Alimta

Drugs

Generic Name: Pemetrexed
Product Name: Alimta

Indication of Alimta
Action of Alimta
Dose Advice of Alimta
Schedule of Alimta
Common side effects of Alimta
Uncommon side effects of Alimta
Reference

Indication of Alimta:

Pemetrexed is used in combination with cisplatin in the treatment of malignant mesothelioma. It is also used in the treatment of advanced or metastatic non-small cell lung cancer, after the failure of platinum-based therapy.

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Action of Alimta:

Pemetrexed is an anticancer drug known as an antimetabolite. After entering cells and being activated, it interferes with the replication of cancer cells by preventing the conversion of folic acid to folinic acid, a building block for new DNA. Pemetrexed aims to reduce tumour size and prolong life for cancer sufferers.

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Dose Advice of Alimta:

Pre-treatment with dexamethasone (4mg orally twice daily the day before) has been reported to reduce skin toxicity. Patients should be advised to take daily folic acid and vitamin B12 supplements during treatment. One IV injection of vitamin B12 is recommended preceding the first dose and every 3 cycles after that.
Each 500mg vial of Pemetrexed should be reconstituted in 20ml sodium chloride 0.9% and then further diluted in a further 100ml for infusion.

Malignant Mesothelioma:

to be used in combination with cisplatin
500mg/m2 IV over 10 minutes
should be given on day 1 of a 21 day cycle
cisplatin 75mg/m2 should be administered over 2 hours approximately 30 minutes after completion of Alimta infusion, also on day 1
adequate hydration (according to cisplatin guidelines) is required

Non-small cell lung cancer:

to be used as single agent
500mg/m2 IV over 10 minutes
should be given on day 1 of a 21 day cycle

Dose reductions should be made based on haematological and non-haematological side effects.

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Schedule of Alimta:

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Common side effects of Alimta:

Bone marrow suppression, resulting in reduced numbers of red and white blood cells and platelets, is a common toxicity. This results in increased risk of infection and bleeding, and anaemia.

Other common side effects include:

nausea and vomiting
loss of appitite
mouth ulcers
diarrhoea
constipation
fatigue
fever
change in liver enzymes
rash
itching
hair loss

When Pemetrexed is used in combination with cisplatin there are additional side effects
conjunctivitis

dehydration
altered sense of taste

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Uncommon side effects of Alimta:

sensory neuropathy
motor neuropathy
abdominal pain
febrile neutropaenia
allergic reactions
severe skin reactions
renal failure (when used in combination with cisplatin)

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Reference:

[1] MIMS Australia Pty Ltd [online]. Alimta. MediMedia: NSW; 2003.
[2] Eli Lilly Australia Pty Ltd. Alimta Consumer Medicine Information [online]. North Ryde, NSW; 2004.

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