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Gemcitabine (Gemzar®)

Gemcitabine is one of the main chemotherapy drugs used to treat pancreatic cancer. It may be given on its own or with other chemotherapy drugs, such as capecitabine (GemCap), to make treatment more effective.

It is usually given after surgery to reduce the chances of the cancer coming back. If surgery to remove the cancer is not possible some people may have it to control the spread of cancer.

How is gemcitabine given? 

You will have your chemotherapy as an outpatient in the chemotherapy unit at the hospital, which means you will go in for treatment, but won’t need to stay overnight.

Gemcitabine is usually given in a four-week cycle, over several months. You will have a dose of the drug once a week for three weeks, with a break from treatment on the fourth week, before starting your next cycle. The exact number of cycles you have will depend on how well the treatment works. If you are having gemcitabine after surgery, you will have six cycles, as long as you are able to cope with it. Your nurse or doctor will tell you more about this.

Gemcitabine is given as a drip (infusion) into a vein, which usually takes 30 minutes. You may have it through a fine plastic tube (a cannula), which is put into a vein in your arm or hand each time you have treatment. Or you may it through a central line, such as a PICC line, Hickmann line or a portacath.These are tubes that deliver drugs directly into a large vein in your chest, and stay in place for as long as your course of chemotherapy lasts. 

Gemcitabine chemotherapy cycle

Gemcitabine Chemotherapy Cycle

What are the side effects of gemcitabine? 

Common side effects

  • Increased risk of infection. Gemcitabine can increase your risk of getting an infection, because it can cause a drop in the number of your white blood cells. This means your body is less able to fight infection. Signs of an infection include a high temperature, headaches, aching muscles, a cough, sore throat or feeling shivery and cold.
  • Feeling or being sick (nausea or vomiting). This is a common side effect of gemcitabine but can be controlled with anti-sickness medication. You will usually be given medication before your chemotherapy starts to help control or prevent sickness. If it doesn’t work, tell your doctor or nurse – you should be able to change the medication. Read more about coping with feeling and being sick.
  • Fatigue (extreme tiredness). Fatigue is a common side effect of gemcitabine. People can feel tired or exhausted for much of the time during treatment. There are ways to deal with fatigue. You might want to keep a fatigue diary, so you can see when you have more energy to do things. This may help you to plan activities on the days that you are feeling better, and rest on days when you’re more tired.
  • Bruising and bleeding. Gemcitabine can lower the number of platelets in your blood. Platelets are cells that help blood to clot. You may bruise more easily than normal, have nosebleeds, bleeding gums or tiny red spots on your skin. You may have blood in your urine but this is less common. Speak to your doctor or nurse straight away about any of these side effects, as the dose of your chemotherapy drug may need to be reduced.
  • Allergic reactions. Gemcitabine may cause an allergic reaction while it’s being given. Signs of this can include a high temperature or an itchy rash. If this happens tell your nurse or doctor immediately as any reaction will need to be treated straight away.
  • Mild breathing problems. You may feel breathless or develop mild breathing problems soon after the gemcitabine infusion is started, but this should not last long. Tell your nurse or doctor if these symptoms don’t improve.
  • Anaemia (low level of red blood cells). Gemcitabine can lower the number of red blood cells in your blood (anaemia). This can make you feel tired, faint or short of breath. If you are very anaemic, you may need to be given extra red blood cells in a drip (blood transfusion).
  • Swelling (oedema). Some people may get oedema. This is a build-up of fluid in your feet, ankles, fingers and face, which makes them look swollen. The swelling usually improves by itself, but it may help to have your legs up on a cushion when you are sitting down to help the fluid to drain. Your doctor may prescribe medication for oedema.
  • Hair loss. Gemcitabine may cause your hair to thin or you may lose some hair. It should grow back after your treatment stops. Your nurse can give you advice on dealing with losing your hair.
  • Loose watery poo (diarrhoea). If you have diarrhoea, make sure you drink plenty of fluids. If you have diarrhoea more than four times a day, tell your doctor or nurse. They may give you medication to control it, or reduce the dose of the chemotherapy drug in future cycles.
  • Problems emptying your bowels (constipation). If this happens, drink plenty of fluids and try to eat high fibre foods, such as vegetables and fruit. Gentle exercise such as walking can also help. There are medications available to help manage constipation. 
  • Sore mouth or mouth ulcers. This can be mild or severe, making eating and drinking difficult. Try to drink lots of fluids, clean your teeth regularly with a soft toothbrush and avoid spicy or citrus foods that might sting your mouth. Your doctor or nurse can give you an anti-bacterial mouthwash which should help. Using painkillers such as paracetamol or ibuprofen can also help.  
  • Flu-like symptoms. You may develop flu-like symptoms and a fever 24-48 hours after receiving gemcitabine. Drinking plenty of water can help, and you may be told to take paracetamol. Tell your doctor or nurse if these symptoms don’t improve.
  • Liver problems. Gemcitabine may affect how your liver works. You will have regular blood tests to check how well your liver is working.

Less common side effects

  • Severe breathing problems. Gemcitabine can cause lung problems, such as inflamed lungs, but this is very rare. If you develop shortness of breath or a dry cough that won’t go away, ring the medical team on the emergency number you should have been given. You may need further tests to check your lungs, or you may be offered different chemotherapy treatment.
  • Heart problems. Gemcitabine can cause breathlessness, palpitations or a fluttering heart. If you have any of these symptoms tell your doctor or nurse. They may prescribe medication. These symptoms usually end after treatment.

We haven’t listed every possible side effect of gemcitabine. Speak to your doctor or nurse for more information if you experience anything unusual. If you are unable to contact your doctor or nurse, contact the medical team on the emergency number that you should have been given.

If you have any questions about gemcitabine or side effects, you can also call our specialist nurses free on our Support Line.

More chemotherapy information

Published May 2017

Review date May 2019

Information Standard