Nab-Paclitaxel

Cytostatic · Taxane

Indications

(1) Metastatic breast cancer, after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy include anthracycline unless contraindicated. (2) Locally advanced or metastatic non-small cell lung cancer (NSCLC), as first-line treatment in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy. Metastatic adenocarcinoma of the pancreas as first-line treatment, in combination with gemcitabine.

Dosage

Adults: IV: Metastatic Breast Cancer: 260 mg/m2 over 30 minutes every 3 weeks. Non-Small Cell Lung Cancer (NSCLC): 100 mg/m2 over 30 minutes on Days 1, 8, and 15 of each 21-day cycle; administer carboplatin on Day 1 of each 21-day cycle immediately after nab paclitaxel. Adenocarcinoma of the Pancreas: 125 mg/m2 intravenously over 30-40 minutes on Days 1, 8, and 15 of each 28-day cycle; administer gemcitabine on Days 1, 8, and 15 of each 28-day cycle immediately after nab paclitaxel. Children: Not recommended.

Administration

Administered via IV route. Closely monitor the infusion site for extravasation or drug infiltration during administration. Limiting the infusion of nab paclitaxel to 30 mins may reduce the risk of infusion-related reactions. Consider premedication in patients who have had prior hypersensitivity reactions to medication. Calculate the exact total dosing volume of 5 mg/mL suspension required for the patient and slowly withdraw the dosing volume of the reconstituted suspension from the vial(s) into a syringe: Dosing volume (mL)=Total dose (mg)/5 (mg/mL). Inject the appropriate amount of reconstituted soln into an empty, sterile IV bag (PVC containers, PVC or non-PVC type intravenous bag). Visually inspect the reconstituted nab paclitaxel suspension in the IV bag prior to administration. Discard the reconstituted suspension if proteinaceous strands, particulate matter, or discoloration are…

Adverse Effects

MBC: Alopecia, neutropaenia, sensory neuropathy, abnormal ECG, fatigue/asthenia, myalgia/arthralgia, AST elevation, alkaline phosphatase elevation, anaemia, nausea, infections and diarrhoea. NSCLC: Anaemia, neutropaenia, thrombocytopaenia, alopecia, peripheral neuropathy, nausea, and fatigue. Adenocarcinoma of the Pancreas: Neutropaenia, fatigue, peripheral neuropathy, nausea, alopecia, peripheral oedema, diarrhoea, pyrexia, vomiting, decreased appetite, rash and dehydration.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: AST > 10 x the upper limit of normal (ULN) or bilirubin >5 x ULN. Patients with metastatic adenocarcinoma of the pancreas who have moderate to severe hepatic impairment. Neutrophil counts <1500 cells/mm3. Precautions: Moderate to severe hepatic impairment in patients with MBC or NSCLC. Monitor for neutropaenia. Perform frequent CBC counts.

Interactions

Inhibitors or inducers of either CYP2C8 or CYP3A4.

Advice to Patient

Females of reproductive potential must use effective contraception and avoid becoming pregnant during treatment and for at least six months after the last dose. Lactating mothers must avoid nursing babies during treatment and for 2 wks after receiving the last dose. Male patients with female partners of reproductive potential must use effective contraception and avoid fathering a child during treatment and for at least 3 months after the last dose. Report immediately if you experience any of the following symptoms: Fever, evidence of infection, numbness/tingling/pain/weakness involving the extremities, sudden onset of dry persistent cough, shortness of breath, signs of an allergic reaction, persistent vomiting, diarrhoea, signs of dehydration.

Pharmacokinetics

Metabolism: Hepatic. Half-life elimination: Terminal: 13-27 hrs. Excretion: Faeces (20%). Urine (<1%).

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

Always consult a pharmacist or doctor.