Pemetrexed (Intravenous Route)

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Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Make sure your doctor knows if you are pregnant before you receive this medicine. Using this medicine while you are pregnant can harm your unborn baby. If you are a woman of childbearing potential, you should use two forms of birth control together to avoid getting pregnant while you are receiving this medicine. If you have become pregnant during your treatment, tell your doctor right away.

It is important that you check with your doctor right away if you have fever or chills, diarrhea, or mouth sores. These may be signs that you have an infection.

You may feel tired or weak for a few days after your pemetrexed treatment. If you have severe weakness or tiredness, call your doctor.

You may get redness or sores in your mouth, throat, or lips. These symptoms may happen a few days after pemetrexed treatment.

You may get a rash or itching during treatment. These usually appear between treatments with pemetrexed and usually go away before the next treatment. Call your doctor if you get a severe rash or itching.

Pemetrexed and cisplatin (a cancer medicine) can sometimes cause nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. You can get medicines to help control the nausea and vomiting. Talk with your doctor if you get any of these symptoms.

You may lose your appetite and some weight during your treatment. Talk to your doctor if this is a problem for you.

While you are being treated with pemetrexed, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Pemetrexed may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Pemetrexed can temporarily affect your blood counts and your doctor will do blood tests to check your blood counts before and during treatment with pemetrexed. Low red blood cells may make you feel tired, get tired easily, appear pale, and become short of breath. Low white blood cells may give you a greater chance for infection. If you have a fever (temperature above 100.4 degrees F) or other signs of infection, call your doctor right away. Low platelets give you a greater chance for bleeding. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, diarrhea, lower back or side pain, mouth sores, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Make sure your doctor knows if you are also using a pain or arthritis medicine (e.g., ibuprofen, Motrin®) while you are receiving this medicine. These medicines should be used with caution in patients with kidney problems.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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