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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
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Alimta - labeled renal guidance
Product / population
Pemetrexed (Alimta), IV lyophilized powder, adults
Renal method
Cockcroft-Gault creatinine clearance, mL/min
Source revision
DailyMed SPL version 59, effective 2023-05-19; posted Jun 28, 2023
All record notes are retained here, including notes about sources not selected in this review.
Alimta - product and source limitations
The U.S. labeling directs withholding below CrCl 45. The dated Ontario monograph instructs discontinuation below that threshold. Verify the applicable treatment protocol before deciding whether treatment may resume.
What to reconcile: The U.S. labeling directs withholding below CrCl 45. The dated Ontario monograph instructs discontinuation below that threshold. Verify the applicable treatment protocol before deciding whether treatment may resume.
Withhold if CrCl is below 45 mL/min. Recheck CrCl before each dose. At 45-79, avoid ibuprofen during the two days before treatment, treatment day and two days afterward. If ibuprofen cannot be withheld, increase monitoring for marrow suppression, renal injury and GI toxicity.
RDM73-alimta-official-1 · Source locator: Renal guidance: 2.3, 2.5 and 5.2
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh Renal Dosing Master v7.4. Review the retrieval and revision dates attached to each source. Selecting a reference does not imply clinical verification.
