So Pemetrexed is an anti folate chemotherapy. And this only works in adenocarcinoma when you’re talking about lung cancers, it does not work in squamous cell carcinoma. Because it is an anti foliate, it’s important to take daily folic acid with your treatments throughout the duration of your treatments, as well as a every three week shot of vitamin B12. Some of the more common side effects are what’s called hand-foot syndrome, where you get either blistering or pain in your hands and feet. It can cause what’s called mucositis or basically lesions in your mouth or mucosal tissues that hurt, diarrhea, and a skin rash. One way to make these symptoms all better is to take dexamethazone. Generally, people recommend four milligrams twice a day the day before, on, and after your chemotherapy with Pemetrexed. Sometimes your physician may order a homocysteine level. And if this level is above 10, it may suggest that you have a higher risk of having what’s called grade three or grade four toxicities. And those are pretty serious that oftentimes require admission. Some of the ways to know if you’re getting low on your folate or B12 is that your red blood cells start getting bigger. However, this is something that happens with chemotherapy in general. In addition, deficiencies in this can cause some little memory short-term recall problems as well as neuropathy, which is a decrease of sensation in your hands and feet. However, chemotherapies can cause a lot of these problems and your physician will hopefully be making sure you’re supplemented.