Skip to main content

Gem-P 456

Gem-P 456

This leaflet provides information on a course of chemotherapy called Gem-P.  The leaflet will explain what this is and when and how it is given.  It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information on Gem-P are given at the end of the leaflet.

This leaflet should be read alongside the ‘General information for patients receiving chemotherapy leaflet.  If you haven’t received this leaflet then please ask your nurse for a copy.

What is Gem-P chemotherapy?

This is a chemotherapy treatment which consists of three drugs: 

  • Cisplatin
  • Gemcitabine
  • Methylprednisolone

Why am I having Gem-P chemotherapy? 

Your doctor has prescribed this chemotherapy because it has been found to be effective in treating lymphomas.

Will I need any tests before I have my chemotherapy?

You will need a series of blood tests before you start your chemotherapy.  One of these blood tests may include an EDTA.  This is a blood test that helps us to check that your kidneys are working well enough to cope with the chemotherapy.  

How often will I receive my chemotherapy?

For this treatment to be most effective it is given at specific time intervals.  These intervals are known as cycles.  It is usual to have a cycle of Gem-P every 4 weeks for up to 4 cycles.  Your doctor will discuss with you the exact number of cycles you will receive.

How will my chemotherapy be given?

The gemcitabine and cisplatin chemotherapy will be given through a drip connected to a small needle which is placed in the back of your hand or arm.  If needed it may be suggested that a fine tube called a PICC line is inserted into one of the large veins in your upper arm.  This line can remain in place for the whole of your treatment.  Your doctor or nurse will explain this in more detail, if required and we also have an information leaflet that tells you more about PICC lines.  

The methylprednisolone is given as tablets.  You should take them once a day for 5 days, starting on the first day of every cycle.  They should be taken with food, preferably in the morning.  The amount of tablets you need to take will be clearly marked on the box.

How often will I have to visit the hospital?

To receive your Gem-P chemotherapy treatment you will need to visit the hospital 4 times in every 4 week cycle: 

Outpatient clinic appointment - you will have a blood test and we will check how you are feeling and discuss any problems you may have.  This is so we can check how the chemotherapy is affecting you.  If your blood results are satisfactory, your chemotherapy will be prescribed.  This appointment is usually a few days before your day one chemotherapy appointment.

Day 1 chemotherapy appointment - you will spend about an hour in one of the day case treatment areas.  Please allow up to an hour longer for your first visit.  We will give you anti sickness medicine, then the gemcitabine chemotherapy in a drip. 

Day 8 chemotherapy appointment - you will need to allow about an hour for this visit in one of the day case treatment areas. We will give you anti sickness medication, then the gemcitabine chemotherapy will be given in a drip.

You will also need to have a blood sample taken the day before your chemo. The nurses will inform you of the arrangements for this on day 1. The result will be checked before pharmacy can make your chemotherapy.  

Day 15 chemotherapy admission - you will be admitted to the chemotherapy in-patient (CIU) ward for one night.  We will give you the gemcitabine and cisplatin chemotherapy in a drip. You will be connected to the drip during your stay in hospital.  The drip will be attached to a portable stand with wheels so you will be able to move around the ward area.  If you need help a nurse will be available.

Visiting hours for CIU are 2 – 5pm and 6 – 8pm. 

Can I bring relatives and friends with me? 

You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person.  Treatment areas are not suitable for young children.

What are the possible side effects?

There are a number of possible side effects which can occur with this chemotherapy.  The doctor, nurses and pharmacists can give you advice or answer any questions you may have.

Hair loss

You should not lose your hair with this chemotherapy.  However, a small number of people experience some hair thinning.  We have a leaflet that tells you more about coping with hair loss.  Please ask your nurse for a copy. 


Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective.  If you are sick more than once in 24 hours despite taking regular anti-sickness medicine when you are at home after your treatment, contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.


You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.  

If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening. 

Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or below 35.5°centigrade.  The telephone number is at the end of the leaflet.


Diarrhoea is not common with this chemotherapy.  However, if you have 4 or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.

Tiredness and fatigue

Chemotherapy can make you feel more tired than usual.  It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able.  Some people find it beneficial to take gentle exercise as well as taking rest.  Some patients find they are particularly tired after gemcitabine treatment.  If you are affected it is not advisable to drive. 

Sore mouth

Your mouth may become sore or you may notice small ulcers.  Please follow the advice on caring for your mouth in the general chemotherapy leaflet.  Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.

Effect on your kidneys

Cisplatin can affect the way your kidneys work.  The blood test which you have before your chemotherapy will check how well your kidneys are working at the start of treatment. We will also monitor you carefully by taking regular blood tests throughout your treatment. 

We always give cisplatin with plenty of fluids in the drip to reduce the effect on your kidneys.  It is also important that you drink plenty of fluids for at least two days after each treatment.  We suggest a cup or glass of fluid every hour during the day and evening.

Flu like symptoms

Approximately 20% of patients experience flu like symptoms in the first 48 hours following gemcitabine treatment.  This is usually mild and short lived.  Symptoms may include fever, chills, aching muscles, headaches and tiredness.  If your temperature is above 37.5oC please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.

Skin changes

Gemcitabine may cause an itchy rash in some patients.  Medication is available to treat this so please tell your doctor or nurse if this occurs. 

Effects on your nerves

Cisplatin may damage the nerves of your hands and feet.  You may experience some numbness or changes in sensation such as tingling or pins and needles.  Although this is very rare it is important that you tell your doctor if this happens so that we can modify your treatment before this side effect becomes permanent.

Cisplatin may also damage the nerves responsible for hearing, although this is rare.  If this occurs you may experience some loss of hearing which may be permanent.

Blood clots

A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further.  It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.  

Blood clots can be very serious.  However, most clots can usually be successfully treated with drugs to thin the blood.  Your doctor or nurse can give you more information.

Driving and Using Machinery

Gemcitabine can sometimes make you feel sleepy or drowsy especially if you have drunk alcohol.  Do not drive or use machinery for a few hours after you have received the gemcitabine. 

Other side effects

You may notice some swelling of your ankles.  This is usually mild and will stop when your treatment is completed. 

Some patients experience some discomfort along the vein when gemcitabine is being given as a drip.  Please tell your nurse if this happens. 

Women sometimes find that chemotherapy treatment affects their periods.  They could become heavier, lighter or even stop altogether.  

It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby.  

Side effects of the methylprednisolone tablets 

When taking these tablets you may notice:

  • An increase in appetite
  • Indigestion
  • Mood swings, irritability and difficulty in sleeping
  • You may feel more thirsty and pass more urine than usual.  This may be a sign of an increase in blood sugar levels.  If you are diabetic this may be a particular problem.  If you experience this please tell your doctor or nurse at your next clinic visit.

Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.

Manufacturer’s patient information leaflets

Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy

Contact telephone numbers

Velindre Cancer Centre 029 2061 5888

Ask for the treatment helpline if you are unwell at home and need immediate advice at any time of the day or night.  For example you should phone if you:

  • Are sick more than once in 24 hours
  • Have a temperature of 37.5°C or above or below 35.5°centigrade
  • Have diarrhoea

Pharmacy department 029 2061 5888 ext 6223

Monday – Friday 9am – 5pm for queries about your medicines

Tenovus freephone 0808 808 1010

cancer helpline 


This leaflet was written by health professionals.  The information contained in this leaflet is evidence based.  It has been approved by doctors, nurses, pharmacists and patients.  It is reviewed and updated every 2 years.

Prepared May 2009
Reviewed January 2018