce important toxicities
What is pemetrexed diarginine used for?
The selected product is licensed for adults in the following settings:
With cisplatin for previously untreated, unresectable malignant pleural mesothelioma.
With cisplatin as first-line treatment for locally advanced or metastatic non-small-cell lung cancer that is not predominantly squamous.
Alone as maintenance treatment for locally advanced or metastatic non-squamous non-small-cell lung cancer that has not progressed immediately after platinum-based chemotherapy.
Alone as second-line treatment for locally advanced or metastatic non-squamous non-small-cell lung cancer.
How does pemetrexed diarginine work?
Pemetrexed blocks several folate-dependent enzymes needed to make building blocks for DNA. This disrupts cell replication, particularly in rapidly dividing cancer cells.
pemetrexed diarginine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 25 mg/mL
How to take pemetrexed diarginine
Pemetrexed diarginine is not taken by mouth. A trained cancer team dilutes the concentrate and administers it intravenously. Take prescribed folic acid and attend for vitamin B12 and corticosteroid treatment as instructed; tell the team if any supportive medicine was missed.
Keep blood-test and treatment appointments.
Tell the team about new symptoms and all medicines, supplements and vaccines.
Do not try to prepare or administer the concentrate yourself.
pemetrexed diarginine side effects
Common or expected effects
- Reduced white cells, red cells or platelets, increasing risks of infection, tiredness, breathlessness, bruising or bleeding
- Nausea, vomiting, diarrhoea, reduced appetite or constipation
- Sore mouth or throat
- Fatigue
- Rash, peeling skin or itching
- Changes in kidney or liver blood tests
- Hair loss or altered sensation in the hands or feet
Get urgent medical advice
- Fever, shivering or other signs of infection, including neutropenic infection or sepsis
- Unexpected bleeding or extensive bruising
- Severe allergic reaction with breathing difficulty, swelling or collapse
- Severe blistering, peeling or painful skin reaction
- Acute kidney injury, which may cause reduced urine, severe thirst or dehydration
- Sudden breathlessness, chest pain, coughing blood or symptoms suggesting a blood clot
- New or worsening breathlessness that may indicate lung inflammation
pemetrexed diarginine in pregnancy
Pemetrexed may seriously harm an unborn baby and should generally be avoided during pregnancy unless a specialist concludes it is clearly necessary. Discuss pregnancy plans, suspected pregnancy, contraception and fertility preservation with the cancer team before treatment.
pemetrexed diarginine while breastfeeding
Breastfeeding is contraindicated during pemetrexed treatment because transfer into milk is unknown and harm to the child cannot be excluded. Seek specialist advice about feeding options.
pemetrexed diarginine interactions
Important interactions include:
Ibuprofen, aspirin and other NSAIDs
They may reduce pemetrexed clearance and increase toxicity, especially with impaired kidney function; the oncology team may require them to be withheld around treatment.
Yellow fever vaccine
Concomitant use is contraindicated because of the risk of severe generalised vaccine infection.
Other live attenuated vaccines
They are generally not recommended during treatment because immunosuppression can cause systemic infection; ask the cancer team before vaccination.
Common questions about pemetrexed diarginine
Answers are fully visible for fast scanning and source review.
What cancers is pemetrexed diarginine used to treat?
It is licensed for selected non-squamous non-small-cell lung cancers and, with cisplatin, previously untreated unresectable malignant pleural mesothelioma.
How is pemetrexed diarginine given?
A specialist cancer team dilutes the concentrate and administers it through a vein; it is not a tablet or home injection.
Why are folic acid and vitamin B12 needed with pemetrexed diarginine?
They reduce important blood, gastrointestinal and other toxicities without preventing pemetrexed's intended action.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.