Pemetrexed Injection : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

Pemetrexed injection is used in combination with other chemotherapy drugs as the first treatment for a certain type of non-small cell lung cancer (NSCLC) that has spread to nearby tissues or to other parts of the body. Pemetrexed injection is also used alone to treat NSCLC as an ongoing treatment in people who have already received certain chemotherapy drugs and whose cancer has not gotten worse and in people who could not be successfully treated with other chemotherapy drugs. Pemetrexed injection is also combined with another chemotherapy drug as the first treatment for malignant pleural mesothelioma (a type of cancer that affects the inner lining of the chest cavity) in people who cannot be treated with surgery. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that can help cancer cells to multiply.

How should this medicine be used?

Pemetrexed injection comes as a solution (liquid) that is injected into a vein over 10 minutes. Pemetrexed injection is given by a doctor or nurse in a doctor’s office or infusion center. It is usually given once every 21 days.

Your doctor will likely direct you to take other medications, such as folic acid (a vitamin), vitamin B12, and a corticosteroid such as dexamethasone to lessen some of the side effects of this medication. Your doctor will give you instructions for taking these medicines. Carefully follow your doctor’s instructions. Ask your doctor or pharmacist to explain any parts you do not understand. If you miss a dose of one of these medications, call your doctor.

Your doctor will instruct you to have regular blood tests before and during treatment with pemetrexed injection. Your doctor may change your dose of pemetrexed injection, delay treatment, or permanently stop it based on the results of blood tests.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before receiving pemetrexed injection,

  • Tell your doctor and pharmacist if you are allergic to pemetrexed, mannitol (Osmitrol), any other medications, or any of the ingredients in pemetrexed injection. Ask your pharmacist or check the manufacturer’s patient information for a list of ingredients.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention ibuprofen (Advil, Motrin). You should not take ibuprofen two days before, on the day, or for two days after you receive your pemetrexed injection. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • Tell your doctor if you have had radiation therapy or have or have ever had kidney disease.
  • Tell your doctor if you are pregnant or plan to become pregnant, or if you plan to have a child. If you are a woman, you must use reliable birth control while receiving pemetrexed injection and for at least 6 months after the final dose. If you are a man, you and your female partner must use effective contraception while receiving the pemetrexed injection and for 3 months after the final dose. If you or your partner become pregnant while using this medicine, call your doctor. Pemetrexed injection can harm the fetus.
  • Tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with pemetrexed injection and for 1 week after the final dose.
  • You should know that pemetrexed injection can cause fertility problems in men that may affect their ability to father a child. It is not known if these effects are reversible. Talk to your doctor about the risks of receiving pemetrexed injection.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

If you miss an appointment to receive a dose of pemetrexed injection, call your doctor as soon as possible.

What side effects can this medication cause?

Pemetrexed injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • diarrhea
  • constipation
  • loss of appetite
  • weight loss
  • tiredness
  • difficulty falling asleep or staying asleep
  • joint pain

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment :

  • blisters, skin sores, skin peeling, or painful ulcers in your mouth, lips, nose, throat, or genital area
  • swelling, blistering, or rash that looks like a sunburn in an area previously treated with radiation
  • unusual bleeding or bruising
  • sore throat, fever, chills, cough or other signs of infection
  • chest pain
  • fast heartbeat
  • difficulty breathing or swallowing
  • slow or difficult speech
  • extreme tiredness or weakness
  • dizziness or faintness
  • weakness or numbness of an arm or leg
  • pain, burning, numbness, or tingling in the hands or feet
  • pale skin
  • headache
  • hives
  • itching
  • decreased urination

Pemetrexed injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim collapsed, had a seizure, is having trouble breathing, or is unable to wake up, immediately call 911 for emergency services.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain laboratory tests to check your body’s response to pemetrexed injection.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you every time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Alimta®

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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