Pemetrexed

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Alimta; Belgium: Alimta; Bulgaria: Alimta; Czech Republic: Alimta; Denmark: Alimta; Estonia: Alimta; Finland: Alimta; France: Alimta; Germany: Alimta; Greece: Alimta; Hungary: Alimta; Ireland: Alimta; Italy: Alimta; Latvia: Alimta; Lithuania: Alimta; Malta: Alimta; Netherlands: Alimta; Poland: Alimta; Portugal: Alimta; Romania: Alimta; Slovakia: Alimta; Slovenia: Alimta; Spain: Alimta; Sweden: Alimta; UK: Alimta.

North America

Canada: Alimta; USA: Alimta.

Latin America

Argentina: Alimta; Brazil: Alimta; Mexico: Alimta.

Asia

Japan: Alimta.

Drug combinations

Chemistry

Pemetrexed Disodium: C~20~H~19~N~5~Na~2~O~6~. Mw: 471.37. (1) L-Glutamic acid, N-[4-[2-(2-amino-4,7-dihydro-4-oxo-1H-pyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]-, disodium salt; (2) Disodium N-[p-[2-(2-amino-4,7-dihydro-4-oxo-1H-pyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]-L-glutamate. CAS-150399-23-8; CAS-137281-23-3 (pemetrexed)(2004).

Pharmacologic Category

Antineoplastic Agents; Antimetabolites. (ATC-Code: L01BA04).

Mechanism of action

Inhibits thymidylate synthase, dihydrofolate reductase, glycinamide ribonucleotide formyltransferase, and aminoimidazole carboxamide ribonucleotide formyltransferase, enzymes involved in folate metabolism and DNA synthesis, resulting in inhibition of purine and thymidine nucleotide and protein synthesis.

Therapeutic use

Treatment of malignant pleural mesothelioma. Treatment of locally advanced or metastatic nonsquamous non-small cell lung cancer.

Pregnancy and lactiation implications

Adverse events observed in animal reproduction studies. There are no adequate, well-controlled trials in pregnant women. Use not recommended during lactation.

Unlabeled use

Treatment of bladder cancer.

Contraindications

Severe hypersensitivity to pemetrexed or any component of the formulation.

Warnings and precautions

Hazardous agent. Use may cause anemia, neutropenia, thrombocytopenia and/or pancytopenia. Cutaneous reactions may occur. Gastrointestinal toxicity may occur. Use caution with hepatic impairment not due to metastases. Decreased renal function results in increased toxicity. Use not recommended if CrCl <45 mL/minute. Use caution in patients receiving concurrent nephrotoxins (may result in delayed pemetrexed clearance). NSAIDs may reduce clearance of pemetrexed.

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