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Cancer Treatment Information

Treatment Options > Chemotherapy > OncoLink Rx

Gemcitabine (Gemzar®)

Hematology-Oncology Patient/Family Education Comittee
Hospital of the University of Pennsylvania
Last Modified: November 1, 2001

Gemcitabine (gem cy tabine )
Other Name: Gemzar^®

How it is given:	Gemcitabine is injected into a vein. It can be given alone or with other drugs.
How it works:	Gemcitabine slows or stops the growth of cancer cells in your body.

Side Effects And Precautions

Let your doctor or nurse know if you have any allergies and what medications you are currently taking, both prescription and over the counter medications. This includes vitamins, herbs, nutritional supplements and any recreational drugs. Ask your doctor about drinking alcoholic beverages. Not everyone experiences side effects during chemotherapy and most side effects are temporary. The side effects that you may experience are:

Common Side Effects

Decrease in the number of white blood cells (neutropenia)
Puts you at risk of infection.
What to do: Call your doctor or nurse for a fever of 100.4 F or greater. Avoid people with the flu or colds. When working in your yard, wear protective clothing including long pants and gloves. Do not handle pet waste. Keep all cuts or scratches clean. Shower or bath daily and refer to Chemotherapy and You (NCI, 1997) for mouth care. Do not cut cuticles or ingrown nails. You may wear nail polish but not fake nails. Ask your doctor or nurse before scheduling dental appointments or procedures. Ask you doctor or nurse before you or a family member has any vaccinations.

Decrease in red blood cells (anemia)
Causes loss of energy.
What to do: Call your doctor or nurse if you feel more tired than usual or short of breath while doing normal activities.

Decrease in platelets (thrombocytopenia)
Puts you at risk for bruising and bleeding.
What to do: Call your doctor or nurse if you notice any unusual bruising or bleeding. Do not floss or use toothpicks. Use a soft-bristle toothbrush or cotton swab. Ask your doctor or nurse before scheduling dental appointments or procedures. Use an electric razor to avoid cuts. Do not use medication containing aspirin or ibuprofen without asking your doctor or nurse.

Nausea and Vomiting
What to do: Take your anti-nausea medications as prescribed. Try to drink 6-8 glasses of fluid a day. Avoid eating fatty foods, large meals, and acidic foods (e.g. tomatoes, lemons, oranges, grapefruits) and spicy or hot foods when you feel nauseated. Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Decreased appetite
What to do: Try to eat five or six small meals or snacks throughout the day. If you are not eating enough, nutritional supplements may help. Ask your nurse for a copy of the Eating Hints booklet (NCI, 1995) and about nutritional counseling services.

Diarrhea
What to do: Call you doctor or nurse if you experience an increase in the number of stools, an increase in the volume of stool or if the stool becomes more liquid. Take the antidiarrheal medication your doctor has prescribed. Increase your fluid intake by drinking more liquids than usual (e.g. sport drinks, broth, gelatin, popsicles, soups). Eat bland foods such as bananas, rice, unsweetened applesauce, toast, cereal, and potatoes. If the diarrhea continues, contact your doctor or nurse again.

Effect on skin
What to do:Call your doctor or nurse if you develop a rash, especially if it is itchy. Your doctor may prescribe a cream or ointment.

Fever
Gemcitabine can cause a low-grade fever the night after your treatment and for 2-3 days after treatment.
What to do:Call your doctor or nurse if you have a fever greater than 100.4F or chills.

Flu-like symptoms
What to do: Call your doctor or nurse if you have a fever greater than 100.4F, weakness, body aches, decrease appetite or headache.

Uncommon Side Effects

Mouth ulcers (sores)
What to do: Call your doctor or nurse if your mouth, tongue or inside of your cheek becomes white, ulcerated or painful. Brush with a soft-bristle toothbrush or cotton swab twice a day. Avoid mouthwashes that contain alcohol. A baking soda and/or salt warm water mouth rinse (2 level teaspoons of baking soda or 1 level teaspoon salt in an eight ounce glass of warm water) is recommended 4 times daily. If your mouth becomes dry, eat moist foods, drink plenty of fluids (6-8 glasses) and suck on sugarless hard candy. Avoid drinking alcoholic beverages and citrus juices, smoking and chewing tobacco.

Loss or thinning of scalp and body hair (alopecia)
Your hair may become thinned, brittle or may fall out. This may begin two weeks after treatment starts.
What to do: The use of scarves, wigs and hairpieces may help during this temporary condition.

Liver changes
Your doctor may order some blood tests to check your liver function.
What to do: Call your doctor or nurse immediately if you have abdominal pain, if you pass dark urine, or if your skin or the white of your eyes become jaundiced (yellow in color).

Lung changes
What to do: Call your doctor or nurse if you have shortness of breath, cough or difficulty breathing.

Kidney changes
Your doctor may order blood tests to check your kidney function.
What to do: Drink 6-8 glasses of fluids a day. Call your doctor or nurse if you notice blood in your urine, have difficulty or pain during urination or have no urine output for more than 12 hours.

Nervous system changes
What to do: Call your doctor or nurse if you experience numbness, tingling, or a "pins and needles" feeling in your hands or feet.

Fluid retention
What to do: Call your doctor or nurse if you experience swelling of hands, feet or abdomen.

Sexual and reproductive changes
The menstrual cycle and sperm production may become irregular or stop permanently. Women may experience menopausal effects including hot flashes and vaginal dryness. The desire for sex may decrease during treatment. Exposure of an unborn child to this medication could cause birth defects.
What to do: Discuss with your doctor or nurse how these changes will affect you. You may want to ask about sperm banking, egg harvesting, menopausal symptoms, sexual or relationship problems. Effective birth control is necessary during treatment. Contact your doctor or nurse if you think you may be pregnant. Do not breast feed while on this medication.