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Delay initiation of the next cycle of pemetrexed for injection until: Upon recovery, modify the dosage of pemetrexed for injection in the next cycle as specified in Table 1

Frank deficiency (below 145 pmol/L): I start aggressive supplementation, often intramuscular for post-RYGB patients, and I will want repletion confirmed on a follow-up blood test before I am comfortable proceeding with surgery