Monograph

L01BA04 - Pemetrexed

Propably not porphyrinogenic

Rationale

Highly watersoluble substance, probably no CYP-affinity. Eliminated mainly in unchanged form in urine. No observations of interactions with CYP-metabolism of other drugs. Not listed as CYP-inducer or inhibitor. Side effects as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Chemical description

Folic acid analogue, administered as disodiumheptahydrate.

Therapeutic characteristics

Used to treat non-resectable, chemotherapynaive malignant pleuramesotheliom and advanced lung cancer. Premedication with dexamethasone needed. Given as intravenous infusion. Common adverse reactions of permetrexed that can be confused with an acute porphyric attack are nausea, vomiting or obstipation.

Metabolism and pharmacokinetics

Mainly elimiated unchanged via renal excretion where 70 - 90 % of the dose is recovered as un-metabolized substance within the first 24 hours. No data supporting CYP-affinity. Interactions with CYP-metabolized drugs are not observed. Not listed as CYP-inducer or inhibitor.

IPNet drug reports

No.

Similar drugs

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References

#	Citation details	PMID
*	Scientific articles
1.	Rendic, S. Summary of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.	11996015
*	Drug reference publications
2.	Sweetman SC, editor. Martindale: The complete drug reference. Pemetrexed. Pharmaceutical Press 2009.
*	Other sources
3.	Swedish National Formulary. FASS. Alimta. www.fass.se (product leaflet).

Citation details

PMID

Scientific articles

Rendic, S. Summary of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.

11996015

Drug reference publications

Sweetman SC, editor. Martindale: The complete drug reference. Pemetrexed. Pharmaceutical Press 2009.

Other sources

Swedish National Formulary. FASS. Alimta. www.fass.se (product leaflet).

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