Gemcitabine

What is gemcitabine?

Gemcitabine (also known as Gemzar^®) is an anticancer medication. It is a colorless liquid given into a vein (IV) over a period of time.

Gemcitabine can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”

Possible side effects of gemcitabine

Early

• Flu-like reaction, which may cause fever, chills, headache, shortness of breath, and dizziness
• Feeling tired or weak
• Nausea or vomiting

Later (more than a day after treatment starts)

• Low blood counts, which can increase the chance of getting an infection, bleeding, or feeling more tired than usual.
• Mouth and lip sores
• Diarrhea or constipation
• Decreased liver and kidney function
• Bleeding and blood clots
• Swelling in the arms or legs
• Changes in your electrolytes
• Rash or “sunburn”

If you have any of these side effects, tell the doctor right away:

• An allergic reaction, including itching, skin redness, severe chills, shortness of breath, low blood pressure, or pain in the chest, side, or back
• Trouble breathing
• Very upset stomach or vomiting
• Yellow eyes or skin
• Dark urine or a decrease in how much or how often you urinate

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Pregnancy risk of gemcitabine

This medicine may be harmful to an unborn child. Avoid becoming pregnant during treatment. Contact one of your caregivers at St. Jude if you are sexually active or think you might be pregnant.

Special instructions for gemcitabine

• Gemcitabine may suppress bone marrow function and cause low blood cell counts. Tell the doctor right away if you have any symptoms of infection, such as a fever or chills.
• It may be easier for you to get infections while you are receiving gemcitabine. Stay away from crowds or people with colds, flu, or other infections.
• If you notice bleeding or unexplained bruising, tell the doctor and be careful to avoid injury. Do not take any medicine that contains aspirin, ibuprofen, or blood thinners without first talking to your doctor. These may increase your risk of bleeding.
• Tell the doctor if you are feeling more tired than usual, because you may need a blood transfusion.
• Patients who have received radiation therapy before, during, or after gemcitabine may get a skin rash, including redness, swelling, and blistering of the skin that received radiation. The rash can be painful and look like a sunburn. Your doctor may call this radiation recall.
• The doctor may ask you to take diphenhydramine (Benadryl^®) and acetaminophen (Tylenol^®) before gemcitabine is given to prevent the flu-like side effects that can occur. You may be asked to take more doses of acetaminophen (Tylenol^®) after you receive gemcitabine if you have flu-like side effects.
• The staff will take blood samples regularly to check for changes in liver and kidney function as well as blood counts. This may result in a dose decrease or a delay in your treatment.
• This medicine might make your mouth sore and irritated. The doctor or nurse may give you oral rinses to keep your mouth clean after you receive gemcitabine.
• Gemcitabine can cause nausea and vomiting. The doctor may prescribe medicine to keep you from feeling sick and throwing up after you receive gemcitabine.
• Tell dentists, surgeons, and other doctors that you are using this medicine.
• Always give a complete list of medicines you are taking to your doctor or pharmacist. Check with your doctor or pharmacist before starting any new vitamins, herbals, or other medicines.