Pemetrexed Dosage

Dosage forms:  INJ

Nonsquamous non-small cell lung CA

[locally advanced dz, initial tx]

Dose: 500 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: use w/ cisplatin; give up to 6 cycles; initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

[locally advanced dz, maintenance tx]

Dose: 500 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Start: after 4 cycles of platinum-based first-line tx; Info: initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

[metastatic dz, initial tx]

Dose: 500 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: use w/ cisplatin and give up to 6 cycles, or use w/ platinum and pembrolizumab for pts w/ no EGFR or ALK genomic tumor aberrations and give x4 cycles; initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

[metastatic dz, maintenance tx]

Dose: 500 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Start: after 4 cycles of platinum-based first-line tx; Info: initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

[metastatic, recurrent dz]

Dose: 500 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

Malignant pleural mesothelioma

[500 mg/m^2/dose IV x1 on day 1 of 21-day cycle]

Info: for pts w/ unresectable dz or who are not candidates for curative surgery; use w/ cisplatin; initiate vitamin supplementation w/ IM vitamin B12 and PO folic acid 1wk before 1st dose, cont. during tx and x3wk after last dose

Renal dosing

[see below]

CrCl >45: no adjustment; CrCl <45: avoid use

HD/PD: not defined

Hepatic dosing

[not defined]