natgillin/translations-raw huggingface dataset:
Rare cases of radiation recall have been reported in patients who have received radiotherapy previously (see section 4.4).
Slučajevi odzivne radijacijske upalne reakcije (engl. radiation recall) prijavljeni su rijetko u bolesnika koji su prethodno liječeni radioterapijom (vidjeti dio 4.4).
As with other potentially toxic anti-cancer agents, care should be exercised in the handling and preparation of pemetrexed infusion solutions.
Kao i kod svih potencijalno toksičnih protutumorskih lijekova, potreban je oprez pri rukovanju i pripremi otopine pemetrekseda za infuziju.
Pemetrexed Pfizer is for intravenous use.
Pemetreksed Pfizer namijenjen je za intravensku primjenu.
Pemetrexed is physically incompatible with diluents containing calcium, including lactated Ringer's injection and Ringer's injection.
Pemetreksed je fizikalno inkompatibilan s otapalima koja sadrže kalcij, uključujući otopinu Ringerovog laktata i Ringerovu otopinu za infuziju.
**Refer to NCI CTCAE Criteria (Version 3.0; NCI 2003) for each grade of toxicity.
**Za sve stupnjeve toksičnosti vidjeti NCI CTCAE (verzija 3.0; NCI 2003).
The use of calcium folinate/folinic acid in the management of pemetrexed overdose should be considered.
U liječenju predoziranja pemetreksedom potrebno je razmotriti primjenu kalcijeva folinata/folinatne kiseline.
Pemetrexed in combination with cisplatin
Pemetreksed u kombinaciji s cisplatinom
Serious renal events, including acute renal failure, have been reported with pemetrexed alone or in association with other chemotherapeutic agents.
Ozbiljni bubrežni događaji, uključujući akutno zatajenje bubrega, zabilježeni su pri primjeni pemetrekseda samog ili u kombinaciji s drugim kemoterapeuticima.
The recommended dose of cisplatin is 75 mg/m2 BSA infused over two hours approximately 30 minutes after completion of the pemetrexed infusion on the first day of each 21-day cycle.
Preporučena doza cisplatina je 75 mg/m2 tjelesne površine, a primjenjuje se infuzijom u trajanju od dva sata, približno 30 minuta nakon završetka infuzije pemetrekseda, prvog dana svakog 21-dnevnog ciklusa.
A subgroup analysis was performed on patients who received folic acid and vitamin B12 supplementation during the entire course of study therapy (fully supplemented).
Provedena je analiza podskupine bolesnika koji su za cijelog trajanja liječenja u ispitivanju primali nadomjestak folatne kiseline i vitamina B12 (potpun nadomjestak).
Reported symptoms of overdose include neutropenia, anaemia, thrombocytopenia, mucositis, sensory polyneuropathy, and rash.
Prijavljeni simptomi predoziranja uključuju neutropeniju, anemiju, trombocitopeniju, mukozitis, senzornu polineuropatiju i osip.
All patients were diagnosed with Stage IIIB or IV NSCLC and had received prior platinum-based chemotherapy.
Svi su bolesnici imali dijagnozu raka pluća nemalih stanica stadija IIIB ili IV i prethodno su primali kemoterapiju na bazi platine.
Pre-medication regimen
Protokol za premedikaciju
A Phase 2 study of pemetrexed in 31 solid tumour patients with stable third-space fluid demonstrated no difference in pemetrexed dose normalised plasma concentrations or clearance compared to patients without third-space fluid collections.
U ispitivanju pemetrekseda faze II u 31 bolesnika sa solidnim tumorom i stabilnom tekućinom u transcelularnom prostoru nije uočena razlika u koncentracijama pemetrekseda u plazmi normaliziranima za dozu, kao ni u klirensu pemetrekseda, u usporedbi s bolesnicima koji nisu imali nakupljanje tekućine u transcelularnom prostoru.
Efficacy parameter pemetrexed / cisplatin (N = 226)
Parametar djelotvornosti pemetreksed / cisplatin (N = 226)
The median time from the start of pemetrexed plus cisplatin induction therapy to the start of maintenance treatment was 2.96 months on both the pemetrexed arm and the placebo arm. Randomised patients received maintenance treatment until disease progression.
Medijan vremena od početka uvodnog liječenja pemetreksedom i cisplatinom do početka terapije održavanja iznosio je 2,96 mjeseci i u skupini koja je primala pemetreksed i u skupini koja je primala placebo.
Progression-free survival (PFS) and overall response rate were similar between treatment arms: median PFS was 4.8 months for pemetrexed plus cisplatin versus 5.1 months for gemcitabine plus cisplatin (adjusted hazard ratio (HR) 1.04; 95% CI= 0.94-1.15), and overall response rate was 30.6% (95% CI= 27.3- 33.9) for pemetrexed plus cisplatin versus 28.2% (95% CI= 25.0-31.4) for gemcitabine plus cisplatin.
Preživljenje bez progresije bolesti (engl. progression-free survival, PFS) i stopa ukupnog odgovora bili su podjednaki između terapijskih skupina: medijan PFS-a iznosio je 4,8 mjeseci za pemetreksed i cisplatin u usporedbi s 5,1 mjeseci za gemcitabin i cisplatin (prilagođen omjer hazarda 1,04; 95% CI = 0,94 - 1,15), a stopa ukupnog odgovora bila je 30,6% (95% CI = 27,3 - 33,9) za pemetreksed i cisplatin u usporedbi s 28,2% (95% CI = 25,0 - 31,4) za gemcitabin i cisplatin.
Reconstituted and infusion solutions
Rekonstituirana otopina i otopina za infuziju
Metabolism and nutrition disorders
Poremećaji metabolizma i prehrane često dehidracija
The most commonly reported undesirable effects related to pemetrexed, whether used as monotherapy or in combination, are bone marrow suppression manifested as anaemia, neutropenia, leucopenia, thrombocytopenia; and gastrointestinal toxicities, manifested as anorexia, nausea, vomiting, diarrhoea, constipation, pharyngitis, mucositis, and stomatitis.
Najčešće prijavljene nuspojave povezane s primjenom pemetrekseda, kako u monoterapiji tako i u kombinaciji s drugim lijekovima, su supresija koštane srži, koja se očituje kao anemija, neutropenija, leukopenija, trombocitopenija; i gastrointestinalna toksičnost, koja se očituje kao anoreksija, mučnina, povraćanje, proljev, konstipacija, faringitis, mukozitis i stomatitis.
Patients also required lower administration of erythropoietin/darbopoietin (10.4% versus 18.1%, p < 0.001), G-CSF/GM-CSF (3.1% versus 6.1%, p = 0.004), and iron preparations (4.3% versus 7.0%, p = 0.021).
U tih je bolesnika također rjeđe trebalo primijeniti eritropoetin/darbepoetin (10,4% naspram 18,1%, p < 0,001), G-CSF/GM-CSF (3,1% naspram 6,1%, p = 0,004) i pripravke željeza (4,3% naspram 7,0%, p = 0,021).
Uncommon cases of radiation pneumonitis have been reported in patients treated with radiation either prior, during or subsequent to their pemetrexed therapy (see section 4.4).
Slučajevi radijacijskog pneumonitisa prijavljeni su manje često u bolesnika koji su liječeni radioterapijom prije, tijekom ili nakon terapije pemetreksedom (vidjeti dio 4.4).
There are limited data in patients with malignant pleural mesothelioma treated with pemetrexed alone.
Podaci o bolesnicima s malignim pleuralnim mezoteliomom liječenima samo pemetreksedom su ograničeni.
Patients receiving pemetrexed should be monitored before each dose with a complete blood count, including a differential white cell count (WCC) and platelet count.
U bolesnika koji primaju pemetreksed prije svake se doze mora provesti kontrola kompletne krvne slike, uključujući i diferencijalnu krvnu sliku (DKS) te broj trombocita.
Patients treated with pemetrexed and cisplatin required fewer transfusions (16.4% versus 28.9%, p < 0.001), red blood cell transfusions (16.1% versus 27.3%, p < 0.001) and platelet transfusions (1.8% versus 4.5%, p =0.002).
Bolesnici liječeni pemetreksedom i cisplatinom trebali su manje transfuzija (16,4% naspram 28,9%, p < 0,001), transfuzija eritrocita (16,1% naspram 27,3%, p < 0,001) i transfuzija trombocita (1,8% naspram 4,5%, p = 0,002).
Pemetrexed Pfizer is given in combination with cisplatin, another anti-cancer medicine, as treatment for malignant pleural mesothelioma, a form of cancer that affects the lining of the lung, to patients who have not received prior chemotherapy.
Pemetreksed Pfizer se primjenjuje u kombinaciji s cisplatinom, još jednim protutumorskim lijekom, za liječenje zloćudnog pleuralnog mezotelioma, oblika raka koji zahvaća plućne ovojnice, u bolesnika koji prethodno nisu primali kemoterapiju.
There were no clinically relevant differences observed for the safety profile of pemetrexed within the histology subgroups.
Nisu uočene klinički značajne razlike u sigurnosnom profilu pemetrekseda unutar podskupina prema histološkom tipu.
Median time to tumour progression (months) (95% CI)
Medijan vremena do progresije tumora (mjeseci) (95% CI)
Pemetrexed was not mutagenic in either the in vitro chromosome aberration test in Chinese hamster ovary cells, or the Ames test. Pemetrexed has been shown to be clastogenic in the in vivo micronucleus test in the mouse.
Ni in vitro ispitivanje kromosomskih aberacija u stanicama jajnika kineskoga hrčka, niti Amesov test nisu ukazali na mutageni učinak pemetrekseda.
All patients were diagnosed with locally advanced or metastatic non-small cell lung cancer and received prior chemotherapy.
Svi su bolesnici imali lokalno uznapredovali ili metastatski rak pluća nemalih stanica i prethodno su primali kemoterapiju.
In the absence of data regarding potential interaction with NSAIDs having longer half-lives such as piroxicam or rofecoxib, the concomitant administration with pemetrexed in patients with mild to moderate renal insufficiency should be interrupted for at least 5 days prior to, on the day of, and at least 2 days following pemetrexed administration (see section 4.4).
U nedostatku podataka o mogućim interakcijama s NSAIL s duljim poluvijekom, poput piroksikama ili rofekoksiba, u bolesnika s blagim do umjerenim zatajenjem bubrega, njihova se istodobna primjena mora prekinuti najmanje pet dana prije, na sam dan i najmanje dva dana nakon primjene pemetrekseda (vidjeti dio 4.4).
The following information is intended for healthcare professionals only: Instructions for use, handling and disposal
Sljedeće informacije namijenjene su samo zdravstvenim radnicima:
METHOD OF ADMINISTRATION Reconstitute and dilute before use See leaflet.
Rekonstituirati i razrijediti prije primjene.
Patients in both study arms were fully supplemented with folic acid and vitamin B12.
Bolesnici u obje ispitivane skupine primali su potpun nadomjestak folatne kiseline i vitamina B12.
In clinical trials, cases of colitis (including intestinal and rectal bleeding, sometimes fatal, intestinal perforation, intestinal necrosis and typhlitis) have been reported uncommonly in patients treated with pemetrexed.
Tijekom kliničkih ispitivanja manje su često prijavljeni slučajevi kolitisa (uključujući intestinalno i rektalno krvarenje, koje je ponekad bilo smrtonosno, perforaciju crijeva, nekrozu crijeva i tiflitis) u bolesnika liječenih pemetreksedom.
• If you experience tiredness, feeling faint, becoming easily breathless or if you look pale (since you might have less haemoglobin than normal which is very common).
• ako osjetite umor, nesvjesticu, nedostatak zraka ili ste blijedi (jer razina hemoglobina može biti niža od normalne, što je vrlo česta pojava)
Pharmacotherapeutic group: antineoplastic agents, folic acid analogues.
Farmakoterapijska skupina: Antineoplastici, analog folatne kiseline, ATK oznaka: L01BA04
Consistent with other pemetrexed studies, a difference in efficacy according to NSCLC histology was observed in JMEN.
Kao i u drugim ispitivanjima pemetrekseda, u ispitivanju JMEN opažena je razlika u djelotvornosti s obzirom na histološki tip NSCLC-a.
Median overall survival in months (95% CI)
Medijan ukupnog preživljenja u mjesecima (95% CI)
Anticipated complications of overdose include bone marrow suppression as manifested by neutropenia, thrombocytopenia, and anaemia.
Očekivane komplikacije predoziranja uključuju supresiju koštane srži koja se manifestira neutropenijom, trombocitopenijom i anemijom.
In the event of neurotoxicity, the recommended dose adjustment for pemetrexed and cisplatin is documented in Table 3.
Preporučena prilagodba doze pemetrekseda i cisplatina u slučaju neurotoksičnosti navedena je u Tablici
Medicinal product subject to restricted medical prescription (see Annex I: Summary of Product Characteristics, 4.2)
Lijek se izdaje na ograničeni recept (vidjeti Prilog I.: Sažetak opisa svojstava lijeka, dio 4.2.).
There is not a specific antidote for extravasation of pemetrexed.
U slučaju ekstravazacije pemetrekseda nema specifičnog protulijeka.
In patients treated for non-small cell lung cancer after prior chemotherapy, the recommended dose of pemetrexed is 500 mg/m2 BSA administered as an intravenous infusion over 10 minutes on the first day of each 21-day cycle.
U bolesnika koji se liječe zbog raka pluća nemalih stanica nakon prethodne kemoterapije preporučena doza pemetrekseda iznosi 500 mg/m2 tjelesne površine, a primjenjuje se u obliku intravenske infuzije tijekom 10 minuta, prvog dana svakog 21-dnevnog ciklusa.
gemcitabine/cisplatin (N = 830)
gemcitabin/cisplatin (n = 830)
Serious cardiovascular and cerebrovascular events, including myocardial infarction, angina pectoris, cerebrovascular accident, and transient ischaemic attack, have been uncommonly reported during clinical studies with pemetrexed, usually when given in combination with another cytotoxic agent.
Tijekom kliničkih ispitivanja pemetrekseda manje su često prijavljeni ozbiljni kardiovaskularni i cerebrovaskularni događaji, uključujući infarkt miokarda, anginu pektoris, cerebrovaskularni inzult i tranzitornu ishemijsku ataku, obično kada se pemetreksed primjenjivao u kombinaciji s nekim drugim citotoksičnim lijekom.
Type I glass vial with bromobutyl rubber stopper containing 100 mg, 500 mg or 1,000 mg of pemetrexed
I s bromobutilnim gumenim čepom sadrži 100 mg, 500 mg ili 1000 mg pemetrekseda
Dose of pemetrexed (mg/m2)
Doza pemetrekseda (mg/m
Pemetrexed is incompatible with diluents containing calcium, including lactated Ringer's Injection and Ringer's Injection 6.
Pemetreksed je inkompatibilan s otapalima koja sadrže kalcij, uključivši otopinu Ringerovog laktata i Ringerovu otopinu za infuziju.
Dose reductions for subsequent cycles are based on nadir ANC, platelet count, and maximum non-haematologic toxicity seen from the previous cycle (see section 4.2).
Smanjenja doze u sljedećim ciklusima temelje se na najnižim vrijednostima apsolutnog broja neutrofila i trombocita te najvećoj nehematološkoj toksičnosti iz prethodnog ciklusa (vidjeti dio 4.2).
Pemetrexed Pfizer is also a treatment for patients with advanced stage of lung cancer whose disease has progressed after other initial chemotherapy has been used.
Pemetreksed Pfizer se također primjenjuje u bolesnika s uznapredovalim rakom pluća u kojih je bolest napredovala nakon primjene neke druge početne kemoterapije.
The table below provides the frequency and severity of undesirable effects considered possibly related to study medicinal product that have been reported in > 5% of 800 patients randomly assigned to receive single-agent pemetrexed and 402 patients randomly assigned to receive placebo in the singleagent pemetrexed maintenance (JMEN: N= 663) and continuation pemetrexed maintenance (PARAMOUNT: N=539) studies.
Tablica koja slijedi prikazuje učestalost i težinu nuspojava za koje se smatra da bi mogle biti povezane s ispitivanim lijekom, a koje su zabilježene u > 5% od 800 bolesnika randomiziranih da primaju samo pemetreksed i 402 bolesnika randomizirana da primaju placebo u ispitivanju monoterapije pemetreksedom kao terapije održavanja (JMEN: N= 663) i ispitivanja kontinuirane terapije održavanja pemetreksedom (PARAMOUNT: N=539).
Dose modification table for pemetrexed (as a single agent or in combination) and cisplatin - Non-haematologic toxicities a, b
Tablica 2. Tablica za prilagodbu doze pemetrekseda (u monoterapiji ili u kombinaciji) i cisplatina - nehematološka toksičnost a, b
Before the start of any cycle of chemotherapy, patients are required to have the following: absolute neutrophil count (ANC) should be ≥ 1,500 cells/mm3 and platelets should be ≥ 100,000 cells/mm3.
Prije početka svakog ciklusa kemoterapije bolesnici moraju imate sljedeće vrijednosti laboratorijskih parametara: apsolutni broj neutrofila (ABN) mora biti ≥ 1500 stanica/mm
Nadir platelets < 50,000/mm3 with bleedinga, regardless of nadir ANC
Najniži broj trombocita < 50 000/mm bez obzira na najniži ABN
Frequency Event*
Događaj*
Fisher's exact p-value* <0.001
Log-rang p-vrijednost* 0,001
Pemetrexed Pfizer is indicated as monotherapy for the maintenance treatment of locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology in patients whose disease has not progressed immediately following platinum-based chemotherapy (see section
Pemetreksed Pfizer je indiciran kao monoterapija u terapiji održavanja lokalno uznapredovalog ili metastatskog raka pluća nemalih stanica kod kojeg histološki ne prevladavaju skvamozne stanice u bolesnika u kojih bolest nije napredovala neposredno nakon kemoterapije na bazi platine (vidjeti dio
A multi-centre, randomised, open-label, Phase-3 study of pemetrexed plus cisplatin versus gemcitabine plus cisplatin in chemonaive patients with locally advanced or metastatic (Stage IIIb or IV) non-small cell lung cancer (NSCLC) showed that pemetrexed plus cisplatin (Intent-To-Treat [ITT] population N = 862) met its primary endpoint and showed similar clinical efficacy as gemcitabine plus cisplatin (ITT N = 863) in overall survival (HR 0.94; 95% CI= 0.84-1.05).
Multicentrično, randomizirano, otvoreno ispitivanje faze III pemetrekseda i cisplatina u odnosu na gemcitabin i cisplatin u bolesnika s lokalno uznapredovalim ili metastatskim (stadij IIIB ili IV) rakom pluća nemalih stanica (NSCLC) koji prethodno nisu primali kemoterapiju pokazalo je da su pemetreksed i cisplatin (ITT populacija, N = 862) ostvarili primarni ishod ispitivanja i pokazali sličnu kliničku djelotvornost kao gemcitabin i cisplatin (ITT N = 863) s obzirom na ukupno preživljenje (HR 0,94; 95% CI = 0,84 - 1,05).
PARAMOUNT: Kaplan-Meier plot of progression-free survival (PFS) and Overall Survival (OS) for continuation pemetrexed maintenance versus placebo in patients with NSCLC other than predominantly squamous cell histology (measured from randomisation)
PARAMOUNT: Kaplan Meierova krivulja preživljenja bez progresije bolesti (PFS) i ukupnog preživljenja (OS) za nastavak terapije održavanja pemetreksedom u odnosu na placebo u bolesnika s NSCLC-om kod kojeg histološki ne prevladavaju skvamozne stanice (mjereno od randomizacije)
Patients with mild to moderate renal insufficiency (creatinine clearance from 45 to 79 ml/min) should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and acetylsalicylic acid (>1.3 g daily) for 2 days before, on the day of, and 2 days following pemetrexed administration (see section 4.5).
Bolesnici s blagim do umjerenim zatajenjem bubrega (klirens kreatinina od 45 do 79 ml/min) moraju izbjegavati uzimanje nesteroidnih protuupalnih lijekova (NSAIL-a) poput ibuprofena i acetilsalicilatne kiseline (> 1,3 g na dan) 2 dana prije, na sam dan i 2 dana nakon primjene pemetrekseda (vidjeti dio
Rare cases of hepatitis, potentially serious, have been reported during clinical studies with pemetrexed.
Tijekom kliničkih ispitivanja pemetrekseda prijavljeni su rijetki, potencijalno ozbiljni slučajevi hepatitisa.
Preparation and administration precautions
Mjere opreza pri pripremanju i primjeni
The efficacy analyses using PQ population are consistent with the analyses for the ITT population and support the non-inferiority of AC versus GC.
Analize djelotvornosti na PQ populaciji konzistentne su s analizom ITT populacije i podupiru neinferiornost kombinacije pemetreksed/cisplatin naspram kombinacije gemcitabin/cisplatin.
After reconstitution as directed, the solution contains 25 mg/ml of pemetrexed.
Nakon rekonstitucije prema uputama, otopina sadrži 25 mg/ml pemetrekseda.
The recommended dose of pemetrexed is 500 mg/m2 of body surface area (BSA) administered as an intravenous infusion over 10 minutes on the first day of each 21-day cycle.
Preporučena doza pemetrekseda je 500 mg/m2 tjelesne površine, a primjenjuje se u obliku intravenske infuzije tijekom 10 minuta, prvog dana svakog 21-dnevnog ciklusa.
50% of previous dose a National Cancer Institute Common Toxicity Criteria (CTC v2.0; NCI 1998)
Zajednički kriteriji toksičnosti Nacionalnog instituta za rak (CTC v2.0; NCI 1998)
JMEN: Kaplan-Meier plots of progression-free survival (PFS) and overall survival pemetrexed versus placebo in patients with NSCLC other than predominantly squamous cell histology:
JMEN: Kaplan Meierova krivulja preživljenja bez progresije bolesti (PFS) i ukupnog preživljenja uz primjenu pemetrekseda u odnosu na placebo u bolesnika s NSCLC-om kod kojeg histološki ne prevladavaju skvamozne stanice:
Pemetrexed infusion solutions prepared as directed above are compatible with polyvinyl chloride and polyolefin- lined administration sets and infusion bags.
Otopina pemetrekseda za infuziju pripremljena na opisani način kompatibilna je s infuzijskim priborom i infuzijskim vrećicama od polivinilklorida i poliolefina.
1050 Bruxelles
50 000/mm
An analysis of the impact of NSCLC histology on the treatment effect on overall survival was in favour of pemetrexed versus docetaxel for other than predominantly squamous histologies (N = 399, 9.3 versus 8.0 months, (HR) = 0.78; 95% CI = 0.61-1.00, p = 0.047) and was in favour of docetaxel for squamous cell carcinoma histology (N =172, 6.2 versus 7.4 months, adjusted HR = 1.56; 95% CI = 1.08-2.26, p = 0.018).
Analiza utjecaja histologije NSCLC-a na učinak liječenja na ukupno preživljenje pokazuje prednost pemetrekseda u odnosu na docetaksel u tumora kod kojih histološki ne prevladavaju skvamozne stanice (N=399, 9,3 naspram 8,0 mjeseci, (HR) = 0,78; 95% CI = 0,61 - 1,00, p = 0,047) i prednost docetaksela u slučaju tumora kod kojih histološki prevladavaju skvamozne stanice (N=172, 6,2 naspram 7,4 mjeseci, prilagođeni HR = 1,56; 95% CI = 1,08 - 2,26, p = 0,018).
Due to the gastrointestinal toxicity of pemetrexed given in combination with cisplatin, severe dehydration has been observed.
Uočena je teška dehidracija zbog gastrointestinalne toksičnosti kod primjene pemetrekseda u kombinaciji s cisplatinom.
A multi-centre, randomised, double-blind, placebo-controlled Phase-3 study (PARAMOUNT), compared the efficacy and safety of continuation maintenance treatment with pemetrexed plus BSC (N = 359) with that of placebo plus BSC (N = 180) in patients with locally advanced (Stage IIIB) or metastatic (Stage IV) NSCLC other than predominantly squamous cell histology who did not progress after 4 cycles of first-line doublet therapy of pemetrexed in combination with cisplatin.
U multicentričnom, randomiziranom, dvostruko slijepom, placebom kontroliranom ispitivanju faze III (PARAMOUNT) uspoređivala se djelotvornost i sigurnost liječenja pemetreksedom kao terapije održavanja uz BSC (N = 359) s djelotvornošću i sigurnošću primjene placeba uz BSC (N = 180) u bolesnika s lokalno uznapredovalim (stadij IIIB) ili metastatskim (stadij IV) NSCLC-om kod kojeg histološki ne prevladavaju skvamozne stanice u kojih nije došlo do progresije nakon 4 ciklusa prve linije dvojne terapije pemetreksedom u kombinaciji s cisplatinom.
Large cell (N = 153)
Karcinom velikih stanica (N = 153)
In patients with mild to moderate renal insufficiency (creatinine clearance from 45 to 79 ml/min), the concomitant administration of pemetrexed with NSAIDs (e.g., ibuprofen) or acetylsalicylic acid at higher doses should be avoided for 2 days before, on the day of, and 2 days following pemetrexed administration (see section 4.4).
U bolesnika s blagim do umjerenim zatajenjem bubrega (klirens kreatinina od 45 do 79 ml/min) mora se izbjegavati istodobna primjena NSAIL-a (npr. ibuprofena) ili viših doza acetilsalicilatne kiseline dva dana prije, na sam dan i dva dana nakon primjene pemetrekseda (vidjeti dio 4.4).
Median overall survival (months) (95% CI)
Medijan ukupnog preživljenja (mjeseci) (95% CI)
Erythematous oedema mainly of the lower limbs has been reported with an unknown frequency.
Prijavljeni su slučajevi eritematoznog edema uglavnom donjih ekstremiteta s učestalosti nepoznato.