Gemcitabine (Intravenous)

Overview

Gemcitabine (Gemzar) belongs to the class of medicines known as antimetabolites. It's used together with other medicines or alone to treat cancers of the ovary, breast, lung and pancreas. It may also help treat other types of cancer, as decided by your doctor.

Gemcitabine stops cancer cells from growing, eventually destroying them. As this medicine may also affect the growth of regular cells, other effects will occur as well. Some of them may be severe and you must report them to your physician. Other effects, including hair loss, may cause concern but may be less serious. Some Gemcitabine effects may happen even after you stop treatment.

Gemcitabine is only available with a physician's prescription under the brand name Gemzar.

Conditions Treated

Type Of Medicine

  • Antimetabolite

Side Effects

Like any treatment, side effects may occur with Gemcitabine treatment. Everybody reacts differently to medications and some persons suffer more effects than others. The following effects won't affect everyone and they can normally be controlled. If you're receiving other anticancer or chemotherapy medications with Gemcitabine, you also may experience side effects from those medications.

If you're worried about any of these side effects, please talk to your cancer specialist (oncologist) or chemotherapy nurse.

Common side effects

  • Fatigue (extreme tiredness) this is a common Gemcitabine side effect. For the better part of the treatment, you may feel exhausted or tired. There are methods to deal with extreme tiredness. You may want to have a tiredness diary. This will help you know when you've got more energy to carry out tasks. This can help you rest when you're more exhausted and plan activities when you're feeling better.
  • Higher risk of infection this medication can raise your risk of developing an infection, as it may lower your white blood cell count. This means your ability to fight infections may be reduced. Symptoms of an infection can include aching muscles, high temperature, headaches, sore throat, a cough or feeling cold and shivery.
  • Nausea or vomiting this is quite a common Gemcitabine side effect but it can be managed with anti-sickness medicine. You'll usually receive medicine before the start of your chemotherapy to help prevent or control sickness. If it fails to work, tell your nurse or doctor. You may be told to alter the medication.
  • Bruising and bleeding this medicine can reduce the platelet count in your blood. Your blood clots with the help platelets. You may have nosebleeds, bleeding gums, small red spots on the skin or bruise quite easily than usual. You may have bloody urine but this is not common. Consult your nurse or doctor promptly about any of the above effects, because your dose of chemotherapy medicine may have to be decreased.
  • Hair loss Gemcitabine can make you lose some hair or make your hair thin. Your hair should be able to grow again after you stop treatment. Your nurse may give you tips on coping with hair loss.
  • Allergic reactions Gemcitabine can trigger an allergic reaction when you're receiving it. Signs of this may include an itchy rash or high temperature. If this occurs, tell your doctor or nurse promptly because any reaction will require urgent treatment.
  • Mild breathing problems soon after the start of Gemcitabine infusion, you may experience mild breathing problems or feel breathless, but this shouldn't last long. If these symptoms do not get better, inform your doctor or nurse.
  • Diarrhea if you suffer diarrhea, be sure to take lots of fluids. If your diarrhea occurs more than four times daily, inform your nurse or doctor. They may hand you medicine to manage it or decrease the dose of your chemotherapy medication in future cycles.
  • Swelling (oedema) some persons may develop oedema, which is an accumulation of fluid in the feet, ankles, face, and fingers, making one look swollen. Usually, the swelling eventually improves but it can be helpful to place your legs on a cushion while you're sitting to help drain the fluid. Your doctor can prescribe medicine for oedema.
  • Flu-like symptoms 24-48 hours after getting Gemcitabine, you may develop a fever and flu-like symptoms. Drinking lots of water may help, as can taking paracetamol. If these symptoms do not get better, tell your nurse or doctor.
  • Sore mouth/mouth ulcers this may be severe or mild, making drinking and eating difficult. Try to regularly clean your teeth using a soft toothbrush, drink a lot of fluids and avoid citrus or spicy foods that may sting your mouth. You may also be given useful antibacterial mouthwash. Using painkillers like ibuprofen or paracetamol may also help.
  • Anemia/low red blood cell count Gemcitabine may reduce your red blood cell count (anemia). This may make you feel short of breath, faint, or tired. If you're severely anemic, you may require additional red blood cells through blood transfusion.
  • Liver problems Gemcitabine can affect your liver function. You'll have blood tests regularly to monitor how your liver is functioning.
  • Constipation if this occurs, drink a lot of fluids and eat fiber-rich foods, such as fruit and vegetables. Gentle exercise like walking may help too. There medicines available to help control constipation.

Less common Gemcitabine side effects:

  • Heart problems Gemcitabine may cause breathlessness, a fluttering heart or palpitations. Tell your nurse or doctor if you develop such symptoms. He or she may prescribe medicine. These symptoms normally end after treatment.
  • Severe breathing problems this medication may cause lung issues, including inflamed lungs, which is really rare though. If you develop a persistent dry cough or shortness of breath, call up your healthcare professional. You may require additional tests to examine your lungs or your doctor may provide different chemotherapy treatment.

These aren't all the possible Gemcitabine side effects. Please speak to your nurse or doctor for more details if you develop anything out of the ordinary.

Dosage

Gemcitabine is normally used together with another chemotherapy medication, either Paclitaxel (Taxol) or Carboplatin.

Gemcitabine is given into a vein as a drip (intravenously) in the arm or hand, but there are other methods of administering it depending on such factors as your preferences and how simple it is for medical staff to locate suitable veins.

Chemotherapy is usually given in a series of therapies with a recess between each therapy to allow your body to recuperate from any temporary side effects. The therapy and interval before the next therapy begins is called a cycle.

A Gemcitabine cycle, with either paclitaxel or carboplatin, lasts 3 weeks, with treatment administered on the first and eighth days of the cycle.

The full number of treatment cycles will be based on your specific situation. Your cancer specialist will talk about this with you.

Interactions

When you're taking Gemcitabine, it's critically important to let your healthcare specialist know if you're using any of the drugs listed below. These interactions aren't necessary all-inclusive and have been picked based on their potential impact.

Using Gemcitabine with any of these drugs isn't recommended. Your healthcare specialist may opt to not treat you with Gemcitabine or may ask you to stop taking some of the drugs.

Using Gemcitabine with any of these drugs is normally not advised, but it sometimes may be necessary. If your doctor prescribes both drugs together, he or she may alter your dose or the frequency of using both or one of the medications.

  • Live influenza virus vaccine
  • Adenovirus vaccine
  • Live cholera vaccine
  • Live Guerin and Bacillus of Calmette vaccine
  • Live poliovirus vaccine
  • Typhoid vaccine
  • Smallpox vaccine
  • Yellow fever vaccine
  • Warfarin

Warnings

It's vitally important for your healthcare specialist to regularly check your progress to ensure that Gemcitabine is working well. You'll need blood tests to check for undesirable effects.

While receiving Gemcitabine, and after the end of the treatment, do not receive any vaccinations (immunizations) without informing your doctor first. Gemcitabine may reduce your body's resistance, potentially causing you the infection for which you receive the immunization.

In addition, other people living in your house shouldn't have oral polio vaccine, because there's a possibility they might give you the polio virus. Also, avoid people who have received oral polio vaccine in the last few months. If you can't observe these precautions, please consider putting on a protective mask to cover your mouth and nose.

Gemcitabine can make you drowsy. Please don't use machinery, drive, or do anything that requires you to be alert until you're certain you can do such things safely. Take alcoholic drinks in moderation.

Before having an operation, inform your dentist or doctor about all the medicine products you take (such as prescription and non-prescription medicines, vitamins, and herbal supplements).

Gemcitabine may make you highly likely to suffer infections or can worsen any existing infections. Please stay away from people with infections that can spread to others (like flu, measles, and chickenpox). Consult your healthcare specialist for more information or if you've been exposed to any infection.

Chemotherapy medications can lower your blood cell count. Having fewer white blood cells can increase your vulnerability to infections. Having fewer red blood cells leads to anemia and having fewer platelets can cause blood clotting problems. For this reason, you'll require blood tests regularly to check your blood cells during Gemcitabine treatment.

If your blood cell count drops, there are some precautions you should take to lower the risk of bleeding or infection:

  • Check with your physician immediately if you develop any abnormal bruising or bleeding, tarry, black stools, blood in stools or urine, or red pinpoint spots on the skin.
  • Be cautious when using a standard toothpick, toothbrush, or dental floss. Your dentist or doctor or nurse can recommend other methods to clean your gums and teeth. Also, consult your medical doctor before you have any dental treatment.
  • Don't touch inside your nose or your eyes unless you've just cleaned your hands and haven't touched anything else for now.
  • Be careful to not cut yourself when using sharp objects like toenail or fingernail cutters or a safety razor.
  • Avoid sports that involve contact or other situations in which injury or bruising could occur.

Tell your doctor promptly if you suffer any of the symptoms below during your treatment with this medicine, as they can indicate issues with blood cells, sore throat or mouth, unexplained bleeding or bruising, purple spots, fever (high temperature) or other infection signs, mouth ulcers, or suddenly feeling breathless, tired, or generally unwell.

You'll also need blood tests regularly to monitor your liver and kidney function while you're receiving Gemcitabine treatment.

Gemcitabine may affect your lungs. Please tell your healthcare professional if you develop shortness of breath or any breathing difficulty during treatment with Gemcitabine.

Since Gemcitabine may harm an unborn child, you should make use of effective birth control methods to avoid fathering a child or getting pregnant during treatment. Continue to use birth control to avoid getting pregnant for at least 6 months after you stop treatment with Gemcitabine. Women should immediately consult their doctor if they get pregnant while receiving treatment.

It's unknown whether Gemcitabine is released into human milk. Women who are receiving Gemcitabine treatment shouldn't breastfeed. Please consult your doctor about this.

This medicine may affect your ability to father a child or get pregnant. It's vital to talk about fertility with your physician before commencing treatment.

You should not use Gemcitabine if you've got allergies to some of its ingredients. Be sure to inform your pharmacist and physician if you have had such an allergy before.

If you feel you've had an allergy, stop using Gemcitabine and alert your physician and pharmacist promptly.

Storage

Since you'll receive Gemcitabine in a hospital or clinic environment, you won't keep it at home.

Summary

Gemcitabine is injected through an IV into a vein. You'll receive the injection in a hospital or clinic environment. Gemcitabine is normally given once per week for a number of weeks. The medication must be administered slowly, and it may take up to half an hour to complete the IV infusion.

Gemcitabine can decrease your blood cell count, making you more susceptible to infections. This may make you fall ill from being around people who are ill or bleed more easily from an injury. To ensure your blood cell count doesn't drop too low, you'll need regular blood tests. You may also need liver and kidney function tests. Don't miss any scheduled appointments with your doctor.

Gemcitabine may affect your lungs, kidneys, or liver. Tell your physician if you've got stomach pain, yellow eyes/skin, dark urine, swelling, little or no urination, very serious shortness of breath, rapid weight gain, wheezing, or a cough containing foamy mucus.

Do not have a œlive vaccine while you're receiving Gemcitabine treatment, and avoid being around anyone who has had a live vaccine recently. There's a possibility that you could get the virus.

If you receive this medication after or during treatment, alert your doctor at once if you develop skin redness, oozing, peeling, or swelling. If a drop of Gemcitabine comes into contact with your skin, make sure to thoroughly wash the area with warm water and soap.

Gemcitabine may also be taken for other purposes not discussed above. For more details, please consult your healthcare provider.