Gemcitabine
Gemcitabine (difluorodeoxycytidine) is a chemotherapy drug that is sometimes recommended for mesothelioma. This drug belongs to a group of chemotherapy drugs called anti-metabolites. In addition to mesothelioma, it is commonly used to treat pancreatic, bladder and breast cancer.
Gemcitabine prevents cells from producing DNA and RNA by interfering with the synthesis of nucleic acids. This stops cancer cells from replicating and thus slows or stops tumor growth.
How Drug is Given
Gemcitabine is given as a drip (infusion) through a fine tube (cannula) inserted into a vein over 30 minutes. It is also given through a 'central line' (a long, hollow tube made from silicone rubber), which is inserted under the skin into a vein near the collarbone, or a 'PICC line' (a long, thin, flexible tube known as a catheter) inserted into a vein in the crook of the arm. The dose depends on patient's size and blood counts, and the cancer being treated. For lung cancer, it is usually given once a week for 3 weeks, then 1 week off.
Before you take gemcitabine
- Before taking gemcitabine, tell your doctor and pharmacist if you are allergic to gemcitabine or any other drugs.
- Tell your doctor and pharmacist about all the prescription and nonprescription medications you are taking, including vitamins and aspirin.
- Tell your doctor if you have or have ever had kidney or liver disease.
- Tell your doctor if you have any of the following medical problems: chickenpox or recent exposure to chickenpox, shingles, heart disease, gout, congestive heart failure, or other forms of cancer.
- Gemcitabine may interfere with the normal menstrual cycle in women and may stop sperm production in men. So, tell your doctor if you want to have children in the future.
- Women who are pregnant should tell their doctors before they begin taking this drug as gemcitabine may harm the fetus. Pregnant women should not take gemcitabine
- Do not plan to have children while receiving chemotherapy and for a while after treatments. You should prevent pregnancy by using a reliable method of birth control. (Do not use oral contraceptives (pills) without consulting with your doctor).
- You should not breast-feed while taking Gemcitabine as it may pass into breast milk.
- You should not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.
While Taking Gemcitabine
Avoid people with infections. Contact your doctor immediately if you think you might have an infection. Also contact your doctor immediately if you see unusual bleeding or bruising, blood in your urine or stools, tarry stools, or tiny red spots on the skin. Be careful not to cut yourself and avoid contact sports.
Side effects of Gemcitabine
The reaction to chemotherapy is different for each person. Some people have less side effects, while others may experience more. The side effects described here will not affect everyone who is given Gemcitabine. Also, it may be different if the patient is having more than one chemotherapy drug.
Many side effects are possible.
Common side effects include:
- Decreased white blood cell count with increased risk of infection
- Decrease platelets, which can cause unusual bruising or bleeding. This can cause black, tarry stools, blood in urine or stool, pinpoint red spots.
- Anemia (low number of red blood cells)
- Nausea
- Vomiting
- Loss of appetite
- Constipation
- Diarrhea
- Runny nose
- Sweating
- Trouble sleeping
- Shortness of breath
- Temporary effect on liver function
- Change in kidney function
- Flu-like illness
- Fluid retention
- Tiredness (fatigue) and feeling weak
Occasional side effects
- Sore mouth,ulcers and white spots in mouth
- Taste changes
- Hair loss, temporary. Hair usually regrows.
- Fever and chills along with the following symptoms: cough or hoarseness, headache, lower back or side pain, painful or difficult urination.
- Pain or redness at injection site.
- Numbness or tingling of hands or feet.
- Pain in chest, arm or back, squeezing or pressure in chest, slurred or difficult speech, tightness in chest with wheezing, weakness in arm or leg on one side (sudden and sever).
There can be other rare and severe side effects. Rare side effects include:
- Severe drowsiness
- Increased or decreased urination
- Yellow eyes or skin (due to liver dysfunction)
- Allergic reaction, with skin rash, hives, itching, swelling or puffiness of face, change in skin color of face. Notify your doctor immediately.
- Coughing with noisy or rattling breathing
- High blood pressure
- Fast or irregular heartbeat
Anna L. Kaplan, M.D.
