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Pemetrexed and carboplatin

Find out what pemetrexed and carboplatin is, how you have it and other important information about having pemetrexed and carboplatin.

Pemetrexed and carboplatin is a chemotherapy drug combination. Pemetrexed is also known by its brand name, Alimta.

This chemotherapy combination is a treatment for:

  • non small cell lung cancer that has come back or spread to another part of the body (advanced NSCLC)
  • mesothelioma that started in the layers of tissue that cover the lung (pleural mesothelioma)

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have it

Pemetrexed and carboplatin drugs are liquids. You have them as a drip into your bloodstream (intravenously). 

Drugs into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

You usually have pemetrexed and carboplatin as cycles of treatment. Each cycle of treatment lasts 21 days (3 weeks). 

You might need to go to your clinic 2 weeks after you have each treatment for a check up. Depending on your needs, you may have 4 to 6 cycles of treatment, taking 3 to 6 months in total. 

You have each treatment cycle in the following way: 

Day 1
  • You have pemetrexed as a drip into your bloodstream over 10 minutes
  • You have carboplatin as a drip into your bloodstream over 60 minutes
Day 2 to 21
  • You have no treatment

Then your next treatment cycle starts.

To help reduce the side effects

To help reduce the side effects this treatment may cause, you have:

  • folic acid tablets – starting 5 days before treatment and for 3 weeks afterwards
  • vitamin B12 injections – 1 injection in the week before treatment and then once, every 9 weeks

You may also have a steroid tablet to help with the side effects, starting on the day before your chemotherapy. You take the tablets twice a day, for 3 or 5 days (with breakfast and lunch). 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Ibuprofen (Neurofen)

You should avoid taking ibuprofen from 5 days before and up until 2 days after pemetrexed. Ibuprofen can make the pemetrexed side effects worse.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. 

Women must use reliable contraception during treatment. Men must use reliable contraception during treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue, but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Having immunisations 

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
23 Oct 2017
  • Electronic Medicines Compendium 
    Accessed October 2014

  • Handbook of Cancer Chemotherapy (8th edition)
    Roland K Keel
    Lippincott, Williams and Wilkins, 2012

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

  • Lung Pathway Group – Pemetrexed & Carboplatin in NonSmall Cell Lung Cancer (NSCLC)

    London Cancer Alliance West and South, November 2016

  • Pemetrexed and Carboplatin 

    St Luke's Cancer Alliance - Chemotherapy Policies and Protocols

    Accessed October 2017

Information and help