Gemcitabine
Brand Names: Avgemsi
Methodology & AI Transparency ⓘ
Gemcitabine Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Gemcitabine Injection is a nucleoside metabolic inhibitor indicated: in combination with carboplatin, for the treatment of advanced ovarian cancer that has relapsed at least 6 months after completion of platinum-based therapy.
- 2 Real-world patient consensus: Real-world cohort score of 85% across 5 de-identified Gemcitabine entries.
- 3 Typical cash cost range: 30-day cash pricing ranges from $185.00 discount cash to $453.25 walk-in retail (NADAC $19.9960/unit).
- 4 Top reported side effects / signs: Leading openFDA/SPL adverse events for Gemcitabine: nausea (11.3%), vomiting (4.9%), cutaneous rash (3.2%).
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Gemcitabine Mechanism, CYP450 Pathways & DailyMed Monograph
Gemcitabine Injection is a nucleoside metabolic inhibitor indicated: in combination with carboplatin, for the treatment of advanced ovarian cancer that has relapsed at least 6 months after completion of platinum-based therapy. ( 1.1 ) in combination with paclitaxel, for first-line treatment of metastatic breast cancer after failure of prior anthracycline-containing adjuvant chemotherapy, unless anthracyclines were clinically contraindicated. ( 1.2 ) in combination with cisplatin for the treatment of non-small cell lung cancer. ( 1.3 ) as a single agent for the treatment of pancreatic cancer.
12.1 Mechanism of Action Gemcitabine kills cells undergoing DNA synthesis and blocks the progression of cells through the G1/S-phase boundary. Gemcitabine is metabolized by nucleoside kinases to diphosphate (dFdCDP) and triphosphate (dFdCTP) nucleosides. Gemcitabine diphosphate inhibits ribonucleotide reductase, an enzyme responsible for catalyzing the reactions that generate deoxynucleoside triphosphates for DNA synthesis, resulting in reductions in deoxynucleotide concentrations, including dCTP. Gemcitabine triphosphate competes with dCTP for incorporation into DNA.
With Elimination kinetics span 8 to 16 hours per Gemcitabine clinical pharmacology residence kinetics and Complete (~100%) parenteral systemic delivery for Gemcitabine (2 g/50mL Injection, Powder, Lyophilized, for Solution) bioavailability, Gemcitabine undergoes systemic clearance of gemcitabine integrates hepatic phase ii conjugation with renal filtration and establishes therapeutic activity over rapid intravascular/parenteral onset within 15–45 minutes after gemcitabine administration.
Standard adult regimens span 2 g/50mL Injection, Powder, Lyophilized, for Solution, 38 mg/mL Injection, Powder, Lyophilized, for Solution, 38 mg/mL Injection, Solution, 1 g/25mL Injection, Powder, Lyophilized, for Solution, 200 mg/5mL Injection, Powder, Lyophilized, for Solution. Prescribers screen specifically against gemcitabine injection is contraindicated in patients with a known hypersensitivity to gemcitabine.; reactions include anaphylaxis .; patients with a known hypersensitivity to gemcitabine., while community micro-logs most frequently note nausea (11.3% of reports), headache (7.2% of reports), dizziness (6.2% of reports).
Verify medication reconciliation lists so Gemcitabine is not inadvertently duplicated with another nucleoside metabolic inhibitor.
Alcohol or high-fat meal timing can shift absorption rate and orthostatic tolerance during Gemcitabine dosing.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- Gemcitabine Injection is contraindicated in patients with a known hypersensitivity to gemcitabine.
- Reactions include anaphylaxis .
- Patients with a known hypersensitivity to gemcitabine.
Logged Side-Effect Incidence (5 Reports)
Gemcitabine Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Gemcitabine)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Immune-mediated side effects in the randomized phase 3 TOPAZ-1 study of: What a 338-Participant Study Found Durvalumab demonstrated an OS benefit versus placebo in aBTC, irrespective of imAEs, which were mostly low grade and manageable. The oncologist • 2025-07-04 • Phase III Randomized Trial | N = 338 | 93/100 | PMID 40622010 ↗ |
| New Insights on Phase 3 trial of Gemcitabine or Nab-paclitaxel combined with cisPlatin as: What a 254-Participant Study Found Of grade 3 or 4 side effects, a significantly higher incidence of neuropathy in AP and thrombocytopenia in GP is noted. Nature communications • 2022-07-12 • Phase III Randomized Trial | N = 254 | 87/100 | PMID 35821019 ↗ |
| New Insights on Prognostic Factors for Overall Survival in the VESPER Trial: Basal Molecular: What a 437-Participant Study Found We identified four factors prognostic for OS for patients with MIBC treated with NAC in VESPER. European urology oncology • 2026-08-15 • Phase III Randomized Trial | N = 437 | 87/100 | PMID 41577609 ↗ |
| New Insights on Nivolumab plus gemcitabine-cisplatin for unresectable or metastatic urothelial: What a 276-Participant Study Found Adding nivolumab to gemcitabine-cisplatin did not worsen HRQoL compared with gemcitabine-cisplatin alone in the first 16 weeks of therapy. ESMO open • 2026-03-15 • Phase III Randomized Trial | N = 276 | 87/100 | PMID 41747587 ↗ |
| New Insights on Neoadjuvant nab-paclitaxel plus gemcitabine followed by modified FOLFIRINOX for: What a 324-Participant Study Found Grade ≥3 side effects occurred in 47.6% versus 30.7% of patients. Cancer cell • 2025-12-08 • Phase III Randomized Trial | N = 324 | 87/100 | PMID 41072417 ↗ |
Gemcitabine Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $19.9960/unit (~$599.88/30u) | Wholesale baseline |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $453.25 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 5 Anonymous DotMD Community Micro-Logs | $185.00 / mo | View logs ↓ |
| Ro Body & Metabolic Clinic (Licensed Telehealth Cash Program) | State-licensed clinician review • ~2d mail fulfillment | $45.00 consult | Program details |
| AgelessRx Geroprotective Telehealth (Licensed Telehealth Cash Program) | State-licensed clinician review • ~3d mail fulfillment | $65.00/mo program | Program details |
Gemcitabine Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Gemcitabine RxNorm Concept ID | 1720960 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $19.9960 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $453.25 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $185.00 / mo (Patient Mean) | Public Cash Reference |
| Real-World Patient Consensus | 85.00% Worth It (5 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Gemcitabine Patient Community, Cohort Filters & Dosage Logs
Federal clinical ledger for Gemcitabine integrating DailyMed SPL (2025-10-24), CMS NADAC ($19.9960/unit), and 5 Zero-PHI patient logs.
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Gemcitabine community threads and patient logs by age, biological sex, dosage, and treatment duration.