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Gemcitabine and capecitabine chemotherapy 320

Information leaflet on gemcitabine and capecitabine chemotherapy 320

This leaflet provides information on a course of chemotherapy called gemcitabine and capecitabine. It 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 gemcitabine and capecitabine are given at the end of the leaflet.

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

What is gemcitabine and capecitabine chemotherapy?

This is a chemotherapy treatment which consists of two drugs:

  • Gemcitabine 
  • Capecitabine 

Why am I having this chemotherapy?

Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.

How will my chemotherapy be given?

The gemcitabine chemotherapy will be given through a drip connected to a small needle which is placed in your hand or arm. Alternatively 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.  

The capecitabine chemotherapy is given as tablets.

How often will I receive my treatment?

You will be given the gemcitabine in a drip once a week for 3 weeks followed by a weeks rest. This 4 week period is called a cycle of treatment. You will take the capecitabine tablets twice a day for 3 weeks, and then have a weeks rest.  

How long will my treatment take?

You should allow approximately 1 hour for each chemotherapy appointment. You will have a blood test before each treatment. Once this blood test has been checked, pharmacy will make your chemotherapy.  

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. 

How often will I see the specialist team?

You will see the specialist team before each cycle. You will have regular blood tests 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. 

How should I take the capecitabine tablets?

Capecitabine tablets should be taken twice a day (9-12 hours apart).  You should take the tablets within 30 minutes of finishing your meal.  The tablets should be swallowed whole with a glass of water.  They must not be chewed or crushed.  

It is important that you wash your hands thoroughly after taking your tablets.

How many tablets will I need to take?

This will vary for each person. There are 2 different strength tablets which are different sizes. The bigger tablets are 500mg and the smaller tablets are 150mg. You will probably have to take a combination of big and small tablets. The amount you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets you need to take.

What should I do if I forget to take my tablets?

  • If it’s within 2 hours of the normal time take them now.
  • If it’s more than 2 hours late, miss this dose.

Do not take the extra tablets when your treatment should have finished. It is important that even if you have missed any doses you should finish the treatment at the planned time.  

What if I take too many tablets?

Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet. 

How should I store the capecitabine tablets?

You should store your tablets in their original packaging in a safe place away from children. They should be kept in a cool dry place. Unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.  

What are the possible side effects?

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

Hair loss

You should not lose your hair. However, a small number of people may experience some hair thinning.  


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, stop taking your capecitabine tablets and 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 if your temperature is below 35.5°.  The telephone number is at the end of the leaflet.


You may have diarrhoea. If this occurs it is important that you drink plenty of fluids. We will give you medication to take if you get diarrhoea. You should stop taking your capecitabine tablets and contact Velindre Cancer Centre immediately if:

  • you have 4 or more bowel movements in 24 hours above what is normal for you.
  • you are woken up at night with diarrhoea.   

You should also contact us if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.

Tiredness and fatigue

You may 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 rest.

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.

If your mouth becomes very painful, or you are finding it difficult to eat and drink, you should stop taking your capecitabine tablets and contact Velindre Cancer Centre. 

Soreness to your hands and feet

You may experience mild pain, redness and swelling of your hands or feet. If this occurs we recommend using a non perfumed cream or lotion regularly. Please contact Velindre Cancer Centre if your hands or feet become painful. 

Heart problems

Very rarely some people having capecitabine chemotherapy experience heart problems.  If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.  If you do have any chest pain you should stop taking your capecitabine tablets and seek urgent medical attention.  Do not start taking your capecitabine again until you have spoken to the team at Velindre.

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, muscle aching, headaches and tiredness. Please contact Velindre Cancer Centre immediately if your temperature is above 37.5oC or below 35.5°. 

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. 


Alcohol content of gemcitabine  

Gemcitabine contains alcohol. If having alcohol is a problem for you, tell your doctor, nurse or pharmacist. It is possible that your blood alcohol level may be above the legal limit after you have gemcitabine. Do not drive or operate machinery for a few hours after having this treatment, even if you feel okay.  

Other side effects

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

Gemcitabine may cause an itchy rash. If this occurs please tell your doctor or nurse.

You may notice some swelling of your ankles. This is usually mild and will stop when your treatment is completed. 
Some patients experience sore or watery eyes. Please tell your doctor or nurse if this occurs.

Women sometimes find that chemotherapy 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.  

This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight and wear a hat and use a sun block when in the sun.

Is it alright to take other medicines with capecitabine?

Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid. Please tell your doctor, nurse or pharmacist if you take warfarin tablets.

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 4 or more bowel movements in 24 hours above what is normal for you
  • Have an increase in bowel movements above what is normal for you which lasts for more than three days
  • Have a very sore mouth 
  • Have very sore hands or feet
  • Have had to stop capecitabine because of chest pain

Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines

Macmillan freephone Helpline 0808 808 0000

Tenovus freephone 0808 808 1010
cancer helpline 

This information is also available in Welsh

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

Reviewed November 2019