Paclitaxel

Cytostatic · Taxane

Indications

See under dosage.

Dosage

Adults: IV: Ovary Carcinoma: Previously untreated: 175 mg/m² over 3 hr or 135 mg/m² over 24 hr every 3 wk. Treated: 135-175 mg/m² over 3 hr every 3 wk. Breast Cancer: 175 mg/m² over 3 hr every 3 wk. Non-Small Cell Lung Cancer: 135 mg/m² over 24 hr every 3 wk. Kaposi's Sarcoma: 135 mg/m² over 3 hr every 3 wk or 100 mg/m² over 3 hr every 2 wk. Children: Not recommended.

Administration

IV Inf: The concentrate must be diluted to a final Paclitaxel conc of 0.3 to 1.2 mg/mL in D5W, NS, D5NS. Administration over 3 hours is often recommended. Compatibility: Stable in D5LR, D5NS, NS. Incompatible with amphotericin B, amphotericin B cholesteryl sulphate complex, chlorpromazine, doxorubicin liposome, hydroxyzine, methylprednisolone sodium succinate, mitoxantrone. Stability: Store intact vials at room temperature of 20°C-25°C (68°F-77°F). Reconstituted solution is stable for up to 27 hours at room temperature (25°C) and ambient light conditions. Solutions in D5W, NS, D5NS and D5LR are stable for up to 48 hours at room temperature (25°C).

Adverse Effects

Pharyngolaryngeal pain, cough, rhinitis, rhinorrhoea, GI upset, dry mouth, dysphagia, GI obstruction, colitis, cholangitis, pain (incl musculoskeletal, extremity, chest), muscle cramps, mucosal inflammation, wt loss, increased LFTs and creatinine, acute renal failure, inf site reactions, myelosuppression, neuropathy, hypoaesthesia, paraesthesia, alopecia, skin and nail disorders, asthenia, fatigue, fever, chills, infections, anorexia, dehydration, hypokalaemia, insomnia, depression, anxiety, headache, dysgeusia, dizziness, ataxia, somnolence, eye disorders, tachycardia, CHF, arrhythmia, flushing, hot flushes, BP changes, oedema, interstitial pneumonitis, dyspnoea, epistaxis, haemoptysis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Neutrophils less than 1.5x109 per litre. Severe hepatic impairment. Precautions: Monitor blood counts. Cardiac conduction abnormalities, peripheral neuropathy, renal or hepatic failure. Ensure resuscitation equipment available. Mild to moderate hepatic impairment; monitor for development of profound myelosuppression. Renal impairment. Previous anthracycline therapy, underlying cardiac disease. Monitor for cardiac events and pneumonitis. CNS metastases. Pancreatic adenocarcinoma or NSCLC . Risk of sepsis during combination treatment with gemcitabine: if fever develops, start antibiotics; if febrile neutropenia develops, withhold treatment until fever resolves and neutrophils = 1500 cells/mm3.

Interactions

CYP3A4 or CYP2C8 inhibitors (e.g., erythromycin, fluoxetine, clopidogrel, azole antifungals) or inducers (e.g., rifampicin, carbamazepine, phenytoin, efavirenz, nevirapine), other antineoplastics.

Advice to Patient

This medication is administered by infusion. Report immediately redness/swelling/pain/burning at infusion site or if there is swelling of lips or mouth, difficulty in breathing or swelling, skin rash, hives, chest tightness. Contact prescriber if there is nausea, vomiting, fever, chills, sore throat, burning or pain on urination, unusual bruising or bleeding, fatigue, dark coloured stool, blood in stool/urine/mouth, unrelieved mouth sores, skin rash, itching. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Consult prescriber for suitable medication if there is severe nausea and vomiting. Using soft toothbrush, cotton swabs, waxed dental floss, regular mouth care, frequent rinses may help to prevent mouth sores. Take…

Pharmacokinetics

Metabolism: Hepatic. Half-life elimination: Children: 4.6 to 17 hours (varies with dose and infusion duration). Adults: 3-hour infusion: Mean (terminal): Approx. 13 to 20 hours. 24-hour infusion: Mean (terminal): Approx. 16 to 53 hours. Excretion: Feces (approx. 71%; approx. 5% as unchanged drug); urine (approx. 14%).

Brands with this active ingredient

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

Always consult a pharmacist or doctor.