Pemetrexed is used in adults to treat a certain type of lung cancer that has returned or has spread to other parts of the body (metastatic).

Pemetrexed is also used to treat a type of cancer that affects the lining of the lungs in adults who cannot have surgery.

Pemetrexed may be used in combination with other cancer medicines.

Pemetrexed may also be used for purposes not listed in this medication guide.

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

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

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

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.

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

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 pemetrexed.

• If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine 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 this medicine. You should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

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

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

In a medical setting an overdose would be treated quickly.

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

Get emergency medical help if you have signs of an allergic reaction (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).

Pemetrexed 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 side effects of pemetrexed 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.

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

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