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ফার্মেসীর জন্য পাইকারি দামে ঔষধ কিনতে রেজিস্টেশন করুন
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Sefety Advices
বাংলা
English
SAFE
Consuming alcohol with Pemetrex does not cause any harmful side effects.
CONSULT YOUR DOCTOR
Pemetrex is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
CAUTION
Pemetrex should be used with caution during breastfeeding. Breastfeeding should be held until the treatment of the mother is completed and the drug is eliminated from her body.
UNSAFE
Pemetrex may cause side effects which could affect your ability to drive. Pemetrex may make you feel tired and this may affect your ability to drive.
CAUTION
Pemetrex should be used with caution in patients with kidney disease. Dose adjustment of Pemetrex may be needed. Please consult your doctor. Use of Pemetrex is not recommended in patients with moderate to severe kidney disease.
SAFE IF PRESCRIBED
Pemetrex is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Pemetrex may not be needed in these patients. Please consult your doctor.
Medical Overview
Introduction
Pemetrex is used in the treatment of non-small cell lung cancer and malignant pleural mesothelioma. Pemetrex is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. The most common side effects of this medicine include nausea, vomiting, loss of appetite, and hair loss. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver and blood uric acid levels. Before taking it, tell your doctor if have heart disease, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using.This medicine is not recommended during pregnancy or while breastfeeding. Use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Pemetrex
  • Non-small cell lung cancer
  • Malignant pleural mesothelioma
Side effects of Pemetrex
Common
  • Nausea
  • Vomiting
  • Sore throat
  • Loss of appetite
  • Stomatitis (Inflammation of the mouth)
  • Hair loss
  • Low blood platelets
  • Rash
  • Fatigue
  • Anemia (low number of red blood cells)
  • Diarrhea
  • Decreased white blood cell count (neutrophils)
  • Neuropathy
How to use Pemetrex
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Pemetrex works
Pemetrex interferes with the growth of DNA and RNA of the cancer cells by substituting their building blocks. It prevents the cancer cells from growing and multiplying.
Quick Tips
  • Use a reliable contraceptive method to prevent pregnancy while you are taking this medicine.
  • Inform your doctor immediately if you notice any signs of infection such as fever, sore throat, rash or severe diarrhea.
Brief Description
Indication
Non-small cell lung cancer, Malignant pleural mesothelioma
Administration
IV Preparation Aseptically reconstitute with 20 mL of 0.9% NaCl (preservative free) to give a 25 mg/mL solution Gently swirl until completely dissolved; resulting solution is clear and ranges in color from colorless to yellow/green-yellow without adversely affecting quality Aseptically dilute required dose to 100 mL with 0.9% NaCl (preservative free) IV Administration Infuse over 10 min
Adult Dose
Intravenous Malignant Pleural Mesothelioma Indicated for mesothelioma in combination with cisplatin in patients whose disease is unresectable or are not candidates for curative surgery Combination use with cisplatin: 500 mg/m² IV over 10 minutes on Day 1 of each 21-day cycle; administer cisplatin (75 mg/m² IV over 2 hr) 30 minutes after end of premetrexed infusion Nonsquamous Non-Small Cell Lung Carcinoma Indications Initial treatment: In combination with cisplatin for initial treatment with locally advanced or metastatic nonsquamous NSCLC Maintenance: Locally advanced or metastatic nonsquamous NSCLC in patients whose disease has not progressed after 4 cycles of platinum-based first-line chemotherapy After prior chemotherapy: As a single agent of locally advanced or metastatic nonsquamous NSCLC after prior chemotherapy Single-agent use: 500 mg/m² IV infusion over 10 minutes on Day 1 of each 21-day cycle Combination use with cisplatin: 500 mg/m² IV over 10 minutes on Day 1 of each 21-day cycle; administer cisplatin (75 mg/m² IV over 2 hr) 30 minutes after end of premetrexed infusion Premedication Regimen Folic acid: 400-1000 mcg PO qDay beginning 7 days before first pemetrexed dose; continue during the full course of therapy and for 21 days after the last dose Vitamin B12: 1 mg IM beginning 1 week before first pemetrexed dose and repeat every 3 cycles thereafter; subsequent doses may be administered on the same day as pemetrexed Do not substitute PO B12 for IM (see Cautions) Dexamethasone: 4 mg PO BID on the day before, day of, and day after pemetrexed administration treatment to help prevent skin rash Dosage Modifications If nadir ANC <500/mm³ & nadir platelets >50,000/mm³ Adjust to 75% of previous dose (both drugs) If nadir platelets <50,000/mm³ regardless of nadir ANC Adjust to 50% of previous dose (both drugs) Any Grade 3 or 4 toxicities except mucositis Adjust to 75% of previous dose (both drugs) Any diarrhea requiring hospitalization Adjust to 75% of previous dose (both drugs) Grade 3 or 4 mucositis Adjust pemetrexed to 50% of previous dose CTC Grade 2 Adjust Cisplatin to 50% of previous dose
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment: CrCl (ml/min) Dosage Recommendation <45 Usage is not recommended.
Contraindication
Hypersensitivity.
Mode of Action
Pemetrexed is a thymidylate synthase inhibitor. It works by inhibiting thymidylate synthase, dihydrofolate reductase, glycinamide ribonucleotide formyltransferase and aminoimidazole carboxamide ribonucleotide formyltransferase, the enzymes involved in folate metabolism and DNA synthesis, thus inhibiting purine and thymidine nucleotide and protein synthesis.
Precaution
Monitor CBC, platelet counts, and CrCl for nadir and recovery before each cycle. Periodic hepatic monitoring Premedication with folate and vitamin B12 are recommended as prophylaxis against haematological and GI toxicity during treatment. Pre-treatment with a corticosteroid also reduces the incidence and severity of skin reactions. Caution when used in renal or hepatic impairment. Not recommended for use in pregnancy. Lactation: not safe
Side Effect
>10% Nausea (84%),Fatigue (80%),Pulmonary dyspnea (66%),Neutropenia (58%),Vomiting (58%),Leukopenia (55%),Constipation (44%),Chest pain (40%),Anorexia (35%),Anemia (33%),Pharyngitis (28%),Stomatitis (28%),Thrombocytopenia (27%),Diarrhea without colostomy (26%),Rash/desquamation (22%),Fever (17%),Neuropathy/sensory (17%),Creatinine elevation (16%),Mood alteration/depression (14%),Infection without neutropenia (11%) 1-10% Dehydration, thrombosis/embolism (7%),Dysphagia/esophagitis/odynophagia (6%),Infection with Grade 3 or Grade 4 neutropenia (6%),Neutropenia-other (3%),Allergic reaction/hypersensitivity (2%),Renal failure (2%),Febrile neutropenia (1%) <1% Esophagitis,Arrhythmia,Motor neuropathy,Febrile neutropenia,Erythema multiforme Potentially Fatal: Acute renal failure.
Interaction
High doses of NSAIDs and aspirin may reduce the elimination of pemetrexed; avoid usage 2 days (5 days for longer-acting NSAIDs) before, during and 2 days after treatment with pemetrexed in patients with impaired renal function. Additive GI side effects when used with SSRIs, acetylcholinesterase inhibitors, aripiprazole or ziprasidone. Additive sedation when used with psychotropics. Concurrent use with nephrotoxic drugs (e.g. aminoglycosides, loop diuretics, platinum compounds and ciclosporin) may decrease pemetrexed clearance, thus increasing the risk of toxicity. Clearance may be reduced when used with drugs that are cleared by tubular secretion e.g. probenecid and penicillin.
ফার্মেসীর জন্য পাইকারি দামে ঔষধ কিনতে রেজিস্টেশন করুন
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Disclaimer
The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.