Gemcitabine

Indications
 Intravenous
Advanced non-small cell lung cancer
Adult: 1000 mg/m2 on days 1, 8 and 15 of each 28-day cycle; or 1250 mg/m2 on days 1 and 8 of each 21-day cycle.
Intravenous
Pancreatic cancer
Adult: 1000 mg/m2 once wkly for up to 7 wk followed by 1 wk of rest. Continue thereafter with once wkly infusions for 3 consecutive wk out of 4.
Intravenous
Bladder cancer
Adult: To be given before cisplatin. 1000 mg/m2 on days 1, 8 and 15 of each 28-day cycle.
Intravenous
Breast cancer
Adult: Usually in combination with a taxane such as paclitaxel: 1250 mg/m2 on days 1 and 8 of each 21-day cycle.
Intravenous
Ovarian carcinoma
Adult: To be given before carboplatin: 1000 mg/m2 on days 1 and 8 of each 21-day cycle.
Contraindications
 Concurrent radical radiotherapy; pregnancy, lactation; hypersensitivity.
Warnings / Precautions
 Children, hepatic and renal impairment. May impair ability to drive or operate machinery. Discontinue on 1st sign of microangiopathic haemolytic anaemia. Prolonged infusion time (>60 minutes) and more frequent than wkly dosing may increase toxicity. Monitor CBC before every dose. Increased risk of haemolytic uraemic syndrome and/or thrombocytcpenic purpura which may lead to irreversible renal failure.
Adverse Reactions
 Bone marrow suppression as manifested by leukopenia, thrombocytopenia, anaemia and myelosuppression. Mild GI effects; rashes; renal impairment, pulmonary toxicity, influenza-like symptoms; interstitial pneumonia, pulmonary oedema. Proteinuria, haematuria and haemolytic uraemic syndrome. Elevation of serum transaminase.
Potentially Fatal: Oesophagitis and pneumonitis when given with radical radiotherapy to the thorax.
Drug Interactions
 May increase the anticoagulant effect of warfarin when used together.
See Below for More gemcitabine Drug Interactions
Mechanism of Actions
 Gemcitabine is a synthetic pyrimidine nucleoside and cytarabine analogue which is metabolised intracellularly to active diphosphate and triphosphate nucleosides. It inhibits DNA synthesis by inhibiting DNA polymerase and ribonucleotide reductase. It also induces apoptosis and is primarily active against cells in the S-phase, but may also arrest cells at the G1-S border.
Metabolism: Rapidly cleared from the blood and metabolised by cytidine deaminase in the liver, kidney, blood, and other tissues after IV admin.
Excretion: Mainly excreted in the urine. Half life ranges from 42-94 minutes.
Storage Conditions
 Intravenous: Store at 25°C.
ATC Classification
 L01BC05 - gemcitabine ; Belongs to the class of antimetabolites, pyrimidine analogues. Used in the treatment of cancer.
Storage
 Intravenous: Store at 25°C.
Available As
  • Gemcitabine 1 gm
  • Gemcitabine 1000 mg
  • Gemcitabine Hcl 1000 mg
  • Gemcitabine 1400 mg
  • Gemcitabine 200 mg

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