New medicines
Alimta
Composition: Pemetrexed (as pemetrexed disodium).
Presentation: Powder for concentrate for solution for infusion.
Class: Folic acid analogues.
Indications: In combination with cisplatin for the treatment of chemotherapy-naive
patients with unresectable malignant pleural mesothelioma. Monotherapy
for the treatment of patients with locally advanced or metastatic non-small
cell lung cancer after prior chemotherapy.
Dosage: 500mg/m2 administered as an intravenous infusion over
10 minutes on the first day of each 21-day cycle. For malignant pleural
mesothelioma
the recommended dose of cisplatin to be used in combination with pemetrexed
is 75mg/m2 infused over two hours approximately 30 minutes
after the completion of the pemetrexed infusion on the first day of each
21-day
cycle.
Precautions: Patients should be monitored for myelosupression during
therapy. Patients should take folic acid and vitamin B12 to reduce treatment-related
toxicity.
Contraindications: Concomitant yellow fever vaccination. Breastfeeding
must be discontinued during therapy.
Side effects: Very common (>= 10 per cent) include decreased haemoglobin,
leucocytes and neutrophils or granulocytes, nausea, vomiting, fatigue
and rash.
Legal category: POM
Net price: 500mg vial £800.
Contact details: Alimta will be available from 29 November. Because it
is a specialised hospital product, supply will only be available direct
from the manufacturer at Eli Lilly and company, Lilly House, Priestley
Road, Basingstoke, Hampshire RG24 9NL. Tel 01256 315000.
Angiox
 Composition: Bivalirudin.
Presentation: Powder for concentrate for solution for injection or infusion.
Class: Antithrombotic agent.
Indications: Anticoagulation in patients undergoing percutaneous coronary
intervention.
Dosage: Intravenous bolus of 0.75mg/kg followed immediately by an intravenous
infusion at a rate of 1.75mg/kg/hour for at least the duration of the
procedure. The infusion may be continued for up to four hours post-PCI
as clinically warranted.
Major precautions: Angiox should not be administered intramuscularly.
Patients must be observed carefully for symptoms and signs of bleeding
during treatment. Preparations should be made to deal with allergic-type
hypersensitivity reactions which have been reported uncommonly in clinical
trials.
Contraindications: Patients with: active bleeding or increased risk of
bleeding because of haemostasis disorders or irreversible coagulation
disorders; severe uncontrolled hypertension and subacute bacterial endocarditis;
severe renal impairment or patients who are dialysis-dependent.
Side effects: Include major and minor bleeding. See SPC.
Legal category: POM
Net price: 10 x 250mg vials £3,100.
Contact details: Nycomed UK,
The Magdalen Centre, Oxford Science Park, Oxford, OX4 4GA.
Tel 01865 784500.
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