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Pemetrexed is prescribed: with malignant pleural mesothelioma (in combination with the drug cisplatin); with locally advanced or metastatic non-small cell lung cancer (after prior chemotherapy).
Description
Pemetrexed composition and form of release
Active ingredient: pemetrexed (500 mg / vial).
It is produced in the form of a powder, lyophilized for the preparation of a solution for infusion.
Pharmacological properties
It is an antimetabolic agent (structural analogue of folic acid). It is an anti-folate with multidirectional effects. The drug inhibits thymidylate synthetase, dehydrofolate reductase and glycinamide ribonucleotide formyltransferase – the main components of folate-dependent biosynthesis of thymidine, purine nucleotides.
Indications
Pemetrexed is prescribed:
- with malignant pleural mesothelioma (in combination with the drug cisplatin);
- with locally advanced or metastatic non-small cell lung cancer (after prior chemotherapy).
Contraindications
You can not prescribe Pemetrexed:
- if you are allergic to pemetrexed;
- with intolerance to the auxiliary components of the drug.
Application during pregnancy and lactation
Pregnant women should be avoided using this drug.
It is recommended to stop breastfeeding during therapy.
Method of administration and dosage
Pemetrexed is administered parenterally.
The treatment is carried out under the supervision of a qualified specialist with experience in anticancer therapy.
The standard dose for malignant pleural mesothelioma (in combination with cisplatin) is 500 mg / m2 as a 10-minute infusion on the 1st day of each 21-day cycle.
The standard dose for non-small cell lung cancer (NSCLC) monotherapy is 500 mg / m2 as a 10-minute infusion on day 1 of each 21-day cycle.
Before administration, the contents of the vial (500 mg of pemetrexed) must be diluted in 20 ml of isotonic sodium chloride solution (without preservatives) to obtain a solution with a concentration of 25 mg / ml. To completely dissolve the powder, gently shake each bottle. The required volume of the diluted solution should be diluted to 100 ml of 0.9% sodium chloride solution (without preservatives) and administered intravenously over 10 minutes.
IV drugs should be visually inspected for color changes, particulate matter.
Since the preparation and solvent do not contain antimicrobial preservatives, the prepared solution should be used immediately.
The physical and chemical stability of the prepared solution is maintained during the day at room temperature (from +15 to +30 ° C).
Unused solution must be destroyed.
Overdose
Overdose symptoms: neutropenia, thrombocytopenia, anemia, mucositis, rash, infection with or without fever, diarrhea.
Treatment: balanced use of leucovorin or thymidine stimulants.
Side effects:
- Digestive disorders: nausea, anorexia, stomatitis, vomiting, constipation.
- Hematological disorders: agranulocytosis, thrombocytopenia, leukopenia, anemia.
- Hepatobiliary disorders: liver dysfunction, increased biochemical parameters of liver function.
- Immune disorders: hypersensitivity reactions (anaphylactic reaction / shock, fever, angioedema).
- Dermatological disorders: desquamation, exanthema, pruritus, alopecia.
- General disorders: malaise, fatigue, fever.
Storage conditions and periods
Store Pemetrexed at temperatures from +15 to +25 ° C for no more than three years.
It is prohibited to use after the expiry date indicated on the package.
Parents are obliged to ensure the safety of children, excluding the possibility of their access to medicine.
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