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Updated: Feb 16, 2026

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Published on: July 11, 2013
Mandatory dexamethasone strictly monitored by pharmacists reduces the severity of pemetrexed-induced skin rash
Naoko Usui1, Yoko Kondo1, Noriko Ryota2
1Department of Pharmacy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Osaka, Japan.
Objective:
The present study aimed to retrospectively examine the effectiveness of mandatory dexamethasone (m-DEX) strictly monitored by pharmacists collaborating with medical physicians and nurses for reducing pemetrexed (PEM)-induced skin rash in patients with non-squamous non-small-cell lung cancer (ns-NSCLC).
Methods:
We compared the rash grades during the first cycle of PEM-containing regimens between patients who received m-DEX after February 2012 and those who received dexamethasone (DEX) at their physician's discretion (d-DEX) before January 2012.
Results:
Of 163 patients with ns-NSCLC included in this study, 89 received d-DEX and 74 received m-DEX. The mean DEX doses the night before and the day after PEM administration were significantly higher in the m-DEX group than in the d-DEX group. The frequency of grade ≥2 skin rash was significantly lower in the m-DEX group than in the d-DEX group.
Conclusions:
The use of m-DEX strictly monitored by pharmacists might significantly reduce the severity of PEM-induced skin rash.
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