Gemzar - Injection Gemcitabine - 200mg/vial 1 Injection(s) / Injection Eli Lilly and Company Introduction: Gemzar is used in the treatment of non-small cell lung cancer, breast cancer, pancreatic cancer, urinary bladder cancer, and ovarian cancer. Gemzar is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you... Uses of Gemzar: Non-small cell lung cancerBreast cancerPancreatic cancerUrinary bladder cancerOvarian cancer Side effects of Gemzar: NauseaVomitingLoss of appetiteHair lossLow blood plateletsAllergic reactionBreathlessnessDecreased white blood cell countIncreased liver enzymesAnemia (low number of red blood cells)Flu-like symptomsBlood in urineSkin rashProtein in urine How to use Gemzar: Your doctor or nurse will give you this medicine. Kindly do not self administer. How Gemzar works: Gemzar interferes with the growth of DNA and RNA of the cancer cells by substituting their building blocks. It prevents the cancer cells from growing and multiplying. Indication: Lung cancer, pancreatic cancer, bladder cancer, breast cancer, ovarian carcinoma Administration: IV Preparation Reconstitute 200 mg vial with 5 mL 0.9% NaCl OR 1000 mg vial with 25 mL 0.9% NaCl IV Administration For IV infusion only Concentrated injection (10 mg/mL) must be diluted to 2 mg/mL prior to administration Infuse over 30 min Avoid rapid infusions Adult Dose: Pancreatic Cancer Indicated as first-line treatment for locally advanced (nonresectable Stage II or Stage III) or metastatic (Stage IV) adenocarcinoma of the pancreas 1000 mg/m² IV infusion over 30 minutes once/week x7 weeks; rest 1 week, THEN 1000 mg/m² IV on Days 1, 8, and 15 of each 28-day cycle Various regimens exist including monotherapy and in combination with other chemotherapy agents (eg, erlotinib, paclitaxel protein bound, capecitabine) Non-small Cell Lung Cancer 1000 mg/m² IV infusion over 30 minutes on days 1, 8, and 15 of each 28-day cycle, OR 1250 mg/m² IV infusion over 30 minutes on days 1... Contraindication: Concurrent radical radiotherapy; pregnancy, lactation; hypersensitivity. Mode of Action: Gemcitabine is a synthetic pyrimidine nucleoside and cytarabine analogue which is metabolised intracellularly to active diphosphate and triphosphate nucleosides. It inhibits DNA synthesis by inhibiting DNA polymerase and ribonucleotide reductase. It also induces apoptosis and is primarily active against cells in the S-phase, but may also arrest cells at the G1-S border. Precaution: Children, hepatic and renal impairment. May impair ability to drive or operate machinery. Discontinue on 1st sign of microangiopathic haemolytic anaemia. Prolonged infusion time (>60 minutes) and more frequent than wkly dosing may increase toxicity. Monitor CBC before every dose. Increased risk of haemolytic uraemic syndrome and/or thrombocytcpenic purpura which may lead to irreversible renal failure. Lactation: not known if excreted in breast milk; do not nurse Side Effect: >10% N/V (69%),Anemia (65%),Elev LFTs (68%),Neutropenia (63%),Leukopenia (62%),Pain (48%),Proteinuria (45%),Fever (41%),Hematuria (35%),Rash (30%),Thrombocytopenia (24%),Dyspnea (23%),Constipation (23%),Diarrhea (19%),Flu-like syndrome (19%),Hemorrhage (17%),BUN increased (16%),Infection (16%),Alopecia (15%),Edema (13%),Elev bilirubin (13%) 1-10% Paresthesia (2-10%),Creatinine increased (2-8%),Inj site reactions (4%),Bronchospasm (2%) Potentially Fatal: Oesophagitis and pneumonitis when given with radical radiotherapy to the thorax. Interaction: May increase the anticoagulant effect of warfarin when used together.