When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to gemcitabine, or if you are pregnant.

How to Use This Medicine:
Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• If this medicine gets on your skin, wash the area with soap and water, and tell your caregiver. If you get the medicine in your eyes, nose, or mouth, rinse the area with large amounts of water, and tell your caregiver.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Make sure your doctor knows if you are breastfeeding, or if you have lung disease, kidney disease, or liver disease.
• Cancer medicines can cause nausea and vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain.
• Dark urine, decrease in how much or how often you urinate.
• Fast, slow, or irregular heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness or fainting.
• Nausea, vomiting, severe itching, bleeding from your gums or nose.
• Numbness or weakness in your arm or leg, or on one side of your body.
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed.
• Pinpoint red or purple spots on your skin.
• Rapid weight gain.
• Sudden or severe headache, problems with vision, hearing, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Tingling, or burning pain in your hands, arms, legs, or feet.
• Trouble breathing.
• Unusual bleeding, bruising, or weakness.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, constipation, loss of appetite.
• Drowsiness.
• Hair loss.
• Mild headache.
• Muscle, joint, or bone pain.
• Skin rash or itching.
• Sores or white patches on your lips, mouth, or throat.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088