Gem-Cis
Gemcitabine and Cisplatin
Gemcitabine + Cisplatin is used for bladder, lung, and other cancers. Given over 3 weeks with a rest week.
21 days
Cycle length
6 cycles
Typical course
5
Side effects tracked
Common Side Effects
Nausea (cisplatin)
acute (0–24 hours) and delayed (days 2–5)
Tip: Cisplatin causes significant nausea. Multiple anti-nausea medications are prescribed — take them all as directed. IV fluids before and after cisplatin help protect kidneys.
Kidney damage (cisplatin)
ongoing risk, monitored by labs
Tip: Staying well hydrated is critical. Drink at least 2 liters of water daily. Avoid NSAIDs (ibuprofen, naproxen) during treatment.
Hearing changes
cumulative
Tip: Report any ringing in ears (tinnitus) or hearing changes immediately.
Fatigue
days 3–14
Tip: Rest during the week after treatment. Activity often returns in the off-week.
Neutropenia
days 10–17
Tip: Fever is an emergency during this window.
Critical Days in the Cycle
Day 1 — Cisplatin Day (with heavy hydration)
Watch for
- •Nausea
- •Reaction
When to call:
Any severe reaction during infusion.
Day 3 — Delayed Nausea
Watch for
- •Vomiting
- •Inability to eat or drink
When to call:
Unable to keep fluids down — risk of dehydration and kidney stress.
Day 12 — Nadir
Watch for
- •Fever
- •Signs of infection
When to call:
Fever ≥100.4°F — go to the ER immediately, do not wait for a callback.
Frequently Asked Questions
Why is hydration so important with cisplatin?
Cisplatin is processed through the kidneys and can cause permanent kidney damage without adequate hydration. You'll receive IV fluids during treatment. At home, drinking 2+ liters of water daily is important, especially the first few days after infusion.
When should I call the oncology team?
For fever ≥100.4°F during nadir — go to the ER immediately, do not wait for a callback. Call the team for: severe vomiting (can't keep any fluids down for 12 hours), ringing in ears or hearing changes, reduced urination, or any severe symptoms.
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