PEMETREXED DISODIUM

AbsorptionThe pharmacokinetics of pemetrexed for injection when pemetrexed was administered as a single agent in doses ranging from 0.2 to 838 mg/m 2 infused over a 10-minute period have been evaluated in 426 cancer patients with a variety of solid tumors. Pemetrexed total systemic exposure (AUC) and maximum plasma concentration (C max ) increased proportionally with increase of dose. The pharmacokinetics of pemetrexed did not change over multiple treatment cycles.

DistributionPemetrexed has a...

14.1 Non-Squamous NSCLC Initial Treatment in Combination with Pembrolizumab and Platinum The efficacy of pemetrexed for injection in combination with pembrolizumab and platinum chemotherapy was investigated in Study KEYNOTE-189 (NCT02578680), a randomized, multicenter, double-blind, active-controlled trial conducted in patients with metastatic non-squamous NSCLC, regardless of PD-L1 tumor expression status, who had not previously received systemic therapy for metastatic disease and in whom there were no EGFR or ALK genomic tumor aberrations. Patients with autoimmune disease that required syste...

The following adverse reactions are discussed in greater detail in other sections of the labeling:

• Myelosuppression [see Warnings and Precautions ( 5.1 ) ]
• Renal failure [see Warnings and Precautions ( 5.2 ) ]
• Bullous and exfoliative skin toxicity [see Warning and Precautions ( 5.3 )]
• Interstitial pneumonitis [see Warnings and Precautions ( 5.4 ) ]
• Radiation recall [see Warnings and Precautions ( 5.5 ) ]
• The most common adverse reactions (incidence ≥20%) of pemetrexed for injection, ...

Pemetrexed for injection is contraindicated in patients with a history of severe hypersensitivity reaction to pemetrexed [see Adverse Reactions ( 6.1 ) ]. History of severe hypersensitivity reaction to pemetrexed. (4)

• Myelosuppression: Can cause severe bone marrow suppression resulting in cytopenia and an increased risk of infection. Do not administer pemetrexed for injection when the absolute neutrophil count is less than 1500 cells/mm 3 and platelets are less than 100,000 cells/mm 3 .Initiate supplementation with oral folic acid and intramuscular vitamin B 12 to reduce the severity of hematologic and gastrointestinal toxicity of pemetrexed for injection ( 2.4 , 5.1 )
• Renal Failure:Can cause severe, and ...

7 DRUG INTERACTIONS Effects of Ibuprofen on Pemetrexed Ibuprofen increases exposure (AUC) of pemetrexed [see Clinical Pharmacology ( 12.3 )]. In patients with creatinine clearance between 45 mL/min and 79 mL/min: Avoid administration of ibuprofen for 2 days before, the day of, and 2 days following administration of pemetrexed for injection [see Dosage and Administration ( 2.5) ]. Monitor patients ...