Gemcitabine Intravenous and Nortriptyline Hydrochloride

• Generic Name: gemcitabine
• Dosage Forms: n.a.
• Other Brand Names: Gemzar, Infugem

Gemcitabine injection is used together with other medicines (eg, carboplatin) to treat patients with advanced ovarian cancer that has come back at least 6 months after treatment with other cancer medicines (platinum-based).

Gemcitabine injection is also used together with other medicines (eg, paclitaxel) to treat metastatic (cancer that has spread) breast cancer in patients who have received other treatments that did not work well.

It is also used together with other medicines (eg, cisplatin) to treat non-small cell lung cancer that has advanced, spread, or cannot be treated with surgery.

Gemcitabine injection is also used to treat pancreas cancer that has advanced or spread to the other parts of the body in patients who have been previously treated with fluorouracil.

Gemcitabine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may occur after treatment with gemcitabine has been stopped.

Gemcitabine is to be given only by or under the direct supervision of your doctor.

• Generic Name: nortriptyline
• Dosage Forms: n.a.
• Other Brand Names: Pamelor, Aventyl HCl, Aventyl

Management of major depressive disorder.

Results of several studies of TCAs in preadolescent and adolescent patients with major depression indicate lack of overall efficacy in this age group.

Second-line agent in attention deficit hyperactivity disorder (ADHD) patients unable to tolerate or unresponsive to stimulants; should be used only under close supervision.

Associated with a narrower margin of safety than some other therapeutic agents; use only if clearly indicated and with careful monitoring, including baseline and subsequent determinations of ECG and other parameters.

Has been used for management of eating disorder (e.g., bulimia, anorexia nervosa) with equivocal results; avoid use in underweight individuals and in those exhibiting suicidal ideation.

US Public Health Service (USPHS) guideline for the treatment of tobacco use and dependence recommends nortriptyline as a second-line drug for smoking cessation after first-line drugs (i.e., bupropion [as extended-release tablets], nicotine polacrilex gum or lozenge, transdermal nicotine, nicotine nasal spray, nicotine oral inhaler, varenicline) have been used without success or are contraindicated.

Has been used for the short-term management of acute depressive episodes in bipolar disorder.

TCAs associated with a greater risk of precipitating hypomania or manic episodes than other classes of antidepressants; should always be used in combination with a mood stabilizer (e.g., lithium).

Has been used for the management of acute depressive episodes (in combination with an antipsychotic) in patients with schizophrenia.

Has been used for the management of anxiety (in combination with anxiolytics, sedatives, or antipsychotics) in patients with depression.

Among the drugs of choice for the symptomatic treatment of postherpetic neuralgia.

Less effective for insomnia and associated with more serious adverse reactions than conventional hypnotics.