docetaxel, Taxotere, Docefrez

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

GENERIC NAME: docetaxel

BRAND NAME: Taxotere, Docefrez

DRUG CLASS AND MECHANISM: Docetaxel is a drug that is used primarily for treating breast cancer. Docetaxel works by attacking cancer cells. Every cell in the body contains a supporting structure (almost like a skeleton) called the microtubular network. If this "skeleton" is changed or damaged, the cell can't grow or reproduce. Docetaxel makes the "skeleton" in cancer cells unnaturally stiff, so that these cells can no longer grow.

PRESCRIBED FOR: Docetaxel is used for the treatment of patients with locally advanced or metastatic breast cancer after failure of prior chemotherapy; second-line treatment of patients with non-small cell lung cancer after failure of platinum-based chemotherapy; prostate cancer; gastric adenocarcinoma; and squamous cell carcinoma of the head and neck.

SIDE EFFECTS: Following are some of the common side effects associated with docetaxel. Patients who have these or other side effects should tell their doctor or nurse.

Low white blood cell count: Usually, the patient will not feel it if you have a low white blood cell count, since there are no specific symptoms associated with this side effect unless, as a result of the low count, an infection develops. The patient's nurse or doctor will check the patient's blood count if he or she thinks it is necessary. The patient's white blood cells protect the body against infection. Like many agents used to treat cancer, docetaxel (Taxotere) may cause a temporary drop in the number of white blood cells (a condition known as neutropenia) and may increase the risk of infection. However, most people receiving docetaxel (Taxotere) don't develop infections, even when their white blood cell count is low.

Fever: Fever is one of the most common and earliest signs of infection. If a person has a fever over 100 F (37.7 C), make sure to call a doctor or nurse immediately. The patient should also tell the doctor about other symptoms of infection, such as a sore throat or cough or a burning sensation while urinating.

Allergic reactions: This type of reaction, which occurs during the infusion of docetaxel, is infrequent. If a person feels a warm sensation, difficulty in breathing, or itching during or shortly after treatment, tell the doctor or nurse immediately. Oral steroids are given to prevent allergic reactions. If the person has a mild allergic reaction to the first few infusions of docetaxel, such as flushing or a rash, notify the nurse. The doctor will generally stop treatment for a few minutes and then restart the infusion.

Fluid retention: Fluid retention is a term used to describe an accumulation of fluid in body tissues and/or body cavities. It is important to let your doctor or nurse know if you have any signs of fluid retention. Watch for shortness of breath, swelling of the feet or hands, or unexplained weight gain. In severe cases, shortness of breath may develop due to fluid accumulation in body cavities such as the area surrounding your lungs, the space around the heart, or in the abdomen. Dexamethasone (a steroid)is used to prevent or reduce fluid retention in patients taking docetaxel. It is important that the patient take dexamethasone exactly as the doctor or nurse advises. If a patient forgets to take dexamethasone, it is very important that they tell the doctor or nurse before receiving next docetaxel treatment.

Hair loss: Loss of hair (including the hair on the head, underarm hair, pubic hair, eyebrows, and eyelashes), which is known as alopecia, occurs in most patients taking docetaxel. For some people, this is a very difficult side effect to experience. However, the hair should grow back once treatment is stops. Meanwhile, the doctor or nurse can refer the patient to a specialty store that carries wigs, hairpieces, and turbans specifically for patients with cancer. The patient can also call the American Cancer Society for more information (1-800-ACS-2345).

Fatigue and muscle discomfort: Many patients receiving docetaxel for injection feel tired at some time during their treatment. Even if the patient is only slightly tired, make sure to get enough rest during treatment. Muscle pain occurs about 20% of the time but is rarely severe. The patient may feel pain in the muscles or joints. Tell the doctor or nurse if this happens. They may suggest ways to make the patient more comfortable.

Rash: Patients on docetaxel may develop a red, blotchy rash. This usually occurs on the feet and hands, but may also appear on the arms, face, or body. If it occurs, the rash generally appears within a week after docetaxel treatment and usually disappears after a week or two.

Numbness: Some patients receiving docetaxel experience numbness, tingling, burning, or weakness in the hands and feet.

Nail changes: Changes in the color of the fingernails or toenails may occur while the patient is taking docetaxel. Occasionally, nails become soft and tender. In more extreme but rare cases, nails may fall off. After docetaxel treatment is finished, the nails will generally grow back. Keeping the nails clean and trimmed while being treated with docetaxel may help prevent nail problems.

Nausea, vomiting, and diarrhea: Nausea, vomiting, and diarrhea may occur but generally are not severe with docetaxel.

Other possible side effects: The side effects listed here include those that occur most frequently in patients receiving docetaxel, but they are not the only ones that may occur. Make sure to report any symptoms to the doctor or nurse.

As part of the patient's treatment plan, the doctor may prescribe other medications, including dexamethasone, which is used to help lessen some of the side effects the patient may have during treatment. Dexamethasone may prevent fluid retention (holding extra water in the body) and may also lessen any allergic reactions to docetaxel. Patients generally begin taking dexamethasone one day before their docetaxel treatment and usually continue for a total of three days. However, the patient should always follow hte doctor's or nurse's instructions on how to take medications and for how many days.

Use of a short course of dexamethasone, a corticosteroid can cause side effects, although they are generally mild in nature. These side effects can include flushing, upset stomach, and nausea. If the patient has previously had side effects while taking corticosteroids, alert the physician or nurse before receiving treatment with docetaxel.

If the patient forgets to take dexamethasone as directed, make sure to tell the doctor or nurse before you receive the docetaxel treatment. If the patient has any problems taking dexamethasone call the doctor or nurse.

Medically Reviewed by a Doctor on 9/29/2015

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