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Gemcitabine (Gemzar®) for pancreatic cancer

Gemcitabine is one of the main chemotherapy drugs used to treat pancreatic cancer. It can be given on its own, or with another chemotherapy drug called capecitabine (Xeloda®) – this is known as GemCap.

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Each hospital may do things slightly differently, and treatment will vary depending on your cancer. Speak to your doctor or nurse about your treatment.

How is GemCap used?

GemCap can be used in different ways.

  • If you have cancer that can be removed with surgery (such as the Whipple’s procedure), you may be offered GemCap after surgery to try stop the cancer coming back.       
  • If you have borderline resectable cancer, you may have GemCap to try to shrink the cancer to make surgery possible. We need more research into this, and you may be offered GemCap before surgery as part of a clinical trial.    
  • If you have locally advanced or advanced pancreatic cancer and surgery is not possible, you may be offered GemCap to try to control the growth of the cancer.   

If you aren’t well enough to cope with GemCap, you may be offered gemcitabine alone, as it may be easier to deal with. The side effects of chemotherapy can be managed. 

Gemcitabine can also be given with the chemotherapy drug nab-paclitaxel (Abraxane®) to treat advanced pancreatic cancer. Talk to your doctor or nurse about which chemotherapy may be best for you.

How is gemcitabine given? 

You will have gemcitabine at the hospital as an outpatient. This means that you will go into hospital for treatment, but you won’t need to stay overnight.

Gemcitabine is given in a four-week cycle. This means you will have gemcitabine once a week for three weeks, and then have a break from treatment for a week. This break allows your body to recover between treatments. The number of chemotherapy cycles you have will depend on how the treatment is working, and how chemotherapy affects you. Your chemotherapy team can tell you more about this.

Gemcitabine is given as an infusion into a vein – you may hear this called a ‘drip’. You will have an infusion of gemcitabine through a cannula. The infusion takes 30 minutes.

Gemcitabine and capecitabine (GemCap)

If you are having gemcitabine together with capecitabine (GemCap), this is given in a four-week cycle. You will have an infusion of gemcitabine for 30 minutes, and you will have this once a week for three weeks. Capecitabine is taken as tablets, which you will take twice a day for the 3 weeks.  

Gemcitabine and nab-paclitaxel

Gemcitabine with nab-paclitaxel (Abraxane®) is given in a four-week cycle. You will have an infusion of these drugs once a week for three weeks. Normally, both of the drugs are given on the same day. You will have an infusion of nab-paclitaxel for 30 minutes. After this, you will have a 30 minute infusion of gemcitabine. 

Allergic reaction

Some people have an allergic reaction while gemcitabine is being given. Signs of an allergic reaction are:

  • an itchy rash
  • high temperature
  • feeling dizzy or faint
  • feeling short of breath or faint.

If you have any of these, tell your chemotherapy team. An allergic reaction needs treating straight away.

What are the side effects of gemcitabine? 

Gemcitabine can cause side effects, but these can affect everyone differently, and you may not get all of the side effects mentioned here.

Your chemotherapy team should tell you about possible side effects and how they are managed. Ask them any questions you have. You can also speak to our specialist nurses on our free Support Line. Most people cope well with gemcitabine, but knowing what to expect can help you to deal with any side effects.

Your chemotherapy team should give you an emergency number to call if you are unwell, or if you need information about any side effects. Your nurse will explain when to use this number. If you haven’t been given a number, ask your nurse about this.

Common side effects

Infection. Gemcitabine can increase your risk of getting an infection. An infection is an emergency if you are having chemotherapy, and needs treating straight away. Read more about the signs of an infection, and how they are treated.

Flu-like symptoms. While you are being given gemcitabine you may get some flu-like symptoms, such as feeling hot, cold or shivery, and having a headache. If these symptoms happen within 24 hours of having an infusion of gemcitabine, they are a side effect of gemcitabine, and not an infection. If these symptoms don’t get better after a day, call your chemotherapy team. 

Feeling or being sick (nausea or vomiting). This is a common side effect of gemcitabine. You will normally be given anti-sickness medicines before your chemotherapy starts. If these medicines don’t help, speak to your chemotherapy team about changing to a different medicine. We have tips for coping with feeling and being sick.

Fatigue (extreme tiredness). Fatigue is a common side effect of gemcitabine. It isn’t the same as feeling tired. Fatigue can make you feel weak and have problems concentrating. Some people find that the fatigue starts a few hours to a few days after having chemotherapy, and starts to get better after a few days. There are things that you can do to help with fatigue. Read our tips on coping with it.

Runny poo (diarrhoea). If you have diarrhoea, make sure you drink lots of water. If you have it more than four times a day, tell your chemotherapy team. They can give you medicines to control it. Read more about diarrhoea and how it is treated.

Problems emptying your bowels (constipation). If this happens, make sure you drink lots of water, and try to eat foods that are high in fibre, such as fruit and vegetables. Gentle exercise such as walking can also help. Speak to your doctor about medicines that can help.

Anaemia (feeling tired or dizzy). Gemcitabine can lower the number of red blood cells in your blood. This is called anaemia, and can make you feel tired, dizzy or short of breath.

Bruising and bleeding. Gemcitabine can lower the number of platelets in your blood – this is called thrombocytopenia. This can cause you to bruise more easily than normal, and you may be more likely to have nosebleeds or bleeding gums. 

Swelling (oedema). Some people get swelling in their feet, ankles, legs, fingers or face. This is because of a build-up of fluid, which is called oedema. This normally gets better by itself. If you have swelling in your feet, it may help to have your legs up on a cushion when you are sitting down. Your doctor may also give you medicines to help.

Loss of appetite. During your treatment you may not feel like eating, and you may start to lose weight. Try to eat small meals often. If your appetite doesn’t get better after a few days, tell your doctor or dietitian. We have tips on dealing with a poor appetite.

Sore mouth and mouth ulcers. Gemcitabine can make your mouth sore, or cause mouth ulcers which can be painful. Tell your chemotherapy team about any problems with your mouth. They can make sure you don’t have a mouth infection, and give you a mouthwash which should help.

Less common side effects

  • Hair loss. Gemcitabine may cause your hair to thin – but it should grow back once your treatment stops.
  • Severe breathing problems. Gemcitabine can cause problems with your lungs, but this is very rare. If you feel short of breath or have a dry cough that won’t go away, call your chemotherapy team. You may need to have some tests to check how your lungs are working.  
  • Heart problems. Gemcitabine can cause an irregular heartbeat. It can also make you feel short of breath or dizzy. It is important to tell your chemotherapy team straight away if you have any of these symptoms. Call the emergency number, or go to A&E and tell them that you are having chemotherapy.

Speak to your doctor or nurse if you feel anything unusual, or if you would like more information. You can also speak to our specialist nurses for information about gemcitabine or its side effects.

Read more information

Read about how chemotherapy is given.

Read about managing the side effects of chemotherapy.

Read about coping with chemotherapy.

Read about other chemotherapy drugs for pancreatic cancer.

Updated August 2019

Review date August 2021