Gemcitabine

It is a nucleoside analogue that exhibits anti-tumour activity.

Indications

Adenocarcinoma of the pancreas - non-resectable stage II, stage III and stage IV; indicated in patients treated previously with 5- fluorouracil.

Dosage

Adults: Administered i.v. at a dose of 1000mg/m2 over 30 minutes, once weekly for upto 7 weeks or if toxicity calls for reducing or holding a dose; followed by a week of rest from treatment. Subsequent cycles consist of infusions once weekly for three weeks out of every 4 weeks.

Contra-Indications

Hypersensitivity. Use in children has not been studied.

Special Precautions

Prolongation of infusion time beyond 60 minutes, more than weekly dosing has been shown to increase toxicity. Patients should be monitored with complete blood count and platelet count before each dose. Renal and hepatic functions should be evaluated before initiation of therapy and periodically thereafter.

Side Effects

Myelo-suppression (leukopenia, anaemia, thrombocytopenia), parasthesias, nausea, anorexia, headache, fever, rash, renal/hepatic impairment, vomiting, dyspnoea, peripheral, oedema, flu like syndrome, asthenia, cough, chills.