- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: paclitaxel
Brand Name: Taxol
Drug Class: Antineoplastics, Antimicrotubular (Taxanes)
What is paclitaxel, and what is it used for?
Paclitaxel is a chemotherapy drug used to treat various types of cancers including ovarian cancer, breast cancer, non-small cell lung cancer and AIDS-related Kaposi sarcoma.
Paclitaxel is an anticancer drug that belongs to a class of medications known as antimicrotubular antineoplastics. Paclitaxel may be used as a first-line, second-line, or adjuvant treatment, often in combination with cisplatin, another chemotherapy drug used to treat cancer.
Paclitaxel is a natural alkaloid known as taxane derived from English yew (Taxus baccata), an evergreen tree. Paclitaxel stops cancer cell growth by preventing cell division (mitosis) in cancer cells. Paclitaxel stabilizes the structure of microtubules within cells, preventing them from normal dynamic reorganization that is required for cell division. This arrests the cell cycle midway, inhibits cell replication, and induces programmed cell death (apoptosis).
Paclitaxel is approved by the FDA for the treatment of following cancers:
- First-line (with cisplatin) and subsequent therapy for the treatment of advanced ovarian cancer
- Adjuvant treatment for node-positive breast cancer administered sequentially to standard doxorubicin-containing combination chemotherapy
- Treatment of metastatic breast cancer after combination chemotherapy has failed or cancer has relapsed after 6 months of adjuvant chemotherapy
- First-line treatment (with cisplatin) of non-small cell lung cancer in patients who are not candidates for potentially curative surgery and/or radiation therapy
Second-line treatment of acquired immunodeficiency syndrome (AIDS)-related Kaposi’s sarcoma
- Paclitaxel is used off-label to treat advanced, refractory, recurrent, or metastatic stages of cancers that include:
- Pancreatic cancer
- Anal cancer
- Penile cancer
- Bladder cancer
- Upper gastrointestinal cancer
- Cervical cancer
- Endometrial cancer
- Head and neck cancer
- Small cell lung cancer
- Testicular germ cell tumor
- High-risk gestational trophoblastic neoplasia
- Thymoma/thymic carcinoma
- Thyroid cancer (anaplastic)
- Unknown primary adenocarcinoma
Orphan designations include:
- Esophageal cancer
- Adenocarcinoma of the stomach or lower esophagus
- Brain cancer
- Hormone-refractory prostate cancer
- Do not administer paclitaxel to patients with hypersensitivity to any of the components in the formulation.
- Do not administer paclitaxel to patients with:
- Solid tumors who have baseline neutrophil counts of less than 1500 cells/mm3
- AIDS-related Kaposi’s sarcoma with baseline neutrophil counts of less than 1000 cells/mm3
- Frequent blood cell counts should be performed on patients on paclitaxel therapy to monitor for occurrence of bone marrow suppression and low neutrophil counts (neutropenia) which can result in infection.
- Paclitaxel should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications.
- All patients should be pretreated with corticosteroids, diphenhydramine, and H2 antagonists and monitored for hypersensitivity reactions. Despite premedication, fatal reaction have occurred, including anaphylaxis with hypotension and breathing difficulty. Patients who have severe reactions should not be rechallenged with the drug.
- Some patients have developed severe heart conduction abnormalities that required pacemaker placement. Cardiac conduction should be monitored during paclitaxel infusion and appropriate therapy instituted, if necessary.
- Risk of cardiac dysfunction increases if administered in conjunction with trastuzumab or anthracyclines.
- Plasticized polyvinyl chloride (PVC) equipment or devices should be avoided for preparing paclitaxel solutions, to prevent plasticizer leaching into the solution. Use storing and administering equipment as recommended by the manufacturer.
What are the side effects of paclitaxel?
Common side effects of paclitaxel include:
- Blood disorders, including:
- Low count of neutrophil immune cells (neutropenia)
- Low count of leukocyte immune cells (leukopenia)
- Low red blood cell count (anemia)
- Low platelet count (thrombocytopenia)
- Low count of all types of blood cells (pancytopenia)
- Injection site reaction
- Leakage of drug out of the vein (extravasation)
- Skin rash
- Hair loss (alopecia)
- Hypersensitivity reactions
- Severe allergic reaction (anaphylaxis)
- Severe skin reactions such as:
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Sore mouth (stomatitis)
- Mucous membrane inflammation (mucositis)
- Muscle pain (myalgia)
- Joint pain (arthralgia)
- Weakness (asthenia)
- Peripheral nerve disease (neuropathy)
- ECG abnormality
- Cardiac conduction abnormalities
- Slow heart rate (bradycardia)
- Low blood pressure (hypotension)
- Congestive heart failure
- Left ventricular dysfunction
- Swelling (edema)
- High temperature (pyrexia)
- Grand mal seizure
- Kidney damage
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of paclitaxel?
- 6 mg/mL
- Premedicate to prevent hypersensitivity reactions (e.g., dexamethasone, diphenhydramine, H2 blockers)
- Previously untreated: 175 mg/m2 intravenously (IV) over 3 hours every 3 weeks (follow with cisplatin), OR
- 135 mg/m2 IV over 24 hours every 3 weeks (follow with cisplatin)
- Previously treated: Various regimens exist: 135-175 mg/m² IV over 3 hours every 3 weeks
- Node positive (adjuvant chemotherapy): 175 mg/m² intravenously (IV) over 3 hours every 3 weeks 4 times (with doxorubicin-containing regimen)
- Metastatic Disease (failure of initial chemotherapy or relapse within 6 months following adjuvant chemotherapy): 175 mg/m² IV over 3 hours every 3 weeks
Non-small Cell Lung Cancer
- 135 mg/m2 intravenously (IV) over 24 hours every 3 weeks (follow with cisplatin)
AIDS-related Kaposi's Sarcoma (2nd-line Treatment)
- 135 mg/m2 intravenously (IV) over 3 hours every 3 weeks; OR
- 100 mg/m2 IV over 3 hours every 2 weeks
Pancreatic Cancer (Off-label)
- Investigational: 125 mg/m2 intravenously (IV) with gemcitabine
- If baseline PMN is less than 1500/m³, do not re-treat until PMN greater than 1500/m³ and platelet count greater than 100,000/m³
- If severe neutropenia occurs (PMN less than 500/m³ for 7 days), reduce subsequent doses by 20%
- Renal impairment: No dosage adjustment is required
With solid carcinomas and not Kaposi sarcoma
- AST/ALT less than 2 times upper limit of normal (ULN) and bilirubin up to 1.5 mg/dL: 135 mg/m² over 24 hours
- AST/ALT 2 to 10 times ULN and bilirubin up to 1.5 mg/dL: 100 mg/m² over 24 hours
- AST/ALT less than 10 times ULN and bilirubin 1.6-7.5 mg/dL: 50 mg/m² over 24 hours
- AST/ALT 10 times ULN or greater OR bilirubin greater than 7.5 mg/dL: Do not administer
- AST/ALT less than 10 times upper limit of normal (ULN) and bilirubin less than 1.25 times ULN: 175 mg/m² over 3 hours
- AST/ALT less than 10 times ULN and bilirubin 1.26-2 times ULN: 135 mg/m² over 3 hours
- AST/ALT less than 10 times ULN and bilirubin 2.01-5 times ULN: 90 mg/m² over 3 hours
- AST/ALT 10 times ULN or greater OR bilirubin greater than 5 times ULN: Do not administer
- Safety and efficacy not established
- Paclitaxel overdose may cause symptoms that include bone marrow suppression, peripheral neurotoxicity, and mucous membrane inflammation (mucositis).
- There are reports of central nervous system toxicity from clinical trials in pediatric patients. The toxicity may be associated with the ethanol component of paclitaxel.
- There is no known antidote for paclitaxel overdose. Overdose may be treated with symptomatic and supportive care.
What drugs interact with paclitaxel?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Paclitaxel has no known severe interactions with other drugs.
- Serious interactions of paclitaxel include:
- adenovirus types 4 and 7 live, oral
- influenza virus vaccine quadrivalent, adjuvanted
- influenza virus vaccine trivalent, adjuvanted
- ropeginterferon alfa 2b
- Paclitaxel has moderate interactions with at least 124 different drugs.
- Paclitaxel has mild interactions with at least 63 different drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Paclitaxel can cause fetal harm, do not use in pregnant women.
- Women of reproductive potential must practice effective contraception while on paclitaxel therapy.
- It is not known if paclitaxel is present in breast milk, however, many drugs are, and paclitaxel has potential for serious adverse reactions in the breastfed infant. Nursing mothers should discontinue breastfeeding while receiving paclitaxel.
What else should I know about paclitaxel?
- Paclitaxel can have serious side effects. If you have severe stomach pain or severe diarrhea, inform your healthcare provider immediately.
- Severe allergic reaction (anaphylaxis) is a medical emergency and can lead to death if not treated promptly. Contact your healthcare provider right away if you have symptoms of anaphylaxis which may include:
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Paclitaxel is a chemotherapy drug used to treat various types of cancers including ovarian cancer, breast cancer, non-small cell lung cancer, and AIDS-related Kaposi sarcoma. Common side effects of paclitaxel include blood disorders, bleeding, infections, injection site reaction, leakage of drug out of the vein (extravasation), skin rash, hair loss (alopecia), hypersensitivity reactions, severe allergic reaction (anaphylaxis), severe skin reactions, nausea, vomiting, diarrhea, sore mouth (stomatitis), and others. Do not use if pregnant or breastfeeding.
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Early menopause does not cause breast cancer. An increasing age, and not menopause, can increase your breast cancer risk.
Breast Cancer Clinical Trials
Breast cancer clinical trials are research programs designed to evaluate new medical treatments, drugs, or devices for the treatment of breast cancer. Clinical trials are designed to test the safety and efficacy of new treatments as well as assess potential side effects. Clinical trials also compare new treatment to existing treatments to determine if it's any better. There are many important questions to ask your doctor before taking part in a breast cancer clinical trial.
What Is the Survival Rate of Non-Small Cell Lung Cancer?
There are two main types of lung cancers, namely, small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC accounts for 85% of all lung cancer cases in the United States. It must be noted that medical science is progressing with leaps and bounds, and treatment for lung cancer must be initiated and maintained despite the stage of diagnosis.
Breast Cancer During Pregnancy
Breast cancer occurs in about 1 in every 1,000 pregnant women. Treatment of breast cancer during pregnancy involves surgery, but it is very difficult to protect the baby from the dangerous effects of radiation and chemotherapy. It can be an agonizing to decide whether or not to undergo breast cancer treatment while one is pregnant.
Can Lung Cancer Go Away?
Lung cancer can go away if treated in the early stages, especially when the cancer is localized and has not spread to nearby lymph nodes or other sites in the body.
What Age Does Breast Cancer Usually Start?
Breast cancer is most often diagnosed in women older than 45 years of age (about 80 percent of all cases).
Breast Cancer Growth Rate
The available evidence suggests that breast cancer may begin to grow around 10 years before it is detected. However, the time for development differs from tumor to tumor.
Where Do You Feel Lung Cancer Pain?
In its early stages, lung cancer typically does not produce any signs and symptoms. However, if it does, you will experience coughing and wheezing that do not go away within three weeks.
Can a Blood Test Detect Ovarian Cancer?
A doctor may advise a blood test to patients having ovarian cancer. A cancer antigen-125 (CA-125) blood test is usually recommended to measure the levels of a protein called CA-125, which could be elevated in women who have ovarian cancer. This test is also used during the treatment of ovarian cancer because the level of this protein goes down as the tumor shrinks. This protein is elevated in more than 80 percent of women with advanced ovarian cancers and 50 percent of those with early-stage cancers.
How Can You Tell if a Guy Has Breast Cancer?
A breast tumor or cancer is suspected if the guy has a hard lump underneath the nipple and areola. Male breast cancer exhibits the same symptoms as female breast cancer, including a lump. Male breast cancer may also cause skin changes around the nipple.
How Can You Detect Breast Cancer Early?
Breast cancer develops from the cells of the breasts and can spread to other parts of the body (metastasis). It is one of the most common cancers diagnosed in women in the United States. A lump in the breast or armpit is often the first sign. Treatment success depends largely on early detection.
How to Manage Menopause Symptoms After Breast Cancer
Breast cancer treatment can cause menopausal symptoms due to the way certain therapies affect the ovaries. Learn about how you can find relief.
What Are the 4 Types of Kaposi Sarcoma?
Kaposi sarcoma (KS) is a type of cancer that forms in the lining of your blood and lymph vessels. The four types include epidemic, classic, endemic, and immunosuppressive KS.
Who Is at High Risk for Ovarian Cancer?
The risk of ovarian cancer increases with age. Almost half of the ovarian cancer cases are seen in women older than 63 years of age. Ovarian cancer is the leading cause of gynecological cancer-related deaths among women between the ages of 35 and 74 years.
What Does Breast Cancer in a Man Feel Like?
Male breast cancer is rare and affects 2.7 out of 100,000 African American men and 1.9 out of 100,000 Caucasian men in the United States.
Is There a Screening Test for Lung Cancer?
A screening test is generally performed as a preventative measure to detect a potential health problem or disease in a person who is yet to have signs or symptoms. There is a screening test for lung cancer, however it is only deemed necessary for people at risk for lung cancer.
What Are the Early Warning Signs of Ovarian Cancer?
Ovaries are small glands on each side of the uterus responsible for producing eggs as well as the female hormones estrogen and progesterone. In ovarian cancer, a mutation in the genetic material of ovarian cells leads to uncontrolled, abnormal cell growth.
What Are the Risk Factors for Developing Breast Cancer?
Breast cancer refers to the uncontrolled growth of cells within the breast. The risk factors for developing breast cancer include age, genetics, family history, personal history, menstrual history, breast density, previous radiation therapy, ethnicity, body weight, physical activity level, reproductive history, alcohol consumption and hormone pill use.
What Causes Kaposi Sarcoma?
Kaposi sarcoma (KS) is a form of cancer caused by herpesvirus infection. This virus is known as Kaposi sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV-8). Causes of Kaposi sarcoma include immune suppression, HIV infection and certain socioeconomic factors.
What Is the Newest Treatment for Breast Cancer?
Targeted therapies are a newer form of breast cancer treatment. They can be used alone or along with other therapies. Targeted therapies directly target cancer cells or specific processes that contribute to the growth of cancer cells. Target therapy often has fewer side effects.
What Are The Main Causes Of Lung Cancer?
Lung cancer refers to an uncontrolled growth of cells that starts in the lungs. The cells then cluster together to form a tumor that can spread to other sites in the body. Lung cancer is the third most common cancer in the United States (skin cancer being the first and prostate and breast cancer being the second most common cancer in men and women, respectively).
What Is the Survival Rate of Localized Breast Cancer?
The 5-year survival rate for localized breast cancer is 99%, and the condition is very treatable. Learn about symptoms and treatment for early stage breast cancer.
What Is the Risk of Breast Cancer by Age?
Age is the most significant risk factor for breast cancer, with the risk increasing with age. The risk peaks during menopause and remains constant or reduces afterwards.
Genetic Testing: Families With Breast Cancer
Breast cancer can be a killer and the decision to get tested to see if a patient is prone to the disease should be discussed with a doctor -- particularly if the woman has a history of breast cancer in her family. Genetic testing can only tell so much about breast cancer risk, however.
How Does Breast Cancer Start?
Breast cancer develops in the cells of the breasts and can spread to other parts of the body (metastasis). It is one of the most common cancers diagnosed in women in the US. Although extremely rare, breast cancer can sometimes occur in men. Breast cancer forms when there are changes or mutations in the deoxyribonucleic acid (DNA), which can cause normal breast cells to become cancerous.
How Is Breast Cancer Cured?
Surgery is the main treatment option for treating stage I breast cancer. Otherwise, the treatment options for breast cancer are determined by the following.
When Does Ovarian Cancer Occur?
Although it is unclear what causes ovarian cancer, the risk increases with age, and many women are diagnosed after menopause around the ages of 55-64.
Is There a Blood Test for Ovarian Cancer?
The CA-125 blood test is one of clinical assessments used to diagnose ovarian cancer. However, CA-125 or other tumor markers alone are insufficient to diagnose ovarian cancer.
What Are the Reasons for Breast Cancer?
Breast cancer is a multifactorial disease that can be caused by genetic and environmental factors. Experts are not yet fully aware of what may be the exact reason for breast cancer. The chances of getting breast cancer depend on the person’s age, personal history, genetic factors, and diet.
What Is Lung Cancer Pain Like?
Lung cancer, also known as lung carcinoma, is defined as an uncontrolled growth of tumor cells in the lungs. The principal role of the lungs is to allow gaseous exchange between the air and blood and facilitate the availability of oxygen for cellular functions.
How Common Is Breast Cancer in Men?
Breast cancer is more common in women. However, men can get breast cancer too. The chances of occurrence of breast cancer in men are rare. Out of every 100 breast cancer diagnosed in the United States, 1 is found in a man.
What Age Can a Male Get Breast Cancer?
Breast cancer risk in men increases with age, and most men with breast cancer are diagnosed in their 60s and 70s. Learn about causes and risk factors for breast cancer in men.
What Are Risk Factors for Ovarian Cancer?
Ovarian cancer is a malignant cancer of the ovaries. Risk factors for ovarian cancer include age, family history, genetics, ethnicity, weight, and others.
Treatment & Diagnosis
- How Long Does Lung Cancer Take to Develop?
- Is a Breast Ultrasound or Mammogram Better?
- What Percentage of Abnormal Mammograms Are Cancer?
- Can You Be Fully Cured of Ovarian Cancer?
- What Age Should a Woman Get a Mammogram?
- Bone Marrow Transplantation for Breast Cancer
- Can Mammograms Detect Cancer?
- Genetic Testing for Breast Cancer
- Radiation Therapy for Breast Cancer
- Role of Estrogen Receptors in Breast Cancer
- Breast Cancer Follow-Up Self-Exam
- Ovarian Cancer
- Breast Cancer
- Lung Cancer
- Breast Cancer Husband
- Breast Cancer: A Feisty Women's Discussion
- Breast Cancer: Mother-daughter relationships
- Inflammatory Breast Cancer
- Male Breast Cancer
- Breast Cancer
- Breast Cancer: Early Stage Treatments
- Breast Cancer: Clinical Trials - Today's Cutting Edge
- Breast Cancer, Metastatic: Treatment Goals and Therapy Options -- Harold J. Burstein, MD
- Breast Cancer: Early Diagnosis and Prevention
- Breast Cancer, Taking Control: Self-Advocacy 101
- Breast Cancer: The Male View on Survival and Support
- Breast Cancer Treatment Update
- Lung Cancer Q & A
- Breast Cancer FAQs
- Ovarian Cancer FAQs
- Lung Cancer FAQs
- Breast Cancer Risk - Reduced With Exercise
- Herceptin Metastatic Breast Cancer Treatment
- Breastfeeding -- Protection from Breast Cancer?
- Hormone Therapy in Survivors of Breast Cancer
- Breast Cancer: Types of Breast Cancer
- Ovarian Cancer Symptoms, Early Warning Signs, and Risk Factors
- Ovarian Cancer: Exercise May Help Prevent
- Exercise Improves Breast Cancer Survival
- Lung Cancer and Chemotherapy
- Lung Cancer Signs and Symptoms
- Advanced Breast Cancer in Young Women Increasing
- Angelina Jolie's Mastectomy
- Stress and Aggressive Breast Cancer: Cause or Effect?
- Does Positive Additude Affect Breast Cancer?
- How Common and Dangerous Is Male Breast Cancer?
- What Are the Early Warning Signs of Ovarian Cancer?
- How Many Breast Cancer Deaths Are there Each Year?
- Where Can Breast Cancer Spread To?
- Can You Get Ovarian Cancer after Tubal Ligation?
- Can You Prevent Ovarian Cancer?
- Why Is Breast Cancer More Common in Females than Males?
- How Much Breast Cancer is Genetic?
- How Long Can Breast Cancer Patients Live?
- Who Does Breast Cancer Affect?
- How Does Breast Cancer Form?
- How Many Breast Cancer Stages Are There?
- Facts on Breast Cancer Causes, Risk Factors, and Types
- Breast Cancer Symptoms and Signs
- Breast Cancer Detection
- Breast Cancer Treatment
Medications & Supplements
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