Cabazitaxel
Cytostatic · Taxane
Indications
With prednisolone for hormone-refractory metastatic prostate cancer previously treated with docetaxel.
Dosage
Adults: 25 mg/m² by IV inf over 1 hr every 3 wk, with daily prednisolone. Premedicate with an antihistamine, corticosteroid and H2 antagonist >30 min before each inf. Children: Not applicable.
Administration
IV as a 1 hour infusion at room temperature. Initial dilution: Each vial of Cabazitaxel 60 mg per 1.5 mL must first be mixed with the entire contents of supplied diluent to get the concentration of 10 mg/mL. This dilution requires further dilution before administration and it should be done within 30 min. Final dilution: Withdraw the recommended dose from the 10 mg/mL and further dilute into a sterile 250 mL PVC free container of NaCl 0.9% solution or dextrose 5% solution for infusion. If a dose greater than 65 mg is required, use a larger volume of the infusion vehicle so that a concentration of 0.26 mg/mL is not exceeded. The concentration of the final dilution should be between 0.1 and 0.26 mg/mL. Stability: Cabazitaxel final dilution should be used immediately or within 8 hours at ambient temperature or within a total of 24 hours if refrigerated. Because the final dilution of…
Adverse Effects
Infections, blood dyscrasias, anorexia, dehydration, hyperglycaemia, hypokalaemia, anxiety, confusion, dysgeusia, peripheral neuropathy, dizziness, headache, paraesthesia, fatigue, hypoesthesia, increased lacrimation, tinnitus, vertigo, arrhythmias, blood pressure changes, DVT, hot flushes, flushing, dyspnoea, cough, oropharyngeal pain, GI upset, haemorrhoids, rectal haemorrhage, dry mouth, alopecia, dry skin, erythema, musculoskeletal pain, muscle spasm, flank pain, renal failure, dysuria, renal colic, haematuria, pollakiuria, hydronephrosis, urinary retention ad incontinence, ureteric obstruction, pelvic pain, asthaenia, fever, oedema, mucosal inflammation, chest pain, chills, weight loss, raised liver enzymes. Reports of pneumonitis, interstitial lung disease.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Hepatic impairment (bilirubin > x ULN or AST/ALT >1.5 x ULN), neutrophils <1500/mm3. Ensure contraception and continue for 6 months after treatment. Precautions: Moderate to severe renal impairment (CrCl <50 mL/min), anaemia. Consider prophylactic G-CSF to reduce risk of neutropenia. Provide anti-emetic prophylaxis. Ensure adequate hydration. Monitor blood counts weekly during cycle 1 and before each subsequent cycle. Measure serum creatinine before treatment and with each blood count. Advise patients to report symptoms of peripheral neuropathy and changes in urinary output. Suspend or reduce dosing if febrile or prolonged grade >3 neutropenia, grade >3 or persistent diarrhoea or grade >2 peripheral neuropathy occurs; discontinue if grade >3 renal failure occurs. Alcoholism,…
Interactions
Inhibitors or inducers of CYP3A4, live vaccines, St. John's Wort, NSAIDs, anticoagulants, antiplatelets.
Advice to Patient
Contact prescriber if there is severe stomach pain, headaches, muscle ache, cough, sore throat, difficulty in urination, feelings of cold and shiver, difficulty in breathing, swelling on face/lips/throat/eyelids. Avoid highly crowded places to prevent infection. Avoid alcohol during treatment. Wash hands regularly, use an electric razor and soft toothbrush to minimize the risk of bleeding. Avoid direct sunlight, use protective clothing, wear sunscreen (SPF 15 or higher) and eyewear to prevent photosensitivity. Take small, frequent meals to maintain good nutritional status. Take plenty of rest. Avoid immunisation with live vaccines during treatment and for 6 months after completion of treatment.
Pharmacokinetics
Metabolism: Extensively hepatic. Half-life elimination: Terminal: 95 hours. Excretion: Feces (76% as metabolites); Urine (approx. 4%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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