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What is pemetrexed?

Pemetrexed is an anticancer medicine. It is a treatment for patients with lung cancer. It may also be given for other reasons. It is a liquid given into a vein (IV) during an infusion.

Pemetrexed can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”

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Possible side effects

  • Fatigue
  • Nausea, vomiting, diarrhea
  • Loss of appetite (not as hungry as usual)
  • Constipation

    If you have any of these side effects, tell the doctor right away:
  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, red skin rash
  • Decrease in how much or how often you urinate
  • Dry mouth or skin; increased thirst
  • Feeling lightheaded, dizzy, or fainting
  • Fever, chills, cough, sore throat, and body aches
  • Lower back or side pain
  • Rapid weight gain; swelling in your hands, ankles, or feet
  • Red or dark brown urine
  • Unusual bleeding, bruising, weakness
  • Sores or white patches on your lips, mouth, or throat.

    These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

Symptoms of an allergic reaction include: rash, hives, itching, chills, fever, headache, muscle ache, shortness of breath, coughing, tightness in the throat, swelling of the face or neck.

Not all patients who take pemetrexed will experience these side effects. Common side effects are bolded, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

Find more information on side effects.

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Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist. 

  • Because pemetrexed may cause birth defects, do not take this medicine if you are pregnant. Both men and women who are taking pemetrexed should use effective birth control methods. Contact one of your caregivers at St. Jude if you are sexually active or think you may be pregnant.
  • It is not known whether pemetrexed passes into breast milk. This medicine might cause serious harm to a nursing infant. Women who are taking pemetrexed should not breast-feed a baby.
  • You should tell your doctor if you are taking medicines called nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, swelling, or fever. There are many NSAID medicines. If you are not sure, ask your doctor or pharmacist if any of your medicines are NSAIDs. This medicine may make you bleed, bruise, or get infections more easily.
    • Examples of NSAIDs: aspirin, diclofenac, ibuprofen (Advil®), indomethacin, meloxicam, naproxen (Aleve®)
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Talk with the doctor before getting any vaccines, including a flu shot. Receiving vaccines while on this drug may either increase the chance of bad infection or make the vaccine not work as well.
  • Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
  • You may need to do the following during treatment to help prevent gastrointestinal (GI) problems, skin rashes, anemia, and other side effects.
    • Take a folic acid supplement or a multivitamin that contains folic acid. Begin taking folic acid at least 5 days before your first injection and continue to take it for at least 21 days after your final injection. Your doctor will tell you what medicine to take.
    • Your doctor will give you a vitamin B-12 injection in the week before your first treatment and then about every 9 weeks while you receive treatment.
    • Your doctor will give you a steroid medicine to take the day before, the day of, and the day after each injection.