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PEMFEXY (pemetrexed)
- EGFR negative, ALK negative, non-small cell lung cancer
- malignant pleural mesothelioma
- nonsquamous non-small cell lung cancer
25 mg/mL intravenous solution
- Infuse 500 mg/m2 over 10 minute(s) by intravenous route on day 1 of a21-day treatment cycle
Default screening record
- Infuse 500 mg/m2 over 10 minute(s) by intravenous route on day 1 of a21-day treatment cycle
- Infuse 375 mg/m2 over 10 minute(s) by intravenous route on day 1 of a21-day treatment cycle
- Infuse 250 mg/m2 over 10 minute(s) by intravenous route on day 1 of a21-day treatment cycle
- Infuse 125 mg/m2 over 10 minute(s) by intravenous route on day 1 of a21-day treatment cycle
- Infuse 281.25 mg/m2 over 10 minute(s) by intravenous route on day 1 of a 21-day treatment cycle
- adenovirus vac live type-4 & 7
- adenovirus vaccine live type-4
- adenovirus vaccine live type-7
- BCG vaccine, live (PF)
- flu vac,qval 2013-14 (2-49yrs)
- Flumist 2013-2014
- M-m-r Ii (pf)
- measles,mumps&rubella vacc(PF)
- measles,mumps,rub,varicel(PF)
- natalizumab
- Proquad (pf)
- Rotateq Vaccine
- rotavirus vaccine live, penta
- typhoid vaccine
- Tysabri
- varicella virus vacc live (PF)
- Varivax (pf)
- Vivotif Berna Vaccine
- yellow fever vaccine live (PF)
- Yf-vax (pf)
- Zostavax (pf)
- zoster vaccine live (PF)
Contraindicated
- Added Strength Headache Relief
- Added Strength Pain Reliever
- Adult Low Dose Aspirin
- Advil
- Advil Allergy Sinus
- Advil Allergy-congestion Rlf
- Advil Cold & Sinus
- Advil Congestion Relief
- Advil Liqui-gel
- Advil Migraine
- Advil Pm
- Advil Pm Liqui-gels
- Aggrenox
- Aleve
- Aleve Cold & Sinus
- Aleve Sinus & Headache
- Aleve-d Sinus & Cold
- Aleve-d Sinus & Headache
- Alka-seltzer
- Alka-seltzer Extra Strength
- Alka-seltzer Original
- Alka-seltzer Plus C/c(pe,dm)
- Alka-seltzer Plus Cold (pe)
- Alka-seltzer Plus Day-night
- Alka-seltzer Plus Night
- Alka-seltzer Pm
- All Day Pain Relief
- All Day Pain Relief Sinus & Co
- All Day Relief
- Anacin
- Anacin Maximum Strength
- Analgesic
- Anaprox
- Anaprox Ds
- Ansaid
- Antacid & Pain Relief
- Arthri-flex
- Arthrotec 50
- ASA-acetaminophen-caff-buffers
- ASA-acetaminophen-salicyl-caff
- Ascomp With Codeine
- Aspir-81
- Aspir-low
- Aspir-trin
- aspirin
- Aspirin Childrens
- Aspirin Low Dose
- Aspirin Low-strength
- aspirin, buffered
- aspirin-acetaminophen-caffeine
- aspirin-caffeine
- aspirin-calcium carbonate
- aspirin-diphenhydramine
- aspirin-diphenhydramine citrat
- aspirin-sod bicarb-citric acid
- Back & Body Pain Reliever
- Bayer Advanced
- Bayer Aspirin
- Bayer Aspirin (with Caffeine)
- Bayer Back & Body
- Bayer Chewable Aspirin
- Bayer Childrens Aspirin
- Bayer Plus Extra Strength
- Bayer Pm
- Bc
- Bc Arthritis
- Buffered Aspirin
- Bufferin
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-aspirin-caffeine
- Caldolor
- Cambia
- carisoprodol-ASA-codeine
- carisoprodol-aspirin
- Cataflam
- Celebrex
- celecoxib
- Child Aspirin
- Child Ibuprofen
- Children's Advil
- Children's Aspirin
- Children's Ibu-drops
- Children's Ibuprofen
- Children's Medi-profen
- Children's Motrin
- Children's Profen Ib
- chlorphen-phenyleph-DM-aspirin
- chlorphen-phenyleph-ibuprofen
- chlorphen-pseudoeph-ibuprofen
- chlorphenir-phenylephrn-aspirn
- clozapine
- Clozaril
- codeine-butalbital-ASA-caff
- Cold & Sinus Pain Relief
- Cold Relief
- Cold Relief Plus
- Cold-sinus Relief
- Daypro
- deferiprone
- diclofenac epolamine
- diclofenac potassium
- diclofenac sodium
- diclofenac submicronized
- diclofenac-misoprostol
- diflunisal
- dihydrocodeine-aspirin-caff
- dipyridamole-aspirin
- doxylamine-phenylep-DM-aspirin
- Duexis
- E.c. Prin
- Ec-naprosyn
- Ecotrin
- Ecotrin Low Strength
- Efferves Pain Relief Antacid
- Effervescent Antacid
- Effervescent Pain Relief
- Effervescent Pain Reliever
- Endodan
- Enteric Coated Aspirin
- etodolac
- Excedrin Extra Strength
- Excedrin Migraine
- Extra Strength Bayer
- Fazaclo
- Feldene
- fenoprofen
- Ferriprox
- Fiorinal
- Fiorinal-codeine #3
- Flanax
- Flector
- flurbiprofen
- gluc-msm-coll2-hyal-antiarthr3
- glucos-msm-C-Mn-ginger-willow
- glucos-msm-C-Mn-herb#21
- glucos-msm-collagen-C-Mn-hrb21
- Glucosamine-msm Complex
- Goody's Extra Strength
- Goody's Migraine Relief
- Headache Formula
- Headache Formula Added Str
- Headache Relief
- hydrocodone-ibuprofen
- I-prin
- Ibu-drops
- Ibudone
- ibuprofen
- Ibuprofen Cold
- Ibuprofen Cold-sinus(with Pse)
- Ibuprofen Ib
- Ibuprofen Jr Strength
- ibuprofen lysine (PF)
- Ibuprofen Pm
- ibuprofen-diphenhydramine
- ibuprofen-diphenhydramine HCl
- ibuprofen-famotidine
- ibuprofen-oxycodone
- ibuprofen-phenylephrine HCl
- Indocin
- indomethacin
- indomethacin sodium
- Infant's Ibuprofen
- Infant's Medi-profen
- Infant's Motrin
- Infants Ibu-drops
- Infants Profenib
- ketoprofen
- ketorolac
- Levacet
- Lite Coat Aspirin
- Lo-dose Aspirin
- Medi-profen
- Medi-seltzer
- Mediproxen
- mefenamic acid
- meloxicam
- Midol (naproxen)
- Migraine Formula
- Migraine Pain Reliever
- Migraine Relief
- Mobic
- Motrin Ib
- Motrin Pm
- Msm Glucosamine Complex
- nabumetone
- Nalfon
- Naprelan Cr
- Naprosyn
- naproxen
- naproxen sodium
- naproxen-esomeprazole
- naproxen-pseudoephedrine
- Neoprofen (ibuprofen Lysn)(pf)
- Orphenadrine Compound Forte
- Orphenadrine Compound-ds
- orphenadrine-ASA-caffeine
- oxaprozin
- oxycodone-aspirin
- Pain Relief
- Pain Relief Extra Strength
- Pain Reliever
- Pain Reliever Extra Strength
- Pain Reliever Plus
- Pain-off
- Pamprin Max
- PE-DM-ASA/doxyla-PE-DM-ASA
- Pennsaid
- Percodan
- piroxicam
- Ponstel
- Provil
- pseudoephedrine-ibuprofen
- Reprexain
- Sinus & Cold-d
- Solaraze
- Sprix
- St Joseph Aspirin
- St. Joseph Aspirin
- sulindac
- Super Pain Relief
- Synalgos-dc
- tolmetin
- Tri-buffered Aspirin
- Vanquish
- Versacloz
- Vicoprofen
- Vimovo
- Voltaren-xr
- Wal-profen
- Wal-profen Cold-sinus
- Wal-proxen
- Women's Aspirin With Calcium
- Zipsor
- Zorvolex
Severe
Moderate
- None
- Chronic kidney disease stage 3B (moderate) GFR 30-44
- Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
- Chronic kidney disease stage 5 (failure) GFr<15 ml/min
- Lactation
Contraindicated
- Anemia
- Interstitial pneumonitis
- Kidney disease with likely reduction in GFR
- Neutropenic disorder
- Pregnancy
- Thrombocytopenic disorder
Severe
Moderate
- None
PEMFEXY (pemetrexed)
- EGFR negative, ALK negative, non-small cell lung cancer
- malignant pleural mesothelioma
- nonsquamous non-small cell lung cancer
- Anemia
- Edema
- Leukopenia
- Neutropenic disorder
- Thrombocytopenic disorder
- Thromboembolic disorder
- Abnormal desquamation
- Alopecia
- Anorexia
- Constipation
- Diarrhea
- Dyspnea
- Fatigue
- Headache disorder
- Nausea
- Pharyngitis
- Skin rash
- Stomatitis
- Vomiting
More Frequent
Severe
Less Severe
- Abnormal hepatic function tests
- Infection
- Acute abdominal pain
- Chest pain
- Conjunctivitis
- Dehydration
- Dysgeusia
- Dyspepsia
- Eye tearing
- Fever
- Peripheral sensory neuropathy
- Pruritus of skin
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Autoimmune hemolytic anemia
- Bullous dermatitis
- Cardiac arrhythmia
- Colitis
- Erythema multiforme
- Esophagitis
- Exfoliative dermatitis
- Gastrointestinal obstruction
- Hypersensitivity drug reaction
- Hypertension
- Interstitial pneumonitis
- Pancreatitis
- Pulmonary thromboembolism
- Radiation recall syndrome
- Renal failure
- Stevens-johnson syndrome
- Supraventricular arrhythmias
- Toxic epidermal necrolysis
- Ventricular tachycardia
Less Severe
- Depression
- Peripheral motor neuropathy
- Urticaria
Contraindicated
None
Severe Precaution
Pemetrexed
No tumor response demonstrated for recurrent solid tumors in pediatric trials.
- 1 Day – 18 Years
- No tumor response demonstrated for recurrent solid tumors in pediatric trials.
Management or Monitoring Precaution
None
Pemetrexed
- Severity Level:
D
- Additional Notes: Based on drug pharmacology developmental toxicity is possible.
Contraindicated
Pemetrexed
Mfr does not recommend; avoid bf 1 week after last dose
| General | Excretion Potential | Effect on Infant | Notes |
| Drug should not be given to breast feeding mothers | Unknown | Not known; no or inclusive data | Mfr does not recommend; avoid bf 1 week after last dose |
Precaution Exists
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Pemetrexed
General-elderly are more susceptible to anemia, neutropenia, thrombocytopenia, fatigue, and hypertension. Renal-Follow renal function closely. Do not administer with CrCL < 45mL/minute as there is no dose recommendation.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | N | Y | N | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- None
| EGFR negative, ALK negative, non-small cell lung cancer | |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| Malignant mesothelioma of pleura | |
| C45.0 | Mesothelioma of pleura |
| Nonsquamous non-small cell lung cancer | |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C39.9 | Malignant neoplasm of lower respiratory tract, part unspecified |
| 0-9 | A-Z |
|---|---|
| C34 | Malignant neoplasm of bronchus and lung |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C39.9 | Malignant neoplasm of lower respiratory tract, part unspecified |
| C45.0 | Mesothelioma of pleura |
Formulary Reference Tool