Lung Cancer Home > Alimta Warnings and Precautions

To help minimize side effects, you will need to take vitamin B12 and folic acid while taking Alimta. Other warnings and precautions include being aware that this product is probably not safe for use during pregnancy and telling your doctor about all your current medications. You shouldn't take this drug if you are allergic to albumin or any other ingredients used to make Alimta.

What Should I Tell My Healthcare Provider?

Prior to receiving Alimta® (pemetrexed), talk to your healthcare provider if you have:
  • Kidney disease, such as kidney failure (renal failure)
  • Pleural effusion (accumulation of fluid in the lining of the lungs and chest cavity)
  • Ascites (accumulation of fluid in the abdominal cavity)
  • Any allergies, including to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Alimta

Warnings and precautions to be aware this this medication include the following:
  • Alimta can decrease the ability of bone marrow to produce blood cells. This can result in anemia and other serious conditions. Because your immune system depends on certain blood cells, you may be more susceptible to infections while taking Alimta (see Chemotherapy and Infections)
You may also be at a higher risk for bleeding (see Blood Clotting Problems and Chemotherapy). You will need blood tests before each Alimta dosage to make sure your blood counts are not too low.
  • If your blood counts become too low while on this drug, your healthcare provider may need to reduce your dosage or delay future doses. In severe cases, you may have to stop taking Alimta altogether.
  • While taking Alimta, it is very important that you take folic acid supplements and get vitamin B12 injections as directed by your healthcare provider. This helps prevent or reduce the severity of some Alimta side effects. Your healthcare provider may also recommend that you take a corticosteroid (such as dexamethasone), as this reduces the risk and severity of skin rashes due to this medication.
  • Your healthcare provider should monitor your kidney function (using a simple blood test) before each dose of this medication, as you should not receive Alimta if your kidneys are functioning too poorly (the kidneys help clear this medication from the blood).
  • At this time, it is not fully known how conditions involving excess fluid accumulation in the body (such as with pleural effusion or ascites) may affect this medication, especially in severe cases (mild or moderate cases do not seem to affect the drug much). Your healthcare provider may need to drain the excess fluid before injecting you with Alimta, especially in cases of severe fluid excess.


  • Alimta can interact with other medications (see Alimta Drug Interactions).
  • Alimta is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug when pregnant (see Alimta and Pregnancy).
  • It is not known if Alimta passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Alimta and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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