Pemetrexed

Early side effects

• Nausea, vomiting or appetite loss may be experienced
• Diarrhea may occur
• Tiredness or weakness may be felt for a few days after treatment

Delayed side effects

• A drop in the blood counts may occur several days after treatment
• Mouth ulcers may develop
• Skin rash or itch may occur between treatment, but is usually mild

Please seek medical attention if any of the following occurs:

• Fever of 38°C or higher
• Unusual bleeding, bruising or black tarry stools
• Diarrhea lasting longer than 24 hours or more than 4 episodes/day
• Soreness in the mouth for more than 3 days
• Severe skin rashes that are painful or blistering
• Persistent shortness of breath or dry cough

• Take oral folic acid 400mcg to 800mcg once daily, starting 1 week before Pemetrexed, and continue throughout the treatment, and for 21 days after the last treatment.
• Receive Vitamin B12 1mg intramuscular injection 1 week prior to Pemetrexed, and then for every 3 cycles thereafter. This is to lower the chance of side effects occurring.

• Avoid taking a painkiller medication called Ibuprofen for 2 days before, on the day of, and 2 days after Pemetrexed treatment.

• ​Take oral dexamethasone tablets (4mg) twice daily for 3 days, starting 1 day after Pemetrexed treatment. This helps to prevent skin rash due to Pemetrexed.