Gemnil

Gemnil - Dosage | Adverse Effects | Interactions

Gemnil, or its active substance gemcitabine, belongs to the group of anti-cancer drugs (according to chemical structure, it is classified as a pyrimidine analog). It acts by killing the tumor cells in the S-phase of DNA synthesis. This drug is indicated for the treatment of the following cancers:

  • Metastatic bladder carcinoma
  • Metastatic non-small cell lung cancer (NSCLC) - first line therapy
  • Metastatic epithelial ovarian cancer
  • Metastatic breast cancer that cannot be chirurgically removed

It is rarely used alone, but mainly in combination with other anti-cancer drugs.

Contraindications

  • Breast-feeding
  • Allergy to the active substance

Safety precautions

Gemnil suppresses the bone marrow function which will lead to reducing the number of leukocytes in the blood, which further results in a weakened immune system. Bone marrow suppression also leads to anemia and thrombocytopenia (reduced number of platelets, which leads to blood clotting disorder). Therefore, the number of leukocytes, erythrocytes and platelets should be monitored regularly while you are on Gemnil treatment.

This drug can damage the liver, and liver function (specifically liver enzyme levels) must be regularly monitored. Patients who already have a history of liver damage are at an increased risk of liver failure while taking this drug.

This drug may also cause adverse cardiovascular effects, and if you notice an irregular heartbeat, inform your doctor about it.

This drug can also cause acute respiratory distress syndrome (ARDS), which can have serious consequences for your health.

This drug has also shown reproductive toxicity, so men who are taking this medicine should be advised not to plan to become a father at least a year after taking this drug.

Application of Gemnil during pregnancy and breastfeeding

This drug should not be used during pregnancy unless necessary.

It should not be used during breastfeeding because of the potential toxic effects on infants.

Dosage

Gemnil is applied as a 30-minute intravenous infusion only in hospitals and only by oncologists. The dose should be calculated according to the body surface area (m2), and only by oncologists or a clinical pharmacist specializing in the oncology field.

In the treatment of bladder cancer, Gemnil is usually applied at a dose of 1000 mg / m2 on the first, eighth and fifteenth day during a 28-day cycle in combination with cisplatin.

In the treatment of pancreatic cancer, it is applied at a dose of 1000 mg / m2 once weekly for up to 7 weeks.

In the treatment of NSCLC, it can be used alone or in combination with cisplatin. If applied alone, the recommended dose is 1000 mg / m2 weekly for three weeks, and when used in combination with cisplatin, the recommended dose is 1250 mg / m2 on the first and eighth day during the 21-day cycle.

In the treatment of metastatic breast cancer, it is administered in a dose of 1250 mg / m2 on the first and eighth day during the 21-day cycle in combination with paclitaxel.

In the treatment of ovarian cancer, it is administered at a dose of 1000 mg / m2 on the first and eighth day during the 21-day cycle.

Interactions

Drugs that should not be applied while using Gemnil include:

  • Yellow fever vaccine
  • Clozapine - atypical antipsychotic
  • Etanercept and leflunomide - drugs used to treat rheumatoid arthritis
  • Deferiprone - a drug used to treat thalassemia
  • Monoclonal antibodies (adalimumab, and golimumab)
  • Mipomersen - a drug for lowering cholesterol

Gemnil adverse effects

Very common Common Uncommon Rare Very rare
Anemia Anorexia Bronchospasm Myocardial infarction Thrombocytosis (increased number of platelets in the blood)
Leukopenia Myalgia Interstitial pneumonitis Hypotension Severe allergic reaction
Thrombocytopenia Arthralgia Scars on the lung Reaction at application site Steven-Johnson syndrome
Alopecia Flu-like symptoms (cough and fever) / / /
Blood in the urine Digestive adverse effects / / /
Edema of different parts of the body Insomnia / / /
Difficulty breathing Febrile neutropenia / / /

This table does not include all possible side effects of this drug and it may cause some other side effects not mentioned in the table.