Pemetrexed: Lung Cancer & Mesothelioma drugs list
Pemetrexed is a modern chemotherapy agent belonging to the antifolate class. Its unique mechanism of action involves the simultaneous inhibition of three key enzymes required for the DNA and RNA synthesis of cancer cells, leading to their destruction.
It serves as the cornerstone for treating non-squamous lung cancer and pleural mesothelioma. On Unifarm, you can find a list of verified medications (lyophilisates and concentrates) containing this active substance.
Indications
- Malignant Pleural Mesothelioma: In combination with cisplatin for unresectable patients (the gold standard of therapy).
- Non-Small Cell Lung Cancer (NSCLC): First-line or maintenance therapy for locally advanced or metastatic disease.
- Important: Indicated only for non-squamous histology.
Dosage and administration
Administered via intravenous infusion (over 10 minutes). The standard dose is 500 mg/m² body surface area every 21 days.
Mandatory Premedication (to reduce toxicity):
- Vitamins: Patients must take folic acid daily and receive Vitamin B12 injections starting one week prior to the first dose and continuing throughout treatment.
- Corticosteroids: Dexamethasone is taken the day before, the day of, and the day after the infusion to prevent severe skin rash.
- Hypersensitivity to Pemetrexed.
- Severe renal impairment (creatinine clearance < 45 ml/min).
- Pregnancy and breastfeeding (high risk of fetal harm).
- Concomitant use of live vaccines (e.g., yellow fever vaccine) during treatment.
Even with proper premedication, monitoring is required for:
- Hematologic: Myelosuppression (low white blood cells, platelets, hemoglobin).
- Gastrointestinal: Nausea, vomiting, stomatitis, loss of appetite.
- Skin: Rash, desquamation (more frequent without dexamethasone).
- General: Severe fatigue, asthenia.
List of medicines by active substance Pemetrexed
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