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Generic Name: pemetrexed (pem e TREX ed)
Brand Names: Alimta
Alimta is used to treat non-small cell lung cancer and mesothelioma, a form of lung cancer associated with exposure to asbestos. Learn about side effects, interactions and indications.
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Drug Information:
Alimta (pemetrexed) is a cancer medicine that interferes with the growth and spread of cancer cells in the body. Alimta is used to treat non-small cell lung cancer, or malignant pleural mesothelioma (a form of lung cancer associated with exposure to asbestos). Alimta is sometimes used in combination with other cancer medicines. Do not use Alimta if you are pregnant. It could harm the unborn baby. Before you receive Alimta, tell your doctor you have kidney or liver disease, bone marrow suppression, a weak immune system, or excess fluid in the space around your lung, liver, or other internal organs. Learn more

Alimta Side Effects

Alimta Side Effects

Note: This document contains side effect information about pemetrexed. Some of the dosage forms listed on this page may not apply to the brand name Alimta.

In Summary

Common side effects of Alimta include: anemia, chest pain, constipation, depression, desquamation, diarrhea, dyspnea, fatigue, fever, increased serum creatinine, infection without neutropenia, leukopenia, nausea, neuropathy, neutropenia, pharyngitis, skin rash, stomatitis, thrombocytopenia, vomiting, anorexia, and mood changes. Other side effects include: embolism, thrombosis, dehydration, dysphagia, esophagitis, and odynophagia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pemetrexed: intravenous powder for solution

Along with its needed effects, pemetrexed (the active ingredient contained in Alimta) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking pemetrexed:

More common

  • Black, tarry stools
  • bleeding gums
  • chest pain
  • chills
  • cough
  • fever
  • loss of coordination
  • lower back or side pain
  • painful or difficult urination
  • pains in the chest, groin, or legs, especially calves of the legs
  • pale skin
  • pinpoint red spots on the skin
  • severe headaches of sudden onset
  • sore throat
  • sudden onset of slurred speech
  • sudden vision changes
  • swollen glands
  • troubled breathing
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less common

  • Bloody urine or bloody stools
  • decreased frequency or amount of urine
  • fainting or loss of consciousness
  • fast or irregular breathing
  • increased blood pressure
  • increased thirst
  • itching, skin rash
  • loss of appetite
  • nausea
  • swelling of the eyes, eyelids, face, fingers, or lower legs
  • tightness in the chest
  • vomiting
  • weight gain

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • joint or muscle pain
  • pain and redness of the skin in the area of earlier radiation treatment
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • stomach cramps, tenderness, or pain
  • watery diarrhea

Some side effects of pemetrexed may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  • confusion
  • cough
  • diarrhea
  • difficulty having a bowel movement
  • difficulty with moving
  • difficulty with swallowing
  • discouragement
  • dizziness
  • dry mouth
  • feeling sad or empty
  • hair loss
  • headache
  • heartburn
  • hoarseness
  • increase in heart rate
  • irritability
  • lightheadedness
  • loss of interest or pleasure
  • mood changes
  • muscle ache, cramp, or stiffness
  • pain or burning in the throat
  • pain produced by swallowing
  • rapid breathing
  • sensation of pins and needles
  • stabbing pain
  • stuffy or runny nose
  • sunken eyes
  • swelling or inflammation of the mouth
  • swollen joints
  • thinning of the hair
  • thirst
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • weight loss
  • wrinkled skin

For Healthcare Professionals

Applies to pemetrexed: intravenous powder for injection


Uncommon (0.1% to 1%): Myocardial infarction, angina pectoris, cerebrovascular accident, transient ischemic attack, peripheral ischemia (sometimes leading to extremity necrosis), supraventricular arrhythmia, ventricular tachycardia, syncope, arrhythmia


Very common (10% or more): Rash/desquamation (up to 16%), alopecia (up to 11%)

Common (1% to 10%): Pruritus, urticaria

Rare (less than 0.1%): Radiation recall, bullous conditions (including Stevens-Johnson syndrome and toxic epidermal necrolysis) which in some cases were fatal


Very common (10% or more): Nausea (up to 82%), vomiting (up to 57%), stomatitis/pharyngitis (up to 23%), anorexia (up to 20%), diarrhea (up to 17%), constipation (up to 12%)

Common (1% to 10%): Dyspepsia/heartburn

Uncommon (0.1% to 1%): Colitis (including intestinal and rectal bleeding, sometimes fatal, intestinal perforation, intestinal necrosis, neutropenic enterocolitis), esophagitis/radiation esophagitis, GI obstruction


Very common (10% or more): Neutropenia (up to 56%), granulocytopenia (up to 56%), leukopenia (up to 53%), hemoglobinemia (up to 26%), platelets decreased (up to 23%), thrombocytopenia (up to 10%)

Common (1% to 10%):

Uncommon (0.1% to 1%): Pancytopenia

Rare (0.01% to 0.1%): Immune mediated hemolytic anemia


Uncommon (0.1% to 1%): Allergic reaction/hypersensitivity

Rare (0.01% to 0.1%): Anaphylactic shock


Common (1% to 10%): SGPT (ALT) elevation, SGOT (AST) elevation


Common (1% to 10%): Sepsis (sometimes fatal), infection


Common (1% to 10%): Dehydration

Uncommon (0.1% to 1%): Edema, increased gamma-glutamyl transpeptidase (GGT)

Nervous system

Very common (10% or more): Sensory neuropathy (up to 10%)

Common (1% to 10%): Taste disturbance

Uncommon (0.1% to 1%): Motor neuropathy


Very common (10% or more): Fatigue (up to 48%), pain

Common (1% to 10%): Fever, chest pain


Uncommon (0.1% to 1%): Depression


Common (1% to 10%): Conjunctivitis


Common (1% to 10%): Renal disorders (including increased serum/blood creatinine, decreased glomerular filtration rate, renal failure, renal/genitourinary- other)

Uncommon (0.1% to 1%): Acute renal failure


Uncommon (0.1% to 1%): Interstitial pneumonitis with respiratory insufficiency (sometimes fatal), radiation pneumonitis, pulmonary embolism

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Alimta