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Pemetrexed (Alimta) (pemetrexed)
Chemotherapy (antifolate) · Used for: Lung cancer
💉 Given by IV or injection · Chemotherapy (antifolate)
Cliff notes
What it is: Chemotherapy (antifolate).
How it's given: An IV infusion over 10 minutes every 3 weeks. You'll take folic acid and get vitamin B12 shots to lower side effects.
How it works: Pemetrexed blocks enzymes cancer cells need to make DNA. It's used for non-squamous non-small cell lung cancer.
Common side effects and what helps at home
| Side effect | What can help |
|---|---|
| Tiredness | Rest. |
| Nausea | Small meals. |
| Low blood counts | Hand washing. |
| Rash | Steroid pills are often given to prevent it. |
| Mouth sores | Salt rinses. |
Not everyone gets these. Your team may suggest other ways to manage them.
Call your care team now if you have:
- Fever of 100.4°F (38°C) or higher, or chills (possible infection when blood counts are low)
- Vomiting or diarrhea that won't stop, or you can't keep fluids down
- Unusual bleeding or bruising
- Shortness of breath or chest pain
- Signs of an allergic reaction during or after an infusion: trouble breathing, swelling of the face or throat, hives
- Peeing much less (possible kidney problems)
- Blistering or peeling skin
- New cough or shortness of breath (possible lung inflammation)
- Skin redness where you had radiation before (radiation recall)
Call 911 for trouble breathing, chest pain or signs of stroke.
🗓 What to expect
1️⃣ Before you start
- Ask your team for a written schedule and an after-hours phone number.
- Start folic acid pills and get a vitamin B12 shot, as the label directs.
- Bring a list of all your medicines and supplements.
2️⃣ During each infusion
- You'll get the medicine through an IV in a clinic; nurses check you during the infusion.
- Tell the nurse right away about chills, itching, flushing or trouble breathing.
- Bring a snack, water and something to pass the time.
3️⃣ Between doses
- Watch for the side effects below and use the checklist.
- Keep up with blood tests and visits.
- Call your team for anything in the red box.
✅ Side-effect checklist
Print this and check off what you notice so you can tell your team.
| Side effect | Noticed? | Notes for my team |
|---|---|---|
| Tiredness | ☐ | |
| Nausea | ☐ | |
| Low blood counts | ☐ | |
| Rash | ☐ | |
| Mouth sores | ☐ |
Help paying for Pemetrexed (Alimta)
Generic chemo has no single manufacturer program, so the copay foundations below are your best bet.
- PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
- HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
- CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
- Good Days: Copay help and some travel costs.
- NeedyMeds: Free database of assistance programs, open to anyone.
📋 Medicare: Medicare Part B usually covers drugs given by infusion in a doctor's office or hospital outpatient clinic. You typically pay 20% after the Part B deductible. See Medicare and your cancer drugs.
More: Our guide to paying for cancer treatment.
Regimens that include Pemetrexed (Alimta)
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❓ Questions to ask your doctor
- What is the goal of this treatment for me?
- How will we know if it's working?
- Which side effects should I call about right away, and what number do I call after hours?
- Which medicines, vitamins or supplements should I avoid?
- Will this affect my ability to work, drive or care for my family?
- What will this cost me, and who can help me with coverage?
Support groups
- LUNGevity: Patient education, support groups and survivorship programs
- GO2 for Lung Cancer: Helpline, biomarker testing support and navigation
- CancerCare: Free counseling, support groups and financial help
- Cancer Support Community: Support groups, a helpline and the MyLifeLine online community
Common questions
Why do I take folic acid and B12 with pemetrexed?
They lower the risk of low blood counts and other side effects, per the FDA label.
📄 The official FDA label for Pemetrexed (Alimta), including its patient information section, is on DailyMed.
Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write