Antineoplastic Agents: Cytotoxic Agents: Alkylating Agents
IALIM1 “Alimta powder for concentration for infusion” 500 mg/vial
IALIM2 “Alimta powder for concentration for infusion” 100 mg/vial
適應症：1.與cisplatin併用於治療惡性肋膜間質細胞瘤；2.單一藥物是治療局部晚期或轉移性非小細胞肺癌（顯著鱗狀細胞組織型除外）之第二線治療用藥；3.併用cisplatin是治療局部晚期或轉移性非小細胞肺癌（顯著鱗狀細胞組織型除外）之第一線化療用藥。
Usual dose:
Non-small cell lung cancer, Locally advanced or metastatic, after prior chemotherapy: 500 mg/m2 IV over 10 min on day 1 of each 21-day cycle.
Malignant mesothelioma of pleura, In combination with cisplatin in p’ts who are not candidates for surgical resection: 500 mg/ m2 IV over 10 min on day 1, followed 30 min later by cisplatin 75 mg/m2 infused IV over 2 h; repeat cycle q21d.
Dose adjustment:
Neurotoxicity: p’ts experiencing any grade 2 NCI common toxicity should have the dose of cisplatin reduced by 50%; any grade 3/4 neurotoxicity warrants discontinuation of therapy.
Neutropenia: p’ts experiencing a nadir ANC of < 500/mm3 should receive 75% of the previous dose for both pemetrexed and cisplatin.
Dose adjustment:
Renal impairment: no dosage adjustments are necessary for p’ts with a creatinine clearance ≧45 ml/min.
Thrombocytopenia: for a nadir platelet count of < 50,000/mm3, regardless of ANC nadir, a 50% dose reduction is recommended for both pemetrexed and cisplatin.
Adverse effect:
Common: peeling of skin, rash, constipation, diarrhea, loss of appetite, nausea, pharyngitis, stomatitis, vomiting.
Serious: shivering, anemia, leukopenia, neutropenia, thrombocytopenia, fever, infectious disease.
健保使用規範：(95/3/1、95/7/1、97/11/1、98/9/1、103/4/1、103/9/1)
1.限用於
(1)與cisplatin併用於惡性肋膜間質細胞瘤。
(2)以含鉑之化學療法治療或70歲(含)以上接受過第一線化學治療，但仍失敗之局部晚期或轉移性非小細胞肺癌病患（顯著鱗狀細胞組織型除外）之單一藥物治療。(95/7/1、97/11/1、98/9/1)
(3)與含鉑類之化學療法併用，作為治療局部晚期或轉移性非小細胞肺癌（顯著鱗狀細胞組織型除外）之第一線化療用藥，且限用於ECOG performance status 為0~1之病患。(98/9/1)
2.需經事前審查核准後，初次申請以6個療程為限，續用應每4個療程評估一次，如有發現病情惡化，應即停止使用。（103/4/1、103/9/1）