GemCarbo (gemcitabine and carboplatin)
This page tells you about the chemotherapy combination GemCarbo and its possible side effects. There is information about
GemCarbo is the name of a chemotherapy combination that includes the drugs
- Gem – Gemcitabine
- Carbo – Carboplatin
You can click on the links above to find out about the side effects of each individual drug.
GemCarbo is a treatment for
- Non small cell lung cancer
- Bladder cancer
- Advanced breast cancer
- Ovarian cancer
There are a number of different drug combinations for people with these cancer types. Your doctor will decide whether GemCarbo or another combination is best to treat your cancer.
You have the drugs into your bloodstream through a drip (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. The tube can stay in place throughout the course of treatment.
You usually have chemotherapy as cycles of treatment. Each GemCarbo treatment cycle takes 3 weeks. A usual course of treatment consists of 4 to 6 cycles making 3 to 4 months. On the first day of the cycle you have gemcitabine and carboplatin. A week later you have gemcitabine only. You then have a two week break with no treatment before starting another cycle.
We have listed the side effects associated with GemCarbo below. You can use the links to find out more about each side effect. Where there is no link please see our cancer drugs side effects section or use the search box at the top of the page.
More than 10 in every 100 people have one or more of these effects.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick is common but usually well controlled with anti sickness injections and tablets. The sickness may last for quite a few days. Let your doctor or nurse know if it is not controlled as there are other anti sickness medicines you can have
- Kidney changes that are mild and unlikely to cause symptoms may occur. These will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your kidneys are working
- A high temperature (fever) about 6 to 12 hours after having gemcitabine happens in about 4 out of every 10 people – it may last about 12 hours. This is a reaction to the drug, and does not mean you have an infection. Taking paracetamol every 6 to 8 hours should control your temperature
- Flu like symptoms occur in about 2 in 10 people having gemcitabine and start a few hours after the infusion, The effects include headaches, muscle aches, a raised temperature and shivering
- A skin rash, which may itch, occurs in about 1 in 4 patients
- Swelling in the face, hands and feet occur in about 3 out of every 10 patients – this usually goes away on its own but tell your doctor or nurse if you notice any swelling
- Numbness or tingling in fingers and toes happen in about 1 out of 25 people (4%). It can cause difficulty with fiddly things such as doing up buttons. It starts within a few days or weeks and usually goes within a few months of finishing treatment
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Liver changes that are very mild and unlikely to cause symptoms may occur. The liver will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
Between 1 and 10 in every 100 people have one or more of these.
- Hair loss or thinning
- Loss of appetite
- Change in the taste of food and drinks
- Diarrhoea or constipation
- A sore mouth or mouth ulcers
- Wheeziness or breathlessness occur in about 1 in 12 people treated with gemcitabine, caused by inflammation of the lungs
- Sleepiness affects about 1 in 10 people soon after having gemcitabine – this usually goes away on its own but tell your doctor or nurse
- Some people have an allergic reaction while having GemCarbo treatment, usually at the first or second treatment – let your treatment team know immediately if you have any skin rashes, itching, or if you feel hot or shivery. Also tell them if you go red in the face, or have dizziness, headaches, shortness of breath, anxiety, or a sudden need to pass urine
A very few people may have ringing in the ears (tinnitus) or damaged hearing (especially loss of high tones) after GemCarbo treatment.
You may have a few of the side effects on this page. They may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
These drugs may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drugs may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This information does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information about GemCarbo drugs look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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