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Indications & Uses
Pemexen is indicated for:
Pharmacology
Pemetrexed works by interfering with the folate-dependent processes a cell needs to copy itself. Laboratory studies show that it blocks thymidylate synthase (TS), dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase (GARFT). These are folate-dependent enzymes that help the body build thymidine and purine nucleotides from scratch.
Pemetrexed gets into cells through membrane carriers, mainly the reduced folate carrier and the membrane folate binding protein transport system. Once inside, the enzyme folylpolyglutamate synthetase adds glutamate units to it, turning it into polyglutamate forms. These forms stay in the cell for a long time, and they are what keep blocking TS and GARFT.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Dosage
Recommended dosage for non-squamous NSCLC
When given with Pembrolizumab and platinum chemotherapy for the initial treatment of metastatic non-squamous NSCLC, the recommended dose of Pemetrexed in patients with a creatinine clearance (calculated by the Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m2 as an intravenous infusion over 10 minutes. It is given after Pembrolizumab and before Carboplatin or Cisplatin on Day 1 of each 21-day cycle for 4 cycles. Once platinum-based therapy is completed, treatment with Pemetrexed, with or without Pembrolizumab, continues until disease progression or unacceptable toxicity.
When given with Cisplatin for the initial treatment of locally advanced or metastatic non-squamous NSCLC, the recommended dose of Pemetrexed in patients with a creatinine clearance (calculated by the Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m2 as an intravenous infusion over 10 minutes, given before Cisplatin on Day 1 of each 21-day cycle for up to six cycles, provided there is no disease progression or unacceptable toxicity.
For maintenance treatment of non-squamous NSCLC, the recommended dose of Pemetrexed in patients with a creatinine clearance (calculated by the Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m2 as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle, continued until disease progression or unacceptable toxicity, after four cycles of platinum-based first-line chemotherapy.
For treatment of recurrent non-squamous NSCLC, the recommended dose of Pemetrexed in patients with a creatinine clearance (calculated by the Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m2 as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity.
Recommended dosage for mesothelioma
When given with Cisplatin, the recommended dose of Pemetrexed in patients with a creatinine clearance (calculated by the Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m2 as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity.
Side Effects
Possible side effects include myelosuppression (low blood cell counts), renal failure, bullous and exfoliative skin toxicity, interstitial pneumonitis, and radiation recall.
Cautions & Contraindications
Warnings & Precautions
Myelosuppression and Increased Risk of Myelosuppression without Vitamin Supplementation: Pemetrexed Ever Pharma Ever Pharma can cause severe myelosuppression, resulting in a need for transfusions and possibly leading to neutropenic infection. The risk of myelosuppression is higher in patients who do not receive vitamin supplementation. Supplementation with oral folic acid and intramuscular vitamin B12 should be started before the first dose of Pemetrexed Ever Pharma Ever Pharma; vitamin supplementation should be continued during treatment and for 21 days after the last dose of Pemetrexed Ever Pharma Ever Pharma to reduce the severity of the haematologic and gastrointestinal toxicity of Pemetrexed Ever Pharma Ever Pharma. Renal Failure: Pemetrexed Ever Pharma Ever Pharma can cause severe, and sometimes fatal, renal toxicity. In clinical studies in which patients received Pemetrexed Ever Pharma Ever Pharma as a single agent, the incidence of renal failure ranged from 0.4% to 0.6%. Creatinine clearance should be determined before each dose, and renal function should be monitored periodically during treatment with Pemetrexed Ever Pharma Ever Pharma. It should be withheld in patients with a creatinine clearance of less than 45 mL/minute. Bullous and Exfoliative Skin Toxicity: Serious and sometimes fatal bullous, blistering and exfoliative skin toxicity, including cases suggestive of Stevens-Johnson syndrome/toxic epidermal necrolysis, can occur with Pemetrexed Ever Pharma Ever Pharma. It should be permanently discontinued for severe and life-threatening bullous, blistering or exfoliating skin toxicity. Interstitial Pneumonitis: Serious interstitial pneumonitis, including fatal cases, can occur with Pemetrexed Ever Pharma Ever Pharmatreatment. Pemetrexed Ever Pharma Ever Pharma should be withheld for the acute onset of new or progressive unexplained pulmonary symptoms such as dyspnoea, cough or fever, pending diagnostic evaluation. If pneumonitis is confirmed, Pemetrexed Ever Pharma Ever Pharma should be permanently discontinued. Radiation Recall: Radiation recall can occur with Pemetrexed Ever Pharma Ever Pharma in patients who have received radiation weeks to years previously. Patients should be monitored for inflammation or blistering in areas of previous radiation treatment. Pemetrexed Ever Pharma Ever Pharma should be permanently discontinued for signs of radiation recall. Increased Risk of Toxicity with Ibuprofen in Patients with Renal Impairment: Exposure to Pemetrexed Ever Pharma Ever Pharma is increased in patients with mild to moderate renal impairment who take ibuprofen at the same time, which increases the risk of adverse reactions to Pemetrexed Ever Pharma Ever Pharma. In patients with a creatinine clearance between 45 mL/min and 79 mL/min, ibuprofen should be avoided for 2 days before, the day of, and 2 days after administration of Pemetrexed Ever Pharma Ever Pharma. If concomitant ibuprofen use cannot be avoided, patients should be monitored more frequently for adverse reactions to Pemetrexed Ever Pharma Ever Pharma, including myelosuppression and renal and gastrointestinal toxicity.
Contraindications
Pemetrexed must not be used in patients who have previously had a severe allergic (hypersensitivity) reaction to Pemetrexed.
Pregnancy & Breastfeeding
Pemetrexed can cause fetal harm when given to a pregnant woman, and no data are available on its use in this population; pregnant women should be told about this potential risk to the fetus. It is not known whether Pemetrexed or its metabolites pass into human milk, and their effects on a breastfed infant or on milk production are unknown. Because of the potential for serious adverse reactions in breastfed infants, women should not breastfeed during treatment with Pemetrexed and for one week after the last dose.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
No drug is approved for treating a Pemetrex overdose. Animal studies suggest that leucovorin may reduce the toxic effects of a Pemetrex overdose. Whether Pemetrex can be removed from the body by dialysis is not known.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Pemetrexed in a cool, dry place where the temperature stays below 30°C, and away from direct sunlight. Make sure children can't reach it.
Drug Interactions
Common questions about Pemexen 500 mg/20 ml
What is Pemexen 500 mg/20 ml IV Infusion?
Pemexen 500 mg/20 ml IV Infusion is a medicine that contains Pemetrexed. It is made by Renata PLC. It belongs to the Cytotoxic Chemotherapy group of medicines.
What is Pemexen used for?
Pemexen is used for: Cancer.
What are the side effects of Pemexen?
Possible side effects include myelosuppression (low blood cell counts), renal failure, bullous and exfoliative skin toxicity, interstitial pneumonitis, and radiation recall.
Can I take Pemexen during pregnancy or while breastfeeding?
Pemetrexed can cause fetal harm when given to a pregnant woman, and no data are available on its use in this population; pregnant women should be told about this potential risk to the fetus. It is not known whether Pemetrexed or its metabolites pass into human milk, and their effects on a breastfed infant or on milk production are unknown. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Pemexen?
No drug is approved for treating a Pemetrex overdose. Animal studies suggest that leucovorin may reduce the toxic effects of a Pemetrex overdose. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Pemexen?
Keep Pemetrexed in a cool, dry place where the temperature stays below 30°C, and away from direct sunlight. Make sure children can't reach it.
Can I take other medicines with Pemexen?
Some medicines can interact with Pemetrexed, for example: Ibuprofen. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Pemexen?
Pemexen is a prescription (Rx) medicine. Take it as your doctor advises.