Gemcitabine

Brand name: Gemzar   

Generic name:Gemcitabine  

Therapeutic Class: antimetabolite  

Manufacturer / Distributor: Eli Lilly and Company  

Availability: Gemcitabine is available by prescription only  

Dosage form: Gemcitabine is given by injection into a vein  

Indications: Gemcitabine is used in the treatment of the following malignancies: 

• soft-tissue sarcoma 
• locally advanced or metastatic non-small cell lung cancer 
• locally advanced or metastatic pancreatic cancer  
• invasive bladder cancer 
• Metastatic breast cancer or a breast cancer that relapses after chemotherapy. 

Gemcitabine can also be prescribed for other medical conditions not mentioned in this article; talk to your doctor or pharmacist for more information.  

Dosage: dosage of Gemcitabine recommended by your doctor depends on the type of cancer being treated, the overall state of your health, and your body surface area (BSA). If you are taking other medications it may also play a role in the choice of the dosage. 

Gemcitabine is given by injection into a vein. Usually, the drug is given intravenously once weekly over a period of 30 minutes. A week of rest is often recommended every four weeks for your body to adapt to the drug.     

Gemcitabine should be given in hospital or a health care center equipped for its preparation. Gemcitabine should be given only by physicians or health professionals who have experience in cancer chemotherapy.  

Overdose: as with any drug, Gemcitabine overdose can be dangerous if it is high and long term. An overdose of Gemcitabine can damage your bone marrow, and lead to serious infections. During the treatment and even months after, avoid anything that can weaken your immune system and the risk of infection. If you think you have taken an overdose, contact your doctor or the poison control center nearest you as soon as possible to reduce or prevent complications.  

Missing dose: because Gemcitabine is administered in hospital, lack of dose is basically difficult if you keep all your doctor’s appointments. If for some reasons you cannot be present at the hospital for the treatment, contact your physician before the date you are scheduled for the injection.  Do not stay home because you are experience side effects; Gemcitabine cause side effects in most patients. Missing a dose or session of the therapy can affect the entire treatment.   

Contraindication: Gemcitabine is contraindicated or should be used with precaution in case of the following conditions:  

• allergy to Gemcitabine or any of its components 
• vaccine against yellow fever 
• chronic kidney failure 
• chronic liver failure 
• pregnancy  
• breast-feeding 
• radiotherapy 
• severe leucopenia 
• severe neutropenia 
• thrombocytopenia 
• Treatment with live attenuated vaccine or phenytoin.

Mechanism of action (MOA): c ancer cells are unable to survive if they cannot divide rapidly; Gemcitabine selectively inhibits the synthesis of DNA that allows the cells to divide, which slows or stops the growth of cancer cells.  

Interactions:  talk to your doctor before taking vitamins or nutritional supplements. Some medicines can affect the curative effects of Gemcitabine, or increase the risk of developing side effects. Consult your doctor before taking these medicines:

• Ganciclovir, an antiviral drug 
• Azathioprine, an immune system inhibitor 
• Barbiturates, depressant drug that causes relaxation and sleepiness 
• Cimetidine , a drug used to inhibit the production of acid in the stomach 
• Colchicines , a medication used to treat pain of gouty arthritis 
• Live vaccines: BCG vaccine, yellow fever vaccine, etc.  
• Cyclophosphamide (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers 
• Celecoxib, a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, painful menstruation, colon and rectum polyps, etc. 

Side effects: while attacking cancer cells, Gemcitabine also affects normal (healthy) cells, which lead, in certain patients, to the following side effects:   

• hair loss
•   fatigue  
•   headache 
•   nausea and vomiting  
•   decreased appetite 
•   weight loss  
•   mouth blistering 
•  diarrhea 
•  constipation 
•  Drying or darkening of the skin or nails.  

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:  

•   fever 
•   chills 
•   persistent cough  
•   bloody diarrhea 
•   muscle and/or bone  
• difficulty swallowing
• severe red skin rash
• severe stomach pain
• shortness of breath
• puffy face
• painful urination or red urine
• unusual bruising or bleeding
• swelling of the feet or legs
• yellowing of the skin or eyes
• Swelling of the feet or ankles.