pemetrexed disodium heptahydrate at a glance
Medicine class
Cytotoxic antifolate chemotherapy
Administration
Given into a vein by a specialist cancer team
Supportive treatment
Prescribed folic acid, vitamin B12 and corticosteroid treatment helps reduce important toxicities
What is pemetrexed disodium heptahydrate used for?
The selected UK product is licensed for:
First-line treatment with cisplatin for locally advanced or metastatic non-small-cell lung cancer that is not predominantly squamous.
Maintenance treatment alone for locally advanced or metastatic non-squamous non-small-cell lung cancer that has not progressed immediately after platinum-based chemotherapy.
Second-line treatment alone for locally advanced or metastatic non-squamous non-small-cell lung cancer.
Treatment with cisplatin for chemotherapy-naive patients with unresectable malignant pleural mesothelioma.
How does pemetrexed disodium heptahydrate work?
Pemetrexed blocks several folate-dependent enzymes needed to produce DNA building blocks. Its active forms remain inside cells and hinder replication, affecting rapidly dividing cancer cells and some healthy tissues.
pemetrexed disodium heptahydrate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 5 mg/mL, 6 mg/mL, 6.5 mg/mL, 7 mg/mL, 7.5 mg/mL, 8 mg/mL, 8.5 mg/mL, 9 mg/mL, 10 mg/mL, 11 mg/mL, 100 mg, 500 mg, 1000 mg
How to take pemetrexed disodium heptahydrate
Pemetrexed is given as an intravenous infusion under specialist supervision; it is not taken by mouth. Attend required blood tests and take prescribed folic acid, vitamin B12, corticosteroid and anti-sickness treatment as directed.
Tell the oncology team about prescription, over-the-counter and herbal products, particularly painkillers such as ibuprofen.
The selected solution is supplied ready to use in a single-use infusion bag.
Report pain, redness, swelling or leakage around the infusion site promptly.
pemetrexed disodium heptahydrate side effects
Common or expected effects
- Reduced white cells and increased infection risk
- Anaemia, tiredness or breathlessness
- Reduced platelets, bruising or bleeding
- Nausea, vomiting, diarrhoea or constipation
- Sore mouth or throat, or reduced appetite
- Rash, itching or skin peeling
- Fatigue
- Changes in kidney or liver blood tests
Get urgent medical advice
- Fever, shivering or sudden illness suggesting serious infection or neutropenic sepsis
- Bleeding that does not stop or marked unexplained bruising
- Sudden breathlessness, chest pain or coughing blood
- Facial swelling, breathing difficulty or collapse from a severe allergic reaction
- Widespread painful, blistering or peeling skin
- New or worsening cough and breathlessness suggesting lung inflammation
- Markedly reduced urine output or other evidence of kidney injury
pemetrexed disodium heptahydrate in pregnancy
Pemetrexed may harm an unborn baby and should generally be avoided during pregnancy unless a specialist concludes it is clearly necessary. Effective contraception is required during treatment and for 6 months afterwards for women who could become pregnant; men are advised not to father a child during treatment and for 3 months afterwards. Discuss fertility preservation before treatment where relevant.
pemetrexed disodium heptahydrate while breastfeeding
Breastfeeding is contraindicated during treatment because transfer into milk is unknown and serious effects in the infant cannot be excluded. Discuss this with the oncology and maternity or infant-feeding teams.
pemetrexed disodium heptahydrate interactions
A complete medication and vaccination review is required because reduced renal clearance can increase pemetrexed toxicity.
NSAIDs, including ibuprofen and higher-dose aspirin
They may reduce pemetrexed elimination and increase bone-marrow or gastrointestinal toxicity, particularly with impaired kidney function.
Nephrotoxic medicines, including aminoglycosides, loop diuretics, platinum compounds and ciclosporin
Combined use may delay pemetrexed clearance; caution and closer renal monitoring may be needed.
OAT3 inhibitors, including probenecid, penicillins and proton-pump inhibitors
These may delay renal clearance of pemetrexed and increase exposure.
Common questions about pemetrexed disodium heptahydrate
Answers are fully visible for fast scanning and source review.
What cancers is pemetrexed disodium heptahydrate used to treat?
It is licensed for selected locally advanced or metastatic non-squamous non-small-cell lung cancers and, with cisplatin, unresectable malignant pleural mesothelioma.
How is pemetrexed disodium heptahydrate given?
It is given into a vein by a specialist cancer team after clinical assessment and blood testing.
Why are folic acid and vitamin B12 used?
They reduce important blood, gastrointestinal and infection-related toxicities without altering pemetrexed pharmacokinetics.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.