Adpem (pemetrexed) is a chemotherapy agent used to treat non-squamous, non-small cell lung cancer (NSCLC) or malignant mesothelioma, extending patient life expectancy. It can be used on its own, but usually is administered with or following treatment with a platinum-based chemotherapy agent, such as cisplatin.

Note that this product is a fluid for IV infusion. Ideal storage temperature is 25 degrees Celsius or 77 degrees Fahrenheit. Fluid, vials, and materials that come into contact with the fluid should be handled with care and disposed of properly.

Adpem is manufactured by Adley Laboratories in India. Its most widely-known brand name is Alimta, but is also sold as Pleumet and Pemecad. Adpem is the same product---the same medication in the same quantity---as its counterparts, but is quite considerably less costly, particularly for US patients. A single 100 mg vial of Alimta can cost upwards of 700 USD, with total treatment costing upwards of 20,000 USD. In comparison, a single 100 mg vial of Adpem costs under 100 USD.

Treatment Overview

The following information summarizes basic dosage and administration information so patients know what to expect, but treatment should not be attempted without doctor involvement. Doctor instructions may deviate from the following to some degree; doctor instructions should always be followed closely.

The majority of patients use Adpem to treat non-squamous NSCLC. The medication is typically used in one of three scenarios:

• Initial treatment in combination with cisplatin or another platinum-based chemotherapy.
• Maintenance therapy in patients who have already had four cycles of platinum-based chemotherapy.
• Treatment of recurring metastatic non-squamous NSCLC after prior chemotherapy.

Less commonly patients use Adpem to treat malignant mesothelioma. There is typically only one scenario in which the medication is used:

• In combination with cisplatin to treat patients who are not candidates for curative surgery.

Regardless of what it's being used for administration is similar. Adpem is given on the first day of a 21-day cycle, administered intravenously over 10 minutes. If cisplatin is also being administered, Adpem should be administered first.

The medication is usually administered for six cycles or until the disease progresses. Dosage can be quite variable and should be determined by a doctor; patient health and response will be taken into consideration.

Sometimes Adpem will prove too toxic for an individual, which may call for modified dosage or the end of treatment. Most patients, however, find the medication helps fight cancer, and it can extend life considerably.

Other medications, vitamins, and supplements can help alleviate side effects that will most likely be encountered with Adpem. In fact some are nearly always administered along with Adpem:

• Folic acid and vitamin B12 may be given one week prior to the start of treatment, throughout treatment, and for 21 days after the end of treatment.
• Steroids may be given the day prior, the day of, and the day following treatment.

Patients should be aware that many medications can produce unpleasant interactions with Adpem---some even potentially fatal. Always check with a doctor before taking any other medication, including over-the-counter NSAIDs and supplements.

Don't be afraid to contact your doctor with any questions or concerns, no matter how trivial they may seem.

Adverse Reactions

As a chemotherapy agent this is a very potent medication which will produce side effects, though they're not as severe as those experienced with many other chemotherapies. Most commonly reported are tiredness, nausea, and loss of appetite. Side effects are more complicated when cisplatin is also being taken.

About 10 to 30 percent of patients experience:

• Vomiting
• Diarrhea
• Constipation
• Pharyngitis
• Rash
• Anemia
• Stomatitis
• Low blood cell count

More rare, but more serious, symptoms include:

• Fever of 100.4 F or 38 C or higher
• Extreme fatigue
• Blood in urine or stools
• Unusual bleeding or bruising
• Infection
• Dehydration
• Depression

Self-care is important during treatment with Adpem, or any chemotherapy agent. Cancer is a distressing illness and even without medication patients may find themselves with symptoms of depression and fatigue.

Be sure to stay hydrated---hydration is important for the body and the mind to function correctly.

Rest is also important. The body heals best when sleeping, and being fully-rested will help improve mood and mental function.

Avoid activities that can cause injury; this ranges from using electric razors and soft toothbrushes to avoiding contact sports or other potentially dangerous activities.

Both men and women should avoid conceiving a child while taking Adpem. Women who are pregnant or breastfeeding should be aware that this medication can cause fetal harm or death. Both genders may find fertility is impaired following treatment, and it's not known if this is reversible.