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Unnecessary supplementation may mask other underlying causes of fatigue or health concerns

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For severe thrombocytopenia, platelet transfusions might be needed to prevent life-threatening bleeding

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Some common side effects of pemetrexed are: Upset stomach, nausea, and vomiting Diarrhea or constipation Changes in taste or loss of appetite Fatigue Sores in the mouth Temporary hair loss Rash Some patients using pemetrexed can experience severe nausea, diarrhea, and vomiting