How much more toxicity and myelosuppression has been associated with gemcitabine (Gemzar) when it is infused over periods longer than 30 minutes? —Name withheld on request

The maximum tolerated gemcitabine doses were 65 mg/m2 when the drug was infused over 30 minutes and 150 mg/m2 when the drug was injected over 5 minutes, in clinical trials. The limiting toxicities reported in these clinical trials included thrombocytopenia, flulike symptoms, and loss of strength and energy; therefore, adhering to the recommended duration for administration is important due to the potential for increased toxicity. —Abimbola Farinde, PharmD, MS, BCPP, CGP, LCDC, PM/PRC, FASCP, FACA, FNAP, Rsi, ARSPharmS