Gemcitabine

Gemcitabine Brand Names- Gemzar | Infugem

What is Gemcitabine

Gemcitabine is a deoxycytidine antimetabolite nucleoside inhibitor, closely related to cytarabine.

Although cytarabine and gemcitabine are similar in structure and metabolic pathways, they differ greatly in the spectrum of antitumor activity. While cytarabine is used almost exclusively for acute leukemias, gemcitabine is active against a variety of solid tumors.

It is indicated as monotherapy for locally advanced or metastatic pancreatic cancer, in combination with cisplatin for locally advanced or metastatic non-small cell lung cancer (NSCLC), in combination with paclitaxel for metastatic breast cancer, and in combination with carboplatin for advanced ovarian cancer.

Increased toxicities including clinically significant hypotension, severe flu-like symptoms, myelosuppression, and asthenia are observed with infusion times greater than 60 minutes or dosing more frequently than once weekly.

Indications

  1. biliary tract cancer
  2. bladder cancer
  3. breast cancer
  4. cutaneous T-cell lymphoma (CTCL)
  5. mesothelioma
  6. mycosis fungoides
  7. non-Hodgkin’s lymphoma (NHL)
  8. non-small cell lung cancer (NSCLC)
  9. ovarian cancer
  10. pancreatic cancer
  11. peripheral T-cell lymphoma (PTCL)

For the treatment of non-small cell lung cancer (NSCLC)

for first-line treatment of inoperable, locally advanced (Stage IIIA or IIIB) or metastatic (Stage IV) NSCLC in combination with cisplatin

Side Effects

  1. acute respiratory distress syndrome (ARDS)
  2. alopecia
  3. alopecia
  4. anaphylactoid reactions
  5. anemia
  6. anemia
  7. anorexia
  8. asthenia
  9. azotemia
  10. bleeding
  11. bleeding
  12. bronchospasm
  13. bullous rash
  14. capillary leak syndrome
  15. chills
  16. colitis
  17. confusion
  18. constipation
  19. constipation
  20. diaphoresis
  21. diarrhea
  22. diarrhea
  23. drowsiness
  24. drowsiness
  25. dyspnea
  26. dyspnea
  27. edema
  28. elevated hepatic enzymes
  29. elevated hepatic enzymes
  30. encephalopathy
  31. enterocolitis
  32. eosinophilia
  33. eosinophilic pneumonia
  34. esophagitis
  35. fatigue
  36. fatigue
  37. fever
  38. fever
  39. headache
  40. heart failure
  41. hematuria
  42. hematuria
  43. hemolysis
  44. hemolytic-uremic syndrome
  45. hepatic failure
  46. hepatotoxicity
  47. hyperbilirubinemia
  48. hyperbilirubinemia
  49. hyperglycemia
  50. hyperglycemia
  51. hypertension
  52. hypocalcemia
  53. hypocalcemia
  54. hypomagnesemia
  55. hypomagnesemia
  56. hypotension
  57. hypotension
  58. infection
  59. infection
  60. injection site reaction
  61. insomnia
  62. lethargy
  63. lymphopenia
  64. lymphopenia
  65. malaise
  66. myalgia
  67. myocardial infarction
  68. nausea
  69. nausea
  70. neutropenia
  71. neutropenia
  72. paresthesias
  73. paresthesias
  74. peripheral edema
  75. peripheral neuropathy
  76. pharyngitis
  77. pharyngitis
  78. pneumonitis
  79. proteinuria
  80. proteinuria
  81. pulmonary edema
  82. pulmonary fibrosis
  83. radiation recall reaction
  84. rash
  85. rash
  86. renal failure (unspecified)
  87. renal tubular necrosis
  88. rhinitis
  89. seizures
  90. sinusoidal obstruction syndrome (SOS)
  91. stomatitis
  92. stomatitis
  93. stroke
  94. thrombocytopenia
  95. thrombocytopenia
  96. thrombotic microangiopathy
  97. vasculitis
  98. veno-occlusive disease (VOD)
  99. visual impairment
  100. vomiting
  101. vomiting

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum creatinine/BUN

Contraindications

  • alcoholism
  • bone marrow suppression
  • breast-feeding
  • children
  • contraception requirements
  • encephalopathy
  • females
  • geriatric
  • hemolytic-uremic syndrome
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • infection
  • infertility
  • infusion-related reactions
  • male-mediated teratogenicity
  • neutropenia
  • pneumonitis
  • pregnancy
  • pregnancy testing
  • pulmonary disease
  • pulmonary edema
  • pulmonary fibrosis
  • radiation therapy
  • renal failure
  • renal impairment
  • reproductive risk
  • thrombocytopenia

Interactions

  • Azelastine; Fluticasone
  • Beclomethasone
  • Betamethasone
  • Budesonide
  • Budesonide; Formoterol
  • Ciclesonide
  • Corticosteroids
  • Cortisone
  • Deflazacort
  • Dexamethasone
  • Fludrocortisone
  • Flunisolide
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Hydrocortisone
  • Lithium
  • Methylprednisolone
  • Mometasone
  • Palifermin
  • Penicillamine
  • Prednisolone
  • Prednisone
  • Tolvaptan
  • Triamcinolone
  • Tuberculin Purified Protein Derivative, PPD
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