Pemetrexed Disodium for Injection

Effects and efficacy:
Non-small cell lung cancer This product is combined with cisplatin and is suitable for first-line chemotherapy in patients with locally advanced or metastatic non-squamous non-small cell lung cancer. This product alone is suitable for maintenance treatment of patients with locally advanced or metastatic non-squamous non-small cell lung cancer who have not progressed after 4 cycles of platinum-based first-line chemotherapy. This product alone is suitable for the treatment of patients with locally advanced or metastatic non-squamous non-small cell lung cancer who have progressed after receiving first-line chemotherapy. This product is not recommended for use in patients with squamous cell carcinoma as the main histology. Malignant pleural mesothelioma This product is combined with cisplatin for the treatment of malignant pleural mesothelioma that cannot be operated on.
Usage and dosage:
Pemetrexed disodium must be used under the guidance of a qualified physician with experience in the application of anti-tumor chemotherapy. This product can only be used for intravenous infusion. The dosage of drugs produced by each manufacturer may vary. For actual application in life, please consult a professional doctor. This product is used in combination with cisplatin for non-squamous non-small cell lung cancer and malignant pleural mesothelioma. The recommended dose of this product is 500 mg/m2 body surface area (BSA), intravenous infusion over 10 minutes. It is administered on the first day of each 21-day cycle. The recommended dose of cisplatin is 75 mg/m2BSA, intravenous infusion time should be more than 2 hours, and cisplatin should be administered about 30 minutes after the end of pemetrexed administration on the first day of the 21-day cycle. An appropriate hydration regimen should be in place before and/or after cisplatin treatment. This product is used alone for non-squamous non-small cell lung cancer. For patients with non-small cell lung cancer who have previously received chemotherapy, the recommended dose of this product is 500 mg/m2 BSA, intravenous infusion over 10 minutes. It is administered on the first day of each 21-day cycle. Pre-medication vitamin supplementation To reduce toxicity, patients receiving pemetrexed treatment must be instructed to take a low-dose folic acid preparation or a multivitamin containing folic acid orally every day. Oral folic acid must be taken daily for at least 5 of the 7 days before the first dose of pemetrexed and should continue to be taken throughout treatment and for 21 days after the last dose of pemetrexed. Patients must also receive an intramuscular injection of vitamin B12 in the week before the first dose of pemetrexed and once every 3 cycles thereafter. Subsequent vitamin B12 injections can be scheduled on the same day as pemetrexed. In clinical trials, the folic acid dose range tested was 350 to 1000 μg and the vitamin B12 dose was 1000 μg. The most commonly used oral dose of folic acid in clinical trials was 400 μg. Supplemental corticosteroids Rash is more common in patients who do not receive corticosteroid premedication. Premedication with dexamethasone (or similar drugs) can reduce the incidence and severity of skin reactions. In clinical trials, dexamethasone 4 mg was administered orally twice daily one day before, on the day of, and one day after pemetrexed. Dose adjustment starts from the second treatment cycle, and the dose of each cycle should be determined based on the results of blood monitoring: When ANC < 500/mm3 and platelet count > 50000/mm3, both this product and cisplatin are only used at 75% of the original dose. When the platelet count is < 50000/mm3, both drugs are only used at 50% of the original dose. When toxic reactions other than mucositis reach grade 3-4, both drugs are used at 75% of the original dose. Any diarrhea requires hospitalization. If diarrhea reaches grade 3-4, 75% of the original dose is used. If grade 3-4 mucositis occurs, only 75% of the original dose is used. If neurotoxicity occurs, the dose should be reduced by 50%. If the toxicity is severe to grade 3-4, the drug should be discontinued.
Adverse reactions:
Due to the great differences in the conditions of each clinical trial, the adverse reaction rate cannot be directly compared with the adverse reaction rate of other clinical trials, nor can it reflect the adverse reaction rate observed in clinical practice. In clinical trials, the most common adverse reactions (incidence ≥ 20%) when using pemetrexed alone were fatigue, nausea, and loss of appetite. When pemetrexed was used in combination with cisplatin, increased common adverse reactions (incidence ≥ 20%) included vomiting, neutropenia, leukopenia, anemia, stomatitis/pharyngitis, thrombocytopenia, and constipation.
Drug contraindications:
Contraindicated for allergic reactions to this product. Use with caution during pregnancy. Use with caution during lactation.