Folic Acid Analog

4 Drugs classified under this drug class

Folic Acid Analog. Methotrexate 25 mg/ml.
VIAL (sol. for inj.): 25 mg/ ml X 2 ml, 4 ml,
8 ml, 20 ml, 40 ml. Dose must be ajust.
individ. for each pt. accord. to med.
cond. See lit.
Antineopl. Chemother.
Tmt. of gestational choriocarcinoma,
chorioadenoma destruens and
hydatidiform mole. Palliation of ALL. Tmt.
and proph. of menin. leukemia.
Greatest effect has been observed in
palliation of acute lymphoblast.(stemcell)
leukemias in child. In comb. with
other anticancer agents, may be used for
the induc. of remis.,but is most common.
used in the mainten. of induced remis.
May be used alone, or in comb. with other
antineoplastic drugs, in the manag. of
breast canc., epidermoid cancers of the
head and neck, lung cancer (partic.
squamous cell ,small cell types), bladder
cancer and osteogenic cancer. Tmt. of the
advan.stages (III and IV, Peter’s Staging
system) of lymphosarcoma, partic. in
child., and in advanced cases of mycosis
fungoides.
Psoriasis. Indic. only in the sympt. control
of sev. recalcitrant, disabling psoriasis
which is not adeq. responsive to other
forms of therapy, and only when the diag.
has been established, as by biopsy and/or
after dermat. consult. RA:Tmt. of selec.
adul.with sev. RA, only when the diag. has
been well established accord. to rheumat.
standards, with inadeq. response to other
forms of antirheum. ther., includ. full dose
NSAIDs and usually a trial of at least one
or more dis.-modif. antirheum. drugs.
C/I: Pregnancy, lact., pts. in poor state of
nutrition, sev. ren. impair. (crCL <20 ml/
min), sev. liver impair., bone marrow
hypoplasia, leucopenia,
thrombocytopenia, anemia, alcohol
abuse, hypersens. and lung toxic.due to
methotrexate, serious, acute or chronic
infect. such as tuberculosis and HIV,
ulcers of the oral cavity and known
active GI ulcer dis. Concur. vaccin. with
live vaccines.

Folic Acid Analog. Pralatrexate 20 mg/ml.
VIAL (sol. for inject.): 1 x 20 mg/ml; 40
mg/ 2 ml. 30 mg/m² admin. as I.V. push
over 3-5 mins via side port of free-flow.
0.9% sod. chlor. inject., USP I.V. line 1 x
wkly for 6 wks in 7-wk. cycles until dis.
progress./unaccept. toxicity. Admin.
under vis. of qualified phys.
experienced in antineoplastic agents.
See lit.
Tmt. relapsed or refract. peripheral T-cell
lymphoma (PTCL).

Folic Acid Analog. Pemetrexed (as diacid monohydrate) 25 mg/ml.
Sol for IV inf. 1 X  4/20/34/40 ml . Dose 500 mg/m² of body surface area (BSA) admin. as an IV inf. over 10 min. on the first day of each 21-day cycle. See lit.
In comb. with cisplatin, for the tmt. of pts with malign. pleural mesothelioma whose dis. is unresect. or who are not candid. for curatible surg. In combin. with cisplatin, for the first line tmt. of pts with locally adv. or metast. non-small cell lung canc. (NSCLC) other than predomin. squam. cell histol. As monother. for the sec. line tmt. of pts with locally adv. or metast. NSCLC other than predom. squam. cell histol. As monother. for the maint. tmt. of locally adv. or metast. NSCLC other than predom. squam. cell histol. in pts whose dis. has not progr. immediate. follow. platinum-based chemother.
C/I: Hypersens. Lact. Concom. yellow fever vacc.

Folic Acid Analog. Pemetrexed 100, 500, 1000 mg.
VIAL (Pwdr. for conc. for sol. for infus.): 1 x 100 mg, 500 mg, 1000 mg. Tmt. to be initiated by physician experienced in the use of anticancer ther. In comb. with cisplatin: recomm. dose is 500 mg/m2 of BSA admin. as IV infus. over 10 min. on the 1^st day of each 21 d cycle. The recomm. dose of cisplatin is 75 mg/m2 BSA infus. over 2 h approx. 30 min. after completion of pemetrexed infus. on the 1^st  d of each 21 d cycle. As single agent: In pts. treated for NSCLC after prior chemother., the recomm. dose is 500 mg/m2 BSA admin. as IV infus. over 10 min. on the 1^st d of each 21d cycle. See lit.
Malignant pleural mesothelioma: in comb. with cisplatin is indic. for the tmt. of pts. with malign. pleural mesothelioma whose dis. is unresectable or who are otherwise not candidates for curatible surgery. Non-small cell lung cancer: In comb. with cisplatin is indic. for the 1^st  line tmt. of pts. with locally adv. or metast. non-small cell lung cancer other than predominantly squamous cell histology. As monother. for the mainten. tmt. of locally adv. or metast. non-small cell lung cancer other than predominantly squamous cell histology in pts. whose dis. has not progressed immed. follow. platinum-based chemotherapy.  As monother. for the 2^d  line tmt. of pts. with locally adv. or metast. non-small cell lung cancer other than predominantly squamous cell histology.
C/I: Hypersens., Lact., Concom. yellow fever vacc.