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Gemcitabine (Gemzar)

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This page tells you about the chemotherapy drug gemcitabine and its possible side effects. There are sections about


What gemcitabine is

Gemcitabine is one of a group of chemotherapy drugs called anti metabolites. Anti metabolites are similar to normal body molecules but they are slightly different in structure. These differences mean that anti metabolites stop cells working properly. 

It is a treatment for

  • Cancer of the pancreas
  • Non small cell lung cancer
  • Breast cancer that has spread (in combination with paclitaxel)
  • Bladder cancer that has spread (in combination with cisplatin)
  • Ovarian cancer (in combination with carboplatin)

Gemcitabine is also sometimes used for other types of cancer as part of clinical trials.


How you have gemcitabine

Gemcitabine is a clear liquid. You have it into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it 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. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it. Having the drip usually takes about half an hour.

You can read our information about having chemotherapy into a vein

You usually have gemcitabine as a course of several cycles in which you have the treatment and then a time with no treatment to allow the body to recover. The exact treatment plan depends on which type of cancer you have. 

The side effects associated with gemcitabine are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link please look in our cancer drugs side effects section or use the search box at the top of the page.


Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • 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, breathlessness and looking pale 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 bleeding gums after brushing your teeth or nosebleeds. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia). Tell your doctor or nurse straight away if you have any bleeding that won't stop or any blood in your urine
  • Tiredness and weakness (fatigue) during and after the course of treatment. Most people find their energy levels are back to normal from 6 months to a year after their treatment ends
  • Drowsiness may oocur for a few hours after having treatment due to small amounts of alcohol in the drug compound – drinking alcohol may make the drowsiness worse
  • Feeling or being sick is usually mild and happens to about 7 out of 10 people (70%)
  • Liver changes affect about 6 out of 10 people – you are unlikely to notice any symptoms and your liver function will almost certainly go back to normal when treatment ends. You will have regular blood tests to check how well your liver is working
  • Flu like symptoms happen in about 2 in 10 people (20%) a few hours after treatment. This may include headaches, muscle aches (myalgia), a high temperature and shivering. Taking paracetamol every 6 to 8 hours can help
  • Swelling in the face, hands and feet occurs in about 3 out of every 10 people (30%) treated – this usually goes away on its own, but tell your doctor or nurse if you have it
  • Wheeziness or breathlessness soon after having the drug happen in from 1 to 4 out of 10 people (10 to 40%) – let your doctor or nurse know straight away if it is severe
  • Small amounts of blood and protein in your urine may be found when your nurse tests your urine. This is not harmful
  • A skin rash happens in about 1 in 4 people (25%)
  • Hair thinning

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Diarrhoea or constipation – drink plenty of fluids and tell your doctor or nurse if it becomes severe or continues for more than 3 days
  • Difficulty sleeping
  • A sore mouth or mouth ulcers – contact your doctor or nurse straight away if you have this
  • Loss of appetite
  • Itchy skin soon after having the drug – let your doctor or nurse know if you have this
  • Women may stop having periods (amenorrhoea) – 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
  • A cough
  • Back or muscle pain
  • A runny nose
  • Sweating
  • Headaches

Rare side effects

Fewer than 1 in 100 people have these effects.


Important points to remember

You may have a few of these side effects. They may be mild or more severe. They may be increased if you are having other drugs or radiotherapy at the same time. 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.

Other medicines

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

This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant if you are having gemcitabine. Men need to use reliable contraception while having the drug and for about 6 months after the end of treatment. Talk to your doctor or nurse about contraception before starting treatment.


Do not breastfeed during this treatment because the drug may come through in the breast milk.


Some brands of gemcitabine contain alcohol (equal to half a glass of wine or half a pint of beer) and may make you drowsy or dizzy, especially if you have drunk alcohol. Don't operate machinery or drive if you feel drowsy.


Immunisations and chemotherapy

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.


More information about gemcitabine

This information does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at

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


Related information

You can find information about different types of cancer.

We also have detailed information about how you have cancer drugs.

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Updated: 4 February 2015