Generic name: pemetrexed [ pem-e-TREX-ed ]
Drug class: Antimetabolites

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 27, 2023.

What is Alimta?

Alimta injection is used in combination with other chemotherapy medications as a first treatment for a certain type of non-small cell lung cancer (NSCLC) that has spread to nearby tissues or to other parts of the body.

Alimta injection is also used alone to treat NSCLC as ongoing treatment in people who have already received certain chemotherapy medications and whose cancer has not worsened and in people who could not be treated successfully with other chemotherapy medications.

Alimta injection is also in combination with another chemotherapy medication as a first treatment for malignant pleural mesothelioma (a type of cancer that affects the inside lining of the chest cavity) in people who cannot be treated with surgery.

Pemetrexed belongs to a class of medications called antifolate antineoplastic agents. Alimta works by blocking the action of a certain substance in the body that may help cancer cells multiply.

Alimta side effects

Get emergency medical help if you have signs of an allergic reaction to Alimta: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Alimta may cause serious side effects. Call your doctor at once if you have:

• kidney problems--swelling, urinating less, feeling tired or short of breath;

• lung problems-- new or worsening cough, trouble breathing;

• low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;

• swelling, redness, or blistering of skin that was treated with radiation in the past; or

• new signs of infection (fever, weakness, cough, diarrhea, burning when you urinate).

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common Alimta side effects may include:

• tiredness, feeling short of breath, cough;

• swelling or sores in mouth, sore throat;

• fever, rash;

• low blood cell count;

• loss of appetite; or

• nausea, vomiting, diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Related/similar drugs

Warnings

Do not use Alimta if you are pregnant. It could harm the unborn baby.

Before you receive Alimta, tell your doctor you have kidney or liver disease, bone marrow suppression, a weak immune system, or excess fluid in the space around your lung, liver, or other internal organs.

Tell your doctor about all other medicines you use, especially an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

To prevent certain side effects of Alimta, you will need to take folic acid supplements and receive vitamin B12 injections (starting 7 days before your first dose of Alimta). Take only the amount of folic acid that your doctor has prescribed.

Alimta can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection.

Call your doctor at once if you have a serious side effect while using Alimta such as fever, flu symptoms, sore throat, mouth sores, pale skin, easy bruising or bleeding, ongoing vomiting or diarrhea, increased thirst, urinating less than usual, pounding heartbeats, and swelling or rapid weight gain.

Before taking this medicine

You should not be treated with Alimta if you are allergic to pemetrexed.

To make sure Alimta is safe for you, tell your doctor if you have ever had:

• bone marrow suppression;

• radiation treatment; or

• kidney disease.

Pemetrexed can harm an unborn baby if the mother or the father is using Alimta.

• If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using Alimta and for at least 6 months after your last dose. Tell your doctor if you become pregnant.

• If you are a man, use birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.

• Tell your doctor right away if a pregnancy occurs.

It may be harder for you to get a woman pregnant while you are using Alimta. You should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Do not breastfeed while using Alimta, and for at least 1 week after your last dose.

How is Alimta given?

Alimta is given as an infusion into a vein for 10 minutes. A healthcare provider will give you this injection.

Alimta is usually given once every 3 weeks. Your doctor will determine how long you should use Alimta.

You will be given other medications such as folic acid, vitamin B12, and a steroid to help prevent serious side effects. Keep taking these medicines for as long as your doctor has prescribed.

You may need frequent medical tests and your cancer treatments may be delayed based on the results.

Your blood pressure may get too low or you may get dehydrated during prolonged illness. Call your doctor if you are sick with vomiting or diarrhea.

Dosing Information

Usual Adult Dose of Alimta for Non-Small Cell Lung Cancer:

500 mg/m2 IV on Day 1 of each 21-day cycle

Comments:
-Limitations of Use: This drug is not indicated for the treatment of patients with squamous cell non-small cell lung cancer (NSCLC)
-With pembrolizumab and platinum chemotherapy for the initial treatment of metastatic nonsquamous NSCLC: This drug should be administered after pembrolizumab and before carboplatin or cisplatin on Day 1 of each 21-day cycle for 4 cycles; after completion of platinum-based therapy, this drug (with or without pembrolizumab) should be administered until disease progression or unacceptable toxicity.
---The manufacturer product information for pembrolizumab and carboplatin or cisplatin should be consulted.
-With cisplatin for initial treatment of locally advanced or metastatic nonsquamous NSCLC: This drug should be administered before cisplatin on Day 1 of each 21-day cycle for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
-As a single agent for maintenance therapy of nonsquamous NSCLC: This drug should be administered until disease progression or unacceptable toxicity after 4 cycles of platinum-based first-line chemotherapy.
-As a single agent for treatment of recurrent nonsquamous NSCLC: This drug should be administered until disease progression or unacceptable toxicity.

Uses:
-In combination with pembrolizumab and platinum chemotherapy, for the initial treatment of patients with metastatic nonsquamous NSCLC, with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma receptor tyrosine kinase (ALK) genomic tumor aberrations
-In combination with cisplatin, for the initial treatment of patients with locally advanced or metastatic, nonsquamous NSCLC
-As a single agent, for the maintenance treatment of patients with locally advanced or metastatic nonsquamous NSCLC whose disease has not progressed after 4 cycles of platinum-based first-line chemotherapy
-As a single agent, for the treatment of patients with recurrent, metastatic nonsquamous NSCLC after prior chemotherapy

Usual Adult Dose of Alimta for Malignant Pleural Mesothelioma:

500 mg/m2 IV on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity

Use: In combination with cisplatin, for the initial treatment of patients with malignant pleural mesothelioma whose disease is unresectable or who are otherwise not candidates for curative surgery

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Alimta injection.

What happens if I overdose?

In a medical setting an overdose would be treated quickly.

What should I avoid while receiving Alimta?

If you have kidney problems, avoid taking ibuprofen (Advil, Motrin) 2 days before, during, and 2 days after you are treated with Alimta.

What other drugs will affect Alimta?

Alimta can harm your kidneys, especially if you also use certain medicines for pain or arthritis (including ibuprofen, Advil, Motrin, and Aleve).

Other drugs may interact with pemetrexed, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Ingredients

Active ingredient: pemetrexed.
Inactive ingredients: mannitol, hydrochloric acid and/or sodium hydroxide may have been added to adjust pH.

Manufacturer

Marketed By: Lilly USA, LLC, Indianapolis, IN 46285, USA.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Alimta only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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