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Prescription only medicine

Alimta 500 mg Injection

Pemetrexed 500 mg

Alimta 500 mg Injection is a trusted medication containing Pemetrexed, designed for personal use under the guidance of a healthcare professional. Available for prescription-based international supply with discreet worldwide delivery.

Active ingredient
Pemetrexed
Strength
500 mg
Form
Injection
Manufacturer
Eli Lilly and Company
Made in
India
Prescription
Required
Commonly used forMesothelioma
$1,630.00 per pack of 1 vial

Prescription required — upload it at checkout.

Verified pharmacy Genuine medication Tracked shipping Medically reviewed by A. Srinivasan
Licensed Pharmacy Trust & safety
Licensed Manufacturers Every medicine from a licensed manufacturer
Dedicated Oncology Team Doctor + pharmacist review every order before dispatch
Worldwide Delivery UK · US · AU · EU · NZ — tracked and insured
About this medicine

What is Alimta 500 mg Injection?

Pemetrexed is a chemotherapy medicine given by drip (intravenous infusion) in a hospital or clinic, usually once every three weeks. It is used for the most common form of lung cancer — non-squamous non-small cell lung cancer — either with a platinum drug (cisplatin or carboplatin) and often an immunotherapy such as pembrolizumab at the start of treatment, on its own as maintenance afterwards, or after other treatments have stopped working. It is also used, with cisplatin, for mesothelioma, a cancer of the lining of the lung.

It belongs to the antifolate group: it blocks several enzymes that cancer cells need to make the building blocks of DNA. To protect healthy cells, everyone on pemetrexed takes folic acid tablets daily and receives a vitamin B12 injection every nine weeks, starting a week before the first dose. A steroid tablet is taken the day before, of and after each infusion to prevent skin rash.

The vials (100 mg and 500 mg) are prepared by the pharmacy for infusion; the dose is calculated from your body surface area. Pemetrexed is a prescription-only medicine; a valid prescription must be provided at checkout, and it must be administered by a healthcare professional.

How it works

How does Pemetrexed work?

Cells need folate (a B vitamin) to make the chemical building blocks of DNA. Pemetrexed looks like folate, so cancer cells pull it inside — where it jams three of the enzymes in that production line at once (thymidylate synthase, DHFR and GARFT). Without new DNA building blocks the cancer cell cannot divide and dies. Healthy fast-dividing cells, such as those in the bone marrow and gut, are affected too, which is why folic acid and vitamin B12 are given: they top up normal cells' supply and noticeably reduce the side effects without protecting the tumour.

Uptake and trapping

Pemetrexed enters cells through folate transporters and is converted to polyglutamate forms that are retained inside the cell for a long time.

Multi-enzyme blockade

The retained drug inhibits thymidylate synthase, dihydrofolate reductase and GARFT — three enzymes required to make thymidine and purines for DNA.

Cell death

Starved of DNA building blocks, dividing tumour cells stall and undergo programmed death. Folic acid and B12 supplementation protects normal tissue.

Uses

What is Pemetrexed used for?

Non-squamous non-small cell lung cancer (NSCLC), locally advanced or metastatic

First-line with a platinum drug (and pembrolizumab where appropriate); maintenance after first-line treatment; or alone after prior chemotherapy. Not for squamous-cell lung cancer.

FDA EMA CDSCO
Malignant pleural mesothelioma

With cisplatin, for patients whose disease cannot be removed surgically.

FDA EMA CDSCO

Only your oncologist can determine whether this medicine is right for your diagnosis. The above is for information only.

Dosage

How to take Alimta 500 mg Injection

Your oncologist will prescribe your exact dose. The right dose for you depends on your weight, kidney and liver function, and — for some medicines — your genetic test results.

Always take exactly as prescribed. Do not change your dose or stop taking this medicine without speaking to your doctor first, even if you feel well.

Missed a dose? If you miss a scheduled infusion, contact your treatment centre to rebook. If you miss folic acid, take it as soon as you remember; if you miss the steroid, tell the clinic before your infusion.

With food? Not applicable — given by infusion. Take your folic acid tablet daily, with or without food, and do not stop it without asking.

Important safety information

Safety & warnings

Please read this section before taking Alimta 500 mg Injection and discuss any concerns with your oncologist.

Common side effects

Side effects affect some people, not everyone. Most are manageable — let your treatment team know about anything that concerns you.

  • Tiredness (fatigue)
  • Nausea, vomiting, loss of appetite
  • Low white blood cells, anaemia, low platelets
  • Mouth soreness (stomatitis)
  • Diarrhoea or constipation
  • Skin rash (much less with the steroid premedication)
  • Raised liver enzymes
  • Watery eyes, conjunctivitis
  • Hair thinning

Contact your doctor immediately if you notice:

  • Fever of 38°C or higher, chills or signs of infection Go to the emergency department — neutropenic infection is a medical emergency.
  • Unusual bruising or bleeding Contact your team the same day — possible low platelets.
  • Passing much less urine, swelling of the legs Contact your team — pemetrexed can affect the kidneys, especially with cisplatin or NSAIDs.
  • New or worsening breathlessness or dry cough Seek urgent review — lung inflammation (pneumonitis) can occur, especially after chest radiotherapy.
  • Painful rash with blistering or peeling Seek urgent review — severe skin reactions have been reported.
  • Severe mouth ulcers or diarrhoea that stops you eating and drinking Contact your team; supportive treatment and a dose change may be needed.
  • Skin redness or pain in an area that was previously treated with radiotherapy Tell your team — "radiation recall" can occur weeks or years after radiotherapy.

Important: tell your doctor about these medicines

Taking Pemetrexed with certain other medicines can be dangerous. Always tell every doctor, dentist, and pharmacist about all medicines you are taking.

  • NSAIDs (ibuprofen, naproxen, diclofenac, high-dose aspirin) Major

    Reduce kidney clearance of pemetrexed and increase toxicity, particularly if kidney function is already reduced.

  • Cisplatin and other nephrotoxic drugs Major

    Additive kidney injury.

  • Live vaccines Major

    Risk of serious infection while immunosuppressed.

Pregnancy & breastfeeding

Pemetrexed can harm an unborn baby and should not be used in pregnancy. Women who could become pregnant should use effective contraception during treatment and for at least six months after the last dose.

Do not breastfeed during treatment or for one week after the last dose.

Pemetrexed may reduce fertility in men. Discuss sperm banking before your first dose if this matters to you.

For full prescribing information see: FDA prescribing information: Alimta (pemetrexed) — DailyMed

Storage

How to store Alimta 500 mg Injection

Temperature

Unopened vials: store at 20–25°C (68–77°F) — check the specific product label, as some presentations require refrigeration.

Light & moisture

Keep vials in the outer carton to protect from light.

Keep away from children

Keep out of the sight and reach of children.

Safe handling

Cytotoxic medicine for professional preparation and administration only. Vials are reconstituted and diluted by the pharmacy in a controlled environment and used within the label's time limits.

Travelling

Vials are dispatched in protective packaging and, wherever possible, delivered directly to the treating clinic. Do not open at home.

Reviewed for accuracy

Medically reviewed content

A. Srinivasan

A. Srinivasan

B.Pharm, M.Pharm

A. Srinivasan is a licensed clinical pharmacist with 24 years of experience. He holds a B.Pharm and M.Pharm from University of Madras. At OnlineMeds, he reviews medicine and health content to help ensure it is accurate, evidence-based, and easy to understand.

Our commitment to you

How we support oncology patients

We understand that accessing the right cancer medicine can feel overwhelming. Here is what you can expect from us.

Personal oncology support

Every enquiry is reviewed by our oncology doctor and pharmacist team — not an automated system.

Genuine, verified medicine

Sourced exclusively from licensed pharmaceutical manufacturers. Every batch is traceable from origin to your door.

Prescription checked before dispatch

We verify every prescription with our internal medical team. No shortcuts, no exceptions.

Cold-chain logistics

Temperature-sensitive medicines shipped with appropriate packaging to maintain integrity.

Discreet, plain packaging

No pharmacy branding or product name on the outer packaging.

FAQ

Frequently asked questions

Why do I have to take folic acid and have B12 injections?

Pemetrexed works by blocking folate-dependent enzymes. Topping up folic acid and vitamin B12 protects your normal cells — it roughly halves the risk of severe low blood counts and gut side effects — without protecting the tumour. Start folic acid at least a week before your first infusion and keep taking it until three weeks after the last.

[1] FDA prescribing information: Alimta (pemetrexed) — DailyMed

Why the steroid tablets around each infusion?

Dexamethasone the day before, the day of and the day after each dose prevents the skin rash pemetrexed can otherwise cause. It is a short course each cycle, not continuous.

[1] FDA prescribing information: Alimta (pemetrexed) — DailyMed

Can I take ibuprofen for pain?

Not around your infusion. Anti-inflammatory painkillers slow the kidneys' clearance of pemetrexed and raise its side effects. Avoid them for two days before, the day of, and two days after each infusion — longer for slow-release types — and use paracetamol instead. Ask your team about any regular pain medicine.

[1] FDA prescribing information: Alimta (pemetrexed) — DailyMed

Can I have Alimta 500 mg Injection at home?

No. Pemetrexed is a cytotoxic drug given by intravenous infusion over about ten minutes in a chemotherapy unit, after blood tests confirm it is safe to proceed. We supply the vials to you or your treating centre; a healthcare professional must prepare and administer them.

[4] Macmillan Cancer Support: Pemetrexed (Alimta)

Why is Alimta 500 mg Injection only for "non-squamous" lung cancer?

In clinical trials pemetrexed helped people with adenocarcinoma and large-cell lung cancer but not those with squamous-cell lung cancer, which has higher levels of the enzyme pemetrexed targets. Your pathology report tells your oncologist which type you have.

[2] NCI Drug Information: Pemetrexed Disodium

How long is a course of treatment?

Typically four to six three-weekly cycles with a platinum drug, after which pemetrexed alone may continue as maintenance for as long as it is working and tolerated. Your oncologist reviews scans and blood tests regularly and decides.

[4] Macmillan Cancer Support: Pemetrexed (Alimta)

Do I need a prescription to order Alimta 500 mg Injection?

Yes. Pemetrexed is prescription-only and for professional administration. Upload your oncologist's prescription at checkout; our pharmacist team reviews it and confirms delivery arrangements with your clinic before dispatch. Used as prescribed by a licensed medical professional.

Sources

References

  1. 1. FDA prescribing information: Alimta (pemetrexed) — DailyMed. https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=alimta U.S. National Library of Medicine. Accessed 12 Sep 2026.
  2. 2. NCI Drug Information: Pemetrexed Disodium. https://www.cancer.gov/about-cancer/treatment/drugs/pemetrexeddisodium National Cancer Institute. Accessed 12 Sep 2026.
  3. 3. EMA: Alimta — European public assessment report. https://www.ema.europa.eu/en/medicines/human/EPAR/alimta European Medicines Agency. Accessed 12 Sep 2026.
  4. 4. Macmillan Cancer Support: Pemetrexed (Alimta). https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/pemetrexed Accessed 12 Sep 2026.
Medical disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional — specifically your oncologist — before starting, changing, or stopping any medication. Information is based on NDA #021462, NCI Drug Information, and NHS patient information.
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