Gemcitabine (Gemzar®)
Gemcitabine (pronounced gem-sight-a-been) is a chemotherapy drug that is given as a treatment for some types of cancer. It is most commonly used to treat non-small cell lung cancer, pancreatic, bladder and breast cancer. This information describes gemcitabine, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about your type of cancer, which give more information and advice.
If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.
- What gemcitabine looks like
- How it is given
- Possible side effects
- Less common side effects
- Additional information
What gemcitabine looks like
Gemcitabine is a colourless fluid after being dissolved from a white powder.
How it is given
Gemcitabine may be given:
- as a drip (infusion) through a fine tube (cannula) inserted into a vein, over a short period of time
- through a central line, which is inserted under the skin into a vein near the collarbone, or a PICC line inserted into a vein in the crook of your arm.
Possible side effects
Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given gemcitabine, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common and less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
Lowered resistance to infection Gemcitabine can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily, and will usually have returned to normal levels before your next course of chemotherapy is due.
Contact your doctor or the hospital straightaway if:
- Your temperature goes above 38ºC (100.5ºF)
- You suddenly feel unwell (even with a normal temperature).
You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Bruising or bleeding Gemcitabine can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.
Anaemia (low number of red blood cells) While having treatment with gemcitabine you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these are a problem.
Feeling sick (nausea) and vomiting If you do feel sick this will usually begin a few hours after the treatment is given and may last for up to a day. This is usually mild and your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs which can prevent or greatly reduce nausea and vomiting. If the sickness is not controlled, or continues, tell your doctor. They can prescribe other anti-sickness drugs that may be more effective.
Loss of appetite This is usually mild and may last a day or so. A dietitian or specialist nurse at your hospital can give advice and tips on boosting your appetite, coping with eating difficulties and maintaining weight.
Temporary effect on liver function Gemcitabine may cause changes in the way that your liver works, though your liver will return to normal when the treatment is finished. You are very unlikely to notice any problems but your doctor will check your liver is working properly before each treatment.
Change in kidney function Some people have a small amount of blood or protein in their urine when it is tested. You are very unlikely to notice any change and it is unlikely to cause any harm.
Skin changes Gemcitabine can cause a rash, which may be itchy. Your doctor can prescribe medicines to relieve the symptoms. You may also notice some swelling of your ankles. This is usually mild and goes away after the treatment ends.
Flu-like illness Occasionally a flu-like illness may occur with gemcitabine. You may have headaches, aching joints and muscles and a high temperature. You should always let your doctor know about a high temperature immediately.
Fluid retention This may cause swelling of the ankles or breathlessness. Let your doctor know if you notice this effect.
Tiredness and feeling weak You may feel very tired. It is important to allow yourself plenty of time to rest.
Less common side effects
Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help reduce the risk of this happening. Tell your doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.
Breathlessness Rarely, gemcitabine can cause temporary breathlessness. Contact your doctor if you feel breathless.
Diarrhoea This can usually be easily controlled with medicine but tell your doctor if it is severe or if it continues. It is important to drink plenty of fluids if you do have diarrhoea.
Hair loss This is rare with gemcitabine, but may occasionally happen. More commonly your hair may just thin. Hair loss is temporary and your hair will regrow once the treatment ends.
Additional information
Gemcitabine may cause drowsiness. Take care if you are driving or operating machinery following this treatment.
Other medicines Some medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.
Contraception It is not advisable to become pregnant or father a child while taking gemcitabine, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.
