pemetrexed disodium
Alimta	Pharmaceutical company: Eli Lilly and Company www.lilly.com

NEW INDICATION & DOSAGE
Locally advanced or metastatic nonsquamous non–small-cell lung cancer that hasn't progressed after four cycles of platinum-based first-line chemotherapy—
Adults: 500 mg/m² administered as an I.V. infusion over 10 minutes on day 1 of each 21-day cycle.
ADJUST-A-DOSE: For patients with nadir absolute neutrophil count (ANC) less than 500/mm³ and nadir platelets of 50,000/mm³ or less, or nadir platelets less than 50,000/mm³ without bleeding regardless of nadir ANC, give 75% of previous dose. For nadir platelets less than 50,000/mm³ with bleeding, regardless of nadir ANC, give 50% of previous dose.
ADJUST-A-DOSE: For those with nonhematologic toxicities (excluding neurotoxicity) of grade 3 or more, withhold treatment until the patient returns to his pre-therapy value or less. For any grade 3 or 4 toxicities (except mucositis), give 75% of the previous dose. For patients with diarrhea requiring hospitalization (irrespective of grade) or grade 3 or 4 diarrhea, give 75% of previous dose. For patients with grade 3 or 4 mucositis, give 50% of the previous dose. For those with grade 2 neurotoxicity, give 50% of previous dose. For grade 3 or 4 toxicity, discontinue therapy.
ADJUST-A-DOSE: For patients with a creatinine clearance of less than 45 ml/minute, withhold therapy.

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