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  • ALIMTA 500 MG 1 FLC

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    Description

    ALIMTA (Pemetrexed) is a chemotherapy medication used primarily in the treatment of certain types of lung cancer, including non-small cell lung cancer (NSCLC) and mesothelioma. It belongs to the class of drugs known as antimetabolites, which interfere with the growth of cancer cells and slow their spread in the body. ALIMTA is administered via intravenous infusion and is typically used in combination with other chemotherapy drugs or as a monotherapy depending on the type and stage of cancer. Developed by Eli Lilly and Company, ALIMTA has been widely used and is considered a standard treatment for patients with specific types of lung cancer.

    How ALIMTA Works

    Mechanism of Action

    1. Inhibition of Folate-Dependent Enzymes:
      • ALIMTA acts as a multi-targeted antifolate agent that disrupts folate-dependent metabolic processes essential for cell replication. It specifically inhibits three key enzymes: thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase (GARFT). These enzymes are involved in the synthesis of purine and pyrimidine, the building blocks of DNA and RNA.
    2. Disruption of DNA and RNA Synthesis:
      • By inhibiting TS, DHFR, and GARFT, ALIMTA effectively blocks the formation of nucleotides, thereby interfering with DNA and RNA synthesis. This disruption prevents cancer cells from dividing and proliferating, ultimately leading to cell death.
    3. Cytotoxicity to Cancer Cells:
      • ALIMTA exerts cytotoxic effects primarily on rapidly dividing cells, such as cancer cells. The drug’s action disrupts the replication cycle, causing apoptosis (programmed cell death) in malignant cells.
    4. Combination Therapy:
      • ALIMTA is often combined with cisplatin, another chemotherapy agent, to enhance its antitumor activity, particularly in patients with mesothelioma and advanced NSCLC. The combination helps to maximize the destruction of cancer cells by targeting different pathways simultaneously.
    5. Maintenance Therapy:
      • In some cases, ALIMTA is used as maintenance therapy in NSCLC patients who have responded to initial chemotherapy, helping to prolong the period of cancer control.

    Combined Effect:

    The combined inhibition of multiple folate-dependent enzymes makes ALIMTA a potent antimetabolite that disrupts the critical processes of DNA and RNA synthesis in cancer cells, effectively slowing down tumor growth and progression.

    Side Effects

    As with any chemotherapy agent, ALIMTA has a range of side effects that vary from mild to severe, depending on the patient’s overall health, cancer type, and concurrent therapies.

    Common Side Effects

    • Fatigue: A very common side effect that can impact daily activities.
    • Nausea and Vomiting: Often managed with antiemetic medications.
    • Loss of Appetite: Patients may experience reduced appetite, leading to weight loss.
    • Anemia: Lower red blood cell counts, which can cause fatigue and weakness.
    • Low White Blood Cell Count (Neutropenia): Increases the risk of infection.
    • Thrombocytopenia: Reduced platelet counts, which can increase bleeding risk.
    • Mouth Sores (Stomatitis): Painful sores or ulcers in the mouth.
    • Rash: Skin reactions, including rash and itching.
    • Diarrhea: Gastrointestinal discomfort and increased bowel movements.

    Serious Side Effects

    • Renal Toxicity: Potential damage to the kidneys, which may require monitoring of kidney function and hydration therapy.
    • Lung Toxicity: Rare cases of interstitial pneumonitis, which can lead to respiratory distress.
    • Liver Toxicity: Elevated liver enzymes, indicating potential liver damage.
    • Severe Neutropenia and Infections: Critically low white blood cell counts that increase the risk of serious infections.
    • Severe Anemia: May require blood transfusions in severe cases.
    • Hypersensitivity Reactions: Rare but possible severe allergic reactions requiring immediate medical attention.

    Indications

    ALIMTA is approved for use in specific cancer types and scenarios where it has shown significant effectiveness, either alone or in combination with other agents.

    Approved Indications

    • Malignant Pleural Mesothelioma: ALIMTA, in combination with cisplatin, is indicated for the treatment of malignant pleural mesothelioma, especially in patients who are not candidates for surgery.
    • Non-Small Cell Lung Cancer (NSCLC):
      • First-Line Treatment: Used in combination with cisplatin for the first-line treatment of locally advanced or metastatic nonsquamous NSCLC.
      • Maintenance Therapy: Used as a maintenance treatment for patients with locally advanced or metastatic nonsquamous NSCLC who have not progressed after four cycles of platinum-based chemotherapy.
      • Second-Line Therapy: As a single agent for the treatment of locally advanced or metastatic nonsquamous NSCLC after prior chemotherapy.
    • Off-Label Uses: ALIMTA may also be used off-label for other cancers that rely heavily on folate-dependent pathways, though these uses require further clinical validation.

    Contraindications

    Certain patient conditions and factors may make the use of ALIMTA inappropriate or require special considerations.

    Contraindications

    • Severe Renal Impairment: ALIMTA is contraindicated in patients with severe renal dysfunction (creatinine clearance <45 mL/min) due to increased risk of toxicity.
    • Pregnancy: Contraindicated during pregnancy due to potential teratogenic effects on the fetus.
    • Breastfeeding: Breastfeeding should be discontinued during treatment due to potential harm to the nursing infant.
    • Hypersensitivity: Known hypersensitivity or allergy to pemetrexed or any of its components.
    • Lack of Vitamin Supplementation: ALIMTA should not be administered without appropriate folic acid and vitamin B12 supplementation, which help mitigate the drug’s toxic effects.

    Price in Different Countries

    The cost of ALIMTA varies widely based on healthcare systems, insurance coverage, and local pricing regulations.
    Country Price (Per 500 mg Vial) Reference
    United States $4,500 – $5,000 GoodRx
    United Kingdom £2,500 – £3,000 NHS UK
    Canada CAD $3,800 – $4,200 Canada Pharmacy
    Australia AUD $5,200 – $5,700 PBS Australia
    India ₹320,000 – ₹350,000 1mg

    Top 5 Global Brands

    ALIMTA is the leading brand of pemetrexed, but other similar drugs and brands are available globally, offering alternative treatment options in chemotherapy.

    1. ALIMTA (Pemetrexed) – Eli Lilly

    • The original and most widely recognized brand of pemetrexed, known for its efficacy in treating mesothelioma and nonsquamous NSCLC.

    2. Pemetrexed (Generic Versions)

    • Generic versions are available from various manufacturers, providing more affordable options for patients worldwide.

    3. Pemfexy (Pemetrexed Injection) – Eagle Pharmaceuticals

    • A branded alternative to ALIMTA, Pemfexy offers similar efficacy and is used in comparable clinical scenarios.

    4. Pemnat (Pemetrexed) – Natco Pharma

    • A generic version widely used in India and other countries, offering a cost-effective alternative to ALIMTA.

    5. Pemcure (Pemetrexed) – Cipla

    • Another widely used generic option, Pemcure is known for its affordability and accessibility in markets with limited access to branded ALIMTA.
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    ALIMTA 500 MG 1 FLC
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