Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: Allergic reactions, including difficulty breathing and swelling of the throat and mouth, can occur with this medication. If you experience these symptoms, get immediate medical attention.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.
Fertility: This medication may cause temporary or permanent fertility problems. Talk to your doctor about your concerns and options.
Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who have contagious infections (e.g., colds, flu), and tell your doctor if you begin to notice signs of an infection such as fever or chills.
Kidney disease: This medication may affect your kidneys. You doctor will monitor your kidney function through blood tests while you are receiving this medication. People with significantly decreased kidney function should not receive pemetrexed. People with diabetes, high blood pressure, or who are dehydrated should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver problems: People with impaired liver function or liver problems (e.g., liver disease, liver cancer) should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lung problems: This medication can cause lung problems that can be severe. If you experience shortness of breath and cough while taking this medication, contact your doctor or get immediate medical attention.
Skin reactions: Because skin reactions are known to occur in people who receive treatment with pemetrexed, it is recommended that a corticosteroid be taken a day before scheduled treatment.
Vitamin supplementation: To avoid undesirable side effects, people using pemetrexed must take a low-dose folic acid supplement or a multivitamin containing folic acid once a day for the week before the start of treatment, and for the 3 weeks after the last dose of treatment. In addition, vitamin B12 injections must be given at least 1 week before the first day of treatment, and then continued every 9 weeks from the previous dose until 3 weeks after the last dose of pemetrexed.
Pregnancy: This medication may harm a fetus or baby. Women who could become pregnant should have a negative blood pregnancy test before starting this medication and should use effective contraception to prevent pregnancy during treatment. If you become pregnant while receiving this medication, contact your doctor immediately.
Breast-feeding: It is not known if pemetrexed passes into breast milk. Women should not breast-feed while receiving this medication.
Children: The safety and effectiveness of using this medication have not been established for children.