Adult Dosing
Ovarian Cancer
- 1000 mg/m2 IV over 30 mins on days 1 and 8 of 21 day cycle
- Administer carboplatin AUC 4 IV on day 1 after gemcitabine administration
Breast Cancer
- 1250 mg/m2 IV over 30 mins on days 1 and 8 of 21 day cycle
- Administer paclitaxel on day 1 as a 3 hr IV infusion before gemcitabine administration
Non-small cell lung cancer
- 1000 mg/m2 IV over 30 mins on days 1, 8 and 15 of a 28-day cycle
- Alt: 1250 mg/m2 IV on days 1 and 8 of a 21-day cycle
- Administer cisplatin IV on day 1 after gemcitabine administration
Pancreatic carcinoma
- 1000 mg/m2 IV qwk for up to 7 wks followed by 1 wk off
- Subsequent cycles of once-weekly doses for 3 wks followed by 1 wk off
Note:
- Refer to package inserts for toxicity related dose adjustments
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- A physician experienced in the use of cancer chemotherapeutic agents should closely monitor a patient receiving gemcitabine therapy
- Toxicity increases with prolongation of the infusion time beyond 60 minutes, and dosing more frequently than weekly
- Bone marrow suppression manifested by leukopenia, thrombocytopenia, anemia and myelosuppression has been reported with gemcitabine therapy. Monitor the patient for myelosuppression during therapy
- Gemcitabine can cause pulmonary toxicity, discontinue the drug immediately and provide appropriate supportive care if pulmonary toxicity occurs
- Hemolytic Uremic Syndrome (HUS) and/or renal failure leading to death or requiring dialysis have been reported following one or more doses of gemcitabine and even on discontinuation of therapy. Use cautiously in patients with preexisting renal impairment
- Gemcitabine can cause serious hepatotoxicity, leading to liver failure and death when used alone or in combination with other potentially hepatotoxic drugs. Use cautiously in patients with preexisting hepatic insufficiency, as it can lead to exacerbation of the underlying hepatic insufficiency
- Do not administer therapy during pregnancy as it can cause fetal harm. If used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus
- Monitor complete blood count (CBC), including differential and platelet count prior to each dose, based on bone marrow suppression suspend or modify therapy
- Monitor renal and hepatic function prior to initiation of therapy and periodically thereafter
- Tissue injury associated with radiation toxicity has been reported with concurrent and nonconcurrent use of gemcitabine
- Capillary leak syndrome (CLS) with severe outcomes has been reported in patients treated with gemcitabine or as a single agent or as a part of combination chemotherapy regimen. Discontinue gemcitabine if CLS occurs during treatment
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Myelosuppression
- Concomitant radiation
Pregnancy Category:D
Breastfeeding: Safety unknown. Because of the potential for possible serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Gemzar 1 GM SOLR [Vial] (LILLY)
1 gm = $850.02
3 gm = $2395.88 - Gemcitabine HCl 200 MG SOLR [Vial] (SANDOZ)
1 mg = $149.98
3 mg = $429.97 - Gemzar 200 MG SOLR [Vial] (LILLY)
1 mg = $174.98
3 mg = $515.99
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
