Gemcitabine and paclitaxel (GemTaxol)
This page tells you about the chemotherapy drug combination gemcitabine and paclitaxel (GemTaxol) and its possible side effects. There is information about
GemTaxol is the name of a combination of chemotherapy drugs used to treat breast cancer and bladder cancer. This combination of drugs is also being researched for other types of cancers. It is made up of the drugs
- Gemcitabine (also called Gemzar)
- Paclitaxel (also known as Taxol)
The side effects associated with GemTaxol are listed below. You can use the underlined links to find out more about each one. For general information, see our cancer drug side effects section or use the search box at the top of the page.
You have the drugs into your bloodstream (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. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
You usually have GemTaxol chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks. On the first day, you have drips (infusions) of gemcitabine and paclitaxel. The gemcitabine drip takes about half an hour and paclitaxel takes 3 hours. One week later you have a gemcitabine drip. Then you have no treatment for 2 weeks. This completes one treatment cycle and you then start again.
You may have 4 to 6 cycles over 3 to 5 months.
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. You may have injections just under the skin of your abdomen to make your bone marrow produce more white blood cells.
- 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, or bleeding gums after brushing your teeth. Or you may have 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 affects about 7 out of every 10 people (70%) but is usually well controlled with anti sickness medicines
- Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons. This begins within a few days or weeks and usually goes within a few months after treatment ends
- Complete hair loss affects most people but this is temporary. Your hair will grow back when the treatment ends
- Aching joints (arthralgia) and aching muscles (myalgia) affect about 6 out of 10 people (60%). These effects may start a couple of days after treatment and last for about 5 days
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
- A sore mouth
- Mild allergic reactions affect about 1 out of 5 people (20%) – let your treatment team know if you have a rash or redness of the face. Usually you have steroids before treatment to prevent a reaction but a few people may have a more severe allergic reaction. Let your treatment team know straight away if you have any skin rashes; itching, or swelling of the lips, face or throat
- Flu like symptoms (headaches, muscle aches, a high temperature and shivering) affect about 2 out of 10 people (20%) within a few hours of having gemcitabine – paracetamol can help
- Swelling in the face, hands and feet affects about 3 out of every 10 people (30%) – it usually goes away on its own, but let your doctor or nurse know if you have it
- A skin rash, which may itch, occurs in about 1 out of 4 people (25%)
- Drowsiness (somnolence) affects about 1 out of 10 people (10%) and you may be very sleepy after treatment. This usually goes away on its own, but tell your treatment team if you have this effect
Between 1 and 10 in every 100 people have one or more of these effects.
- Wheeziness or breathlessness affects about 1 out of 12 people (8%)
- Women may stop having periods (amenorrhoea) but this may 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
- Low blood pressure
- Slowing of the heart rate (bradycardia)
- Tummy (abdominal) pain
- Temporary taste changes
- Liver changes that are very mild and unlikely to cause symptoms – the liver usually goes back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
- Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
You may have some of the above effects. They may be mild or more severe. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on
- How many times you've had a drug before
- Your general health
- How much 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
This drug 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.
Don't breastfeed during this treatment because the drug 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 page 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 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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