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Gemcitabine (Gemzar)

Gemcitabine is a type of chemotherapy drug. You might have it as a treatment for a number of different cancers, including bladder and breast cancer.

How gemcitabine works

Gemcitabine destroys quickly dividing cells, such as cancer cells.

How you have gemcitabine

You have gemcitabine into your bloodstream. It takes about 30 minutes.

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have gemcitabine

You might have gemcitabine once a week for 2 or 3 weeks. And then have a week or 2 with no treatment to allow the body to recover. 

The exact number of cycles and how long the cycle is depends on your cancer type. 

Tests during treatment

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

We haven't listed all the side effects. Your doctor or nurse will talk to you about the possible side effects. Tell your doctor or nurse if you notice anything unusual or different during and after treatment.

When to contact your team

Your doctor and nurse will monitor you closely for any side effects. Let your doctor or nurse know as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C.

Common side effects

Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them. They include:

Increased risk of getting an infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include headaches, aching muscles, cough, sore throat, pain passing urine, feeling cold and shivery or tooth ache. Infections can sometimes be life threatening. You should contact your team urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums or nosebleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. 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).

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all help.

Liver changes

You might have liver changes that are very mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in levels of chemicals produced by the liver.

Flu like symptoms

This can happen a few hours after treatment. It 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

This usually goes away on its own, but tell your doctor or nurse if you have it.

Difficulty breathing

You may have difficulty breathing with wheezing and coughing. 

Let your doctor or nurse know straight away if this happens. 

Blood and protein in your urine 

Small amounts of blood and protein in your urine may be found when your nurse tests your urine. This is not harmful.

Skin rash

Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes.

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will grow back once treatment has finished. But it is likely to be softer. And it may grow back a different colour or be curlier than before. 

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them. They include:

  • diarrhoea
  • constipation
  • difficulty sleeping
  • a sore mouth or mouth ulcers
  • loss of appetite
  • itchy skin
  • a cough
  • back or muscle pain
  • a runny nose
  • sweating
  • headaches
  • tiredness and weakness (fatigue) during and after treatment
  • drowsiness

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • kidney changes that are usually mild and go back to normal after treatment
  • lung scarring that can cause shortness of breath and a dry cough
  • an irregular heart beat or heart muscle changes

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. 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. Women may be able to store eggs or ovarian tissue but this is rare.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who've had live vaccines as injections

Avoid close contact with people who’ve recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

Alcohol

Some brands of this drug 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.

More information about this treatment

We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.

You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
10 Oct 2018
  • Electronic Medicines Compendium 
    Accesseed September 2018

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

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