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Get bloodwork including B12, iron, vitamin D, and a comprehensive metabolic panel every 8 to 12 weeks while on treatment

Because anti-folates can interfere with the normal metabolic pathway of folates in the body, it might be reasonable to speculate that treatment with pemetrexed would alter folate metabolism and that this would be reflected by an elevation of plasma Hcy concentration

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Vitamin B12 is essential for many bodily functions, including the formation of red blood cells and the maintenance of a healthy nervous system