Gemcitabine

Lactation. Admin of yellow fever and other live attenuated vaccines.

Patient w/ history of cirrhosis, hepatitis, alcoholism, CV events. Patients on radiotherapy. Hepatic (e.g. hepatic metastases) and renal impairment. Pregnancy. Prolonged infusion duration of >60 min or more frequent than wkly dosing may increase toxicity. Patient Counselling This drug may cause somnolence, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CBC w/ differential and platelet count prior to each dose. Monitor pulmonary, hepatic, and renal function; electrolytes (i.e. K, Mg, Ca) when in combination therapy w/ cisplatin. Monitor for signs and symptoms of capillary leak syndrome and PRES.

Significant: Bone marrow suppression manifested by neutropenia, thrombocytopaenia, and anaemia; capillary leak syndrome, posterior reversible encephalopathy syndrome (PRES). Nervous: Somnolence, flu-like symptoms, paraesthesia. CV: Peripheral oedema. GI: Nausea, vomiting, diarrhea, stomatitis, constipation. Resp: Dyspnoea. Hepatic: Transient liver enzyme elevations (e.g. AST, ALT, bilirubin, alkaline phosphatase). Genitourinary: Haematuria, proteinuria, increased BUN. Haematologic: Haemorrhage. Musculoskeletal: Myalgia. Dermatologic: Rash, pruritus, oedema, thrombocytopenic purpura, alopecia, peripheral vasculitis, gangrene. Immunologic: Infection. Others: Pain, fever, extravasation, injection site reaction.
Potentially Fatal: Severe hepatotoxicity (e.g. liver failure), pulmonary toxicity (e.g. pulmonary oedema, pulmonary fibrosis, interstitial pneumonitis, adult resp distress syndrome), ischaemic colitis w/ necrosis. Rarely, haemolytic uremic syndrome leading to renal failure.

May cause pulmonary toxicity w/ concurrent use of bleomycin. May enhance anticoagulant effect of warfarin.

Cytotoxic Chemotherapy

L01BC05 - gemcitabine ; Belongs to the class of antimetabolites, pyrimidine analogues. Used in the treatment of cancer.