{"id":4038,"date":"2025-03-31T18:11:56","date_gmt":"2025-03-31T18:11:56","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/gemcitabine-txt\/"},"modified":"2025-03-31T18:11:56","modified_gmt":"2025-03-31T18:11:56","slug":"gemcitabine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/gemcitabine-txt\/","title":{"rendered":"Gemcitabine.txt"},"content":{"rendered":"

Gemcitabine <\/h1>\n

CLINICAL USE <\/H3>
\nPalliative treatment, or first-line treatment with cisplatin, of locally advanced or metastatic non-small cell lung cancerPancreatic and breast cancer Bladder cancer in combination with cisplatin

DOSE IN NORMAL RENAL FUNCTION <\/H3>1\u20131.25 g\/m2, frequency dependent on chemotherapy regimen; dose reduced according to toxicity

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :299.7 (as hydrochloride)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Negligible<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :12.4 litres\/m2 (women); 17.5 litres\/m2 (men)<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :42\u201394 minutes\/\u2013

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Use with caution
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Likely dialysability. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min. Dose after dialysis, and give next dialysis after 48 hours
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min. Dose after dialysis, and give next dialysis after 48 hours
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • None known

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>Reconstitute with sodium chloride 0.9%, 5 mL to 200 mg vial and 25 mL to 1 g vialCan be further diluted in sodium chloride 0.9% if required

    Route <\/H4>IV

    Rate of Administration <\/H4>30 minutes

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>Rapidly metabolised by cytidine deaminase in the liver, kidney, blood and other tissues. The active intracellular metabolites have not been detected in plasma or urine. Urinary excretion of parent drug and inactive metabolite (dFdU) accounts for 99%Terminal T\u00bd is ~1 hour; this increases if the drug is administered over a longer periodCauses reversible haematuria with or without proteinuria in about 50% of patients; no evidence for cumulative renal toxicity with repeated dosing of gemcitabineHaemolytic uraemic syndrome (HUS) has been reported with a crude incidence rate of 0.015%A study looking at the use of gemcitabine 500\u20131000 mg\/m2 administered IV on days 1, 8, and 15 every 28 days in patients with renal dysfunction, concluded that this regimen was well tolerated in patients with a GFR as low as 30 mL\/min. (Data on file from Eli Lilly)Another study in patients with serum creatinine in the range 130\u2013420 \u00b5mol\/L, at doses of 650 mg\/m2 \u2013 800 mg\/m2 weekly for 3 weeks out of a 4 week cycle, found dose limiting toxicities, including neutropenia, fever, raised transaminases and increased serum creatinine. It was concluded that a reduced dose of gemcitabine may be appropriate in patients with established renal impairment.
    \n","protected":false},"excerpt":{"rendered":"

    Gemcitabine CLINICAL USE Palliative treatment, or first-line treatment with cisplatin,<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4038","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4038","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4038"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4038\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4038"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4038"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4038"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}