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Gemkabi

Fresenius Kabi

Koncentrat till infusionsvätska, lösning 38 mg/ml
(klar, färglös till svagt halmgul lösning fri från synliga partiklar)

Antineoplastiska läkemedel; pyramidinanalog

Aktiv substans:
ATC-kod: L01BC05
Utbytbarhet: Ej utbytbar
Läkemedel från Fresenius Kabi omfattas av Läkemedelsförsäkringen.
Vad innebär restanmält läkemedel?
Information om restanmält läkemedel
Vissa förpackningar av Gemkabi Koncentrat till infusionsvätska, lösning 38 mg/ml är restanmälda hos Läkemedelsverket. Kontrollera lagerstatus för att se om ditt apotek har läkemedlet i lager.

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Injektionsflaska 1000 milligram (vnr 393795)
Inte utbytbart.
Alternativ förpackning.
Startdatum: 2025-09-04
Prognos för slutdatum: 2025-10-31
  • Vad är miljöinformation?

Miljöinformation

Miljöpåverkan

Gemcitabin

Miljörisk: Användning av gemcitabin har bedömts medföra försumbar risk för miljöpåverkan.
Nedbrytning: Gemcitabin är potentiellt persistent.
Bioackumulering: Gemcitabin har låg potential att bioackumuleras.


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Detaljerad miljöinformation

Environmental Risk Classification

Predicted Environmental Concentration (PEC)

PEC is calculated according to the following formula:

PEC (μg/L) = (A*109*(100-R))/(365*P*V*D*100) = 1.37*10-6*A(100-R)


PEC = 0,0028 μg/L

Where:

A = 20,51 kg (total sold amount API in Sweden year 2020, data from IQVIA). Reduction of A may be justified based on metabolism data.

R = 0 % removal rate (due to loss by adsorption to sludge particles, by volatilization, hydrolysis or biodegradation) = 0 if no data is available.

P = number of inhabitants in Sweden = 10 *106

V (L/day) = volume of wastewater per capita and day = 200 (ECHA default) (Ref. I)

D = factor for dilution of waste water by surface water flow = 10 (ECHA default) (Ref. I)

Predicted No Effect Concentration (PNEC)


Ecotoxicological studies (Ref. II)

Algae (Desmodesmus subspicatus)

Growth inhibition test (guideline European standard EN ISO 8692:1989 (ISO, 1989b)


LOEC 72 h = 10 mg/L

EC50 72 h (growth rate) = 45 mg/L


Crustacean, Giant water flea (Daphnia magna, invertebrate, acute test)

Acute immobilization test (European Standard EN ISO 6341:1996 (ISO, 1989a)


LOEC 48 h = 50 mg/L

EC50 48 h (Immobility) = 110 mg/L


Bacteria (Pseudomonas putida):

Growth inhibition test (guideline International Standardization Organization Standard EN ISO 10712:1995 and the Czech Standard (CSN, 1995)


LOEC 16 h = 50 mg/L

EC50 16 h (growth rate) = 100 mg/L


Based on the most sensitive acute species; Algae (Desmodesmus subspicatus) 72 h LOEC of 10 mg/L (equivalent to 10000 µg/L) and an assessment factor of 1000 in accordance with ECHA guidance (Ref. I)

PNEC = 10 000 µg/L /1000 = 10 µg/L


Environmental risk classification (PEC/PNEC ratio)

PEC/PNEC = 0,0028 / 10 = 2,8X10-4, PEC/PNEC ≤ 0,1 which justifies the phrase ‘Use of gemcitabine has been considered to result in insignificant environmental risk.’


Biotic degradation

Degradation: (Ref. VI)

Study type

Result

Remark

FDA 3.11

Not ready

70% of parent remained after 28 d

301 D

Not ready

42% after 28 d

302B

Not inherent

45% after 4 d, 50% at test end (28 d)

DT50 biodegradation 5


0.0049 d

5 times a 2 d cyclic act. sludge incubation

Hydrolysis DT50

0.28 d

dark; 22°C. pH not reported

Since gemcitabine fails to meet the above criteria, and there are no simulation studies or analytical monitoring data to support elimination within the ECHA persistence half-lives, the phrase ,The gemcitabine is potentially persistent, was chosen.


Bioaccumulation

BCF = 3 (Ref. V)

LogP = 0,14 (Ref IV)

Since log P < 4 at pH 7, the substance has low potential for bioaccumulation.


References:

  1. ECHA, European Chemicals Agency. 2008 Guidance on information requirements and chemical safety assessment. http://guidance.echa.europa.eu/docs/guidance_document/information_requirements_en.htm

  2. Martín J., Camacho-Muñoz D., Luis Santos J., Aparicio I., Alonso E. Occurrence and Ecotoxicological Risk Assessment of 14 Cytostatic Drugs in Wastewater. Water Air Soil Pollut (2014) 225:1896

  3. Kummerer K, Al-Ahmad A. Biodegradability of the anti-tumour agents 5-fluorouracil, cytarabine, and gemcitabine: impact of the chemical structure and synergistic toxicity with hospital effluent. Acta Hydrochim Hydrobiol 1997;25(4):166–72.

  4. https://go.drugbank.com/drugs/DB00441

  5. Booker V., Halsall C., Llewellyn N., Johnson A., Williams R. Prioritising anticancer drugs for environmental monitoring and risk assessment purposes. Science of the Total Environment 473–474 (2014) 159–170