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Indications of Alimta-500.
Alimta – 500 has only two indications for taking. First, it is malignant mesothelioma (carcinosarcoma) of the pleura. This pathology develops from the cells of the mesothelium, which are located above the connective tissue. In this case, the therapy is carried out simultaneously with the using of platinum preparations.
The second indication is not small-cell lung cancer, and also those cases when a tumor in the lungs was the result of metastases from other organs. Such a tumor is detected in 80 – 85% of all cases of cancer in this organ.
Dosage of Alimta-500.
The administration is carried out only intravenously drip for at least 10 minutes. Dosage and duration of treatment depend on the diagnosis and stage of the disease.
If it is adenocarcinoma or large-cell lung cancer, then only combined treatment with Cisplatin is carried out. The administration is carried out every 21 days in a dose of 500 mg. As for the second remedy, it is administered at least half an hour after Alimta, 75 mg, also once every 21 days.
After the full course, the second line of treatment is carried out, where only Alimta remedy is used at a dose of 500 mg.
As for the treatment of malignant pleural mesothelioma, the pattern of administration here is identical to the previous one.
Recommendations before using Alimta-500.
It is very important to remember that before the introduction of Alimta – 500, it is necessary to introduce a correctly selected amount of dexamethasone or its analogues. It is prescribed for 4 mg in the morning and in the evening a day before intravenous administration, on the day of administration and on the following day. This will help to reduce the side effect, which often manifests itself in the form of skin reactions.
To reduce toxicity, patients must necessarily take folic acid or vitamin complexes that contain this substance. At least 400 mcg of folic acid should be consumed a day, although individually and can be assigned to large quantities. Start taking folic acid 7 days before the start of the first course, and do not interrupt the reception until the treatment is stopped altogether.
It is also very important to subcutaneously administration of cobalamin cyanide at a dose of 1,000 μg for 7 days before the introduction of Alimta – 500, and every third course of its use.
Recommendation for reducing the dose of Alimta-500.
After the first course of administration, it is necessary to adjust the dose depending on the state of the blood. If the toxicity of the remedy was very severe, then further treatment can be canceled or delayed for a period of time.
Here everything will depend on the blood counts. So, for example, if the content of neutrophils in the blood is more than 500 cells, and the amount of platelets is thus reduced to a minimum, then the next time only 75% of the amount of the remedy is administered.
If the minimum allowable amount of platelets is found in the blood, but this does not cause bleeding, the dose should also be brought up to 75% of the previous one.
And, finally, if there is a bleeding with a minimal amount of platelets, the dose is reduced to 50%.
According to the instructions for use, the correction of the introduction of Alimta – 500 is carried out depending on the severity of the toxic effect on the body. So, for example, with toxicity of 3 or 4 degree, but if there is no inflammation in the mucous membrane, the dose is reduced to 75%.
If diarrhea started to develop on the background of treatment, which requires immediate hospitalization, then the next dosage should be 75% of the previous one.
And, finally, in the presence of the inflammatory process of the mucous membranes of the 3rd or 4th degree, the dose decreases exactly half.