Gemcitabine (Gemzar®)

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.

Signs of an infection include:

• a high or low temperature – your chemotherapy team will tell you what to watch out for
• feeling shivery and cold
• headaches
• sore muscles
• a cough or sore throat
• pain or burning when you pee
• feeling generally unwell or tired.

Call the 24 hour emergency number your chemotherapy team will have given you if you have signs of an infection. You should phone if you have any of these symptoms or feel suddenly unwell, even if your temperature is normal or low.

Read more about infections 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 may be a side effect of gemcitabine. You should call the emergency number to check.

Feeling or being sick (nausea or vomiting)

This is a common side effect of gemcitabine. but you will be given anti-sickness medicines to stop you feeling or being sick. If these don’t help, call the emergency number. You may be able to change 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 is not 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 a few days later. See how the chemotherapy affects you and work out how much activity you can manage. There are things that can help with fatigue. Read our tips on coping with it.

Runny poo (diarrhoea)

If you have diarrhoea, try to drink as much water as you can manage. Call the 24 hour emergency number if you have diarrhoea more than four times a day or are finding it hard to drink enough fluids. They can give you medicines to control the diarrhoea. Read more about diarrhoea and how it is treated.

Constipation

Constipation is when you find it harder to poo. Drink as much water as you can manage 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 (low red blood cells)

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. If any of these symptoms happen suddenly, call the 24 hour emergency number. If your red blood cell level is very low, you may need to be given a blood transfusion through a drip.

Bruising and bleeding

Gemcitabine can lower the number of platelets in your blood. This is called thrombocytopenia. It can make you bruise more easily than normal, and you may be more likely to have nosebleeds or bleeding gums. If you have a nosebleed that does not stop after five minutes, call the 24 hour emergency number.

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. If you have swelling in your feet, it may help to have your legs up on a cushion when you are sitting down. Tell your doctor or nurse, as they 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 mouth problems. They can make sure you don’t have a mouth infection and give you a mouthwash to help. You should also tell them if you have white spots in your mouth. This is a sign of oral thrush, which is normally easy to treat.

Hair loss

Gemcitabine may cause your hair to thin but it should grow back once your treatment stops. Read more about hair loss and things that can help.

Effects on the kidneys and liver

Gemcitabine can affect how your kidneys and liver work. You will have regular blood tests to check this. It usually goes back to normal after treatment ends.

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 will not 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. If you have any of these symptoms, call the 24 hour emergency number. Or go to A&E and tell them that you are having chemotherapy.