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Alimta ® (pemetrexed for injection)
This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information.For current prescribing information for all Lilly products, including Summaries of Product Characteristics, Patient Information Leaflets and Instructions for Use, please visit: www.medicines.org.uk (England, Scotland, Wales) or www.emcmedicines.com/en-GB/northernireland/ (Northern Ireland).
Alimta® (pemetrexed): Storage and Stability of Reconstituted Vials
Reconstituted vials and diluted infusion solutions of pemetrexed are stable for up to 24 hours when stored under refrigeration 2°C to 8°C.
Reconstitution and further dilution prior to IV infusion are only recommended with 0.9% sodium chloride injection (preservative free), USP. Pemetrexed is physically incompatible with diluents containing calcium such as Lactated Ringer’s injection, USP and Ringer’s injection, USP. Coadministration of pemetrexed with other drugs and diluents has not been studied, and therefore is not recommended.1,2
Label Recommendations: Refrigerated Storage
When prepared as directed, reconstituted and infusion solutions of pemetrexed contain no antimicrobial preservatives. Chemical and physical in-use stability of reconstituted and infusion solutions of pemetrexed were demonstrated for 24 hours at refrigerated temperature. From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would not be longer than 24 hours at 2°C to 8°C.1
Discard any unused portion. Pemetrexed is not light sensitive.2
Guidance on Room Temperature Storage
Where reconstituted solutions of pemetrexed cannot be stored under refrigerated conditions for a certain period, Lilly advises customers to follow the USP guidance for low-risk compounded sterile preparations, prepared under aseptic technique (ISO Class 5 or cleaner air), which allows for the storing of reconstituted solutions such as pemetrexed at controlled room temperature for up to 6 hours in the vial and 12 hours in the infusion solution (for a total of 18 hours).2,3
Stability in Polypropylene Syringes
Although a stability study demonstrated that pemetrexed solutions were physically and chemically stable when stored in polypropylene syringes at room temperature for 2 days and when refrigerated for 31 days, this study did not address bacteriologic concerns.4 Therefore, storage should be limited to the manufacturer-recommended 24 hours under refrigeration.1
Stability in PVC Bags for >24 Hours
Although chemical stability is unaffected, a substantial amount of microparticulates may form if pemetrexed diluted in infusion solutions is stored under refrigeration in PVC bags for longer than 24 hours.5 Therefore, storage should be limited to the manufacturer-recommended 24 hours under refrigeration.1
Physical Instability of Frozen Solutions in PVC Bags
Although chemically stable, freezing of pemetrexed admixtures in PVC bags should be avoided due to the large number of microparticulates formed. Therefore, previously frozen pemetrexed solutions should not be used.6
3. The United States Pharmacopeial (USP) Convention, Inc. U.S. Pharmacopeia 43 and National Formulary 38 2S. Rockville, MD: United States Pharmacopeia Convention, Inc; 2020. http://www.usp.org/usp-nf
4. Zhang Y, Trissel LA. Physical and chemical stability of pemetrexed solutions in plastic syringes. Ann Pharmacother. 2005;39(12):2026-2028. http://dx.doi.org/10.1345/aph.1G161
5. Zhang Y, Trissel LA. Physical and chemical stability of pemetrexed in infusion solutions. Ann Pharmacother. 2006;40(6):1082-1085. http://dx.doi.org/10.1345/aph.1G715
6. Zhang Y, Trissel LA. Physical instability of frozen pemetrexed solutions in PVC bags. Ann Pharmacother. 2006;40(7-8):1289-1292. http://dx.doi.org/10.1345/aph.1G558
ISO = International Organization for Standardization
IV = intravenous
Lilly = Eli Lilly and Company
PVC = polyvinyl chloride
USP = United States Pharmacopeia
Date of Last Review: 07 December 2020