Docetaxel

Cytostatic · Taxane

Indications

Locally advanced or metastatic breast cancer resistant or refractory to cytotoxic therapy that should have included an anthracycline.

Dosage

Adults: Breast Cancer: 60-100 mg/m² IV over 1 hr every 3 wk. Dosage adjustment may be required. Adjuvant Treatment Operable Node-Positive Breast CA: Neutrophil Count >1500 cells/cubic mm: 75 mg/m² 1 hr after doxorubicin 50 mg/m² and cyclophosphamide 500 mg/m² every 3 wk x 6 courses. Dosage adjustment may be required. Non-Small Cell Lung Cancer: 75 mg/m² IV over 1 hr every 3 wk. Dosage adjustment may be required. Hormone-Refractory Metastatic Prostate Cancer: 75 mg/m² IV over 1 hr every 3 wk with prednisone 5 mg twice daily. Dosage adjustment may be required. Children: Not recommended.

Administration

IV: Irritant. Anaphylactoid-like reactions have been reported: Pre-medication with dexamethasone (4-8 mg orally twice daily for 3 or 5 days starting 1 day prior to administration of docetaxel). Prevention of fluid retention (e.g. pleural effusion, ascites, peripheral oedema); Patients receiving docetaxel should be treated with a steroid (e.g. dexamethasone 8-10 mg orally twice daily) for 3-5 days, beginning the day before docetaxel administration. Administer IV infusion over 1 hour through non-absorbing (non-polyvinylchloride) tubing; in-line filter is not necessary. When administered as sequential infusions, taxane derivatives should be administered before platinum derivatives (cisplatin, carboplatin) to limit myelosuppression and to enhance efficacy. Intact vials of solution should be diluted with 13% (w/w) ethanol/water to a final concentration of 10 mg/mL. Docetaxel dose should be…

Adverse Effects

Neutropenia, thrombocytopenia, anaemia, hypersensitivity reactions, cutaneous reactions, fluid retention, peripheral neuropathy, mucositis, arthralgia, myalgia, increase in liver enzyme, GI upset, stomatitis, asthenia, anorexia, dysgeusia, dyspnoea, alopecia, fatigue, skin and nail disorders, increased lacrimation, hearing impairment, arrhythmia, BP changes, haemorrhage, cough, hot flush, chest pain, fever, amenorrhoea, wt change, inf site reactions.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Previous severe hypersensitivity to docetaxel. Neutrophils, severe liver impairment. Precautions: Monitor blood counts; Perform liver function tests. Contraception must be used. Monitor patient for hypersensitivity during inf and for fluid retention. Monitor closely if new or worsening pulmonary symptoms. Severe renal impairment. Reduce dose if severe peripheral neuropathy occurs. Risk of cystoid macular oedema. Perform baseline cardiac assessment. Risk of GI toxicity, evaluate GI symptoms promptly.

Interactions

Cyclosporin, terfenadine, ketoconazole, erythromycin, troleandomycin, other potent CYP3A4 inhibitors (e.g., ritonavir), carboplatin.

Advice to Patient

This medication is administered intravenously. Inform prescriber immediately if there is burning/swelling/pain/irritation/redness at infusion site or unusual weight gain, difficulty in breathing, swelling of extremities, chest pain, palpitations, abdominal discomfort, fever, chills, unrelieved diarrhoea, unusual bruising or bleeding, fatigue, rash. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber.

Pharmacokinetics

Metabolism: Hepatic. Half-life elimination: Terminal: Approx. 11 hours. Excretion: Feces (approx. 75%, <8% as unchanged drug); urine (approx. 6%)

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.