Route of administration: Intravenous
Available dose:
- Injection: 100 mg, 500 mg
Mechanism of action: Pemetrexed disrupts folate-dependent metabolic processes essential for cell replication. It inhibits three key enzymes (thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase) involved in the synthesis of thymidine and purine nucleotides, leading to disruption of DNA and RNA synthesis and thus inhibiting cancer cell growth.
Drug usage cases: Pemetrexed is used for the treatment of malignant pleural mesothelioma and non-small cell lung cancer (NSCLC).
Drug contraindications: Contraindicated in patients with a known hypersensitivity to pemetrexed or any of its components.
Side effects: Common side effects include fatigue, nausea, vomiting, loss of appetite, and skin rash. It can also cause anemia, leukopenia, and thrombocytopenia. Rarely, it may lead to severe renal impairment and interstitial pneumonitis.
Warnings: Use with caution in patients with renal impairment and those with a history of myelosuppression. It is important to supplement with folic acid and vitamin B12 to reduce treatment-related toxicity. Monitor blood cell counts and renal function regularly.
Use during pregnancy or breastfeeding: Pemetrexed is categorized as a pregnancy category D drug. It can cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant while receiving pemetrexed. It is unknown if pemetrexed is excreted in human milk; therefore, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
