About
Pemetrexed is an antifolate antineoplastic agent that exerts its cytotoxic effects by disrupting folate-dependent metabolic processes essential for cell replication. It inhibits multiple enzymes involved in purine and pyrimidine synthesis, including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. This multi-targeted inhibition leads to the depletion of nucleotide precursors, thereby impeding DNA synthesis and repair, and ultimately inducing apoptosis in rapidly dividing cancer cells. Its mechanism of action makes it effective against various solid tumors.
Administered intravenously, pemetrexed is often used in combination with other chemotherapeutic agents or as a monotherapy. Its pharmacokinetic profile involves renal excretion, necessitating dose adjustments in patients with impaired kidney function. Pre-medication with folic acid and vitamin B12 is crucial to mitigate hematological and gastrointestinal toxicities associated with its antifolate activity, improving patient tolerability and treatment outcomes.
Uses
- Treatment of non-small cell lung cancer (NSCLC)
- Management of malignant pleural mesothelioma
- Adjuvant therapy for certain solid tumors
- Palliative care in advanced malignancies
Directions For Use
Administer intravenously over 10 minutes. Dosage and frequency are determined by a physician based on the specific cancer type and patient's condition.
Benefits
- Effective against various types of cancer
- Can be used as monotherapy or in combination
- Improves progression-free survival in some cancers
- Offers a targeted approach to cancer cell inhibition
- May extend overall survival in specific patient populations
- Part of established chemotherapy regimens
Side Effects
- Myelosuppression (anemia, neutropenia, thrombocytopenia)
- Nausea and vomiting
- Fatigue and asthenia
- Diarrhea or constipation
- Mucositis/stomatitis
- Skin rash
- Peripheral neuropathy
- Elevated liver enzymes
- Renal dysfunction
- Infection risk
- Alopecia (hair loss)
- Anorexia
Safety Measures
- Alcohol - Avoid alcohol during treatment as it may exacerbate gastrointestinal side effects and potentially interact with the medication's metabolism.
- Pregnancy - Pemetrexed is contraindicated in pregnancy due to its genotoxic and teratogenic potential. Effective contraception is required for both male and female patients during and after treatment.
- Breastfeeding - Breastfeeding is contraindicated during pemetrexed treatment due to the potential for serious adverse reactions in the infant.
- Liver - Use with caution in patients with pre-existing liver impairment. Monitor liver function tests closely, and dose adjustments may be necessary based on the severity of hepatic dysfunction.
- Kidney - Pemetrexed is primarily renally excreted. Dose adjustments are required for patients with moderate to severe renal impairment. Regular monitoring of renal function is essential.
- Lung - While not a primary concern, interstitial lung disease is a rare but serious side effect. Monitor for new or worsening respiratory symptoms.
Disclaimer
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Always consult your doctor for any medical concerns, and discuss your questions about health conditions or medications with a qualified healthcare professional. Do not ignore or delay seeking professional medical advice based on information found on Med E Hub.
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