Paclitaxel

The recommended dose and dosing schedule of paclitaxel varies according to the specific type of cancer being treated, the response to treatment, and other medications or treatments being used. The dose given is also based on body size. Paclitaxel is usually injected into a vein (intravenously) by a qualified health care professional through a specially prepared site on your skin. It is often scheduled to be given in this manner over a 3-hour period once every 3 weeks.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. Very careful handling of Paclitaxel is required. It is always given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.

It is important Paclitaxel be given exactly as recommended by your doctor. If you miss an appointment to receive paclitaxel, contact your doctor as soon as possible to reschedule your appointment.

Store Paclitaxel at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each mL of sterile nonpyrogenic solution contains 6 mg of paclitaxel from Taxus Canadensis, 527 mg of Cremophor® EL (purified polyethoxylated castor oil), and 49.7% (v/v) dehydrated alcohol, USP.

Do not use paclitaxel if you:

• are allergic to paclitaxel, polyethoxylated castor oil, or any ingredients of the medication
• have a very low level of neutrophils (a type of white blood cell) in the blood

There may be an interaction between paclitaxel and any of the following:

• other cancer medications (e.g., Cisplatin, Doxorubicin, Teniposide, Etoposide, Vincristine)
• Abiraterone acetate
• Amiodarone
• amphotericin B
• Aprepitant
• Atorvastatin
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., Phenobarbital, secobarbital)
• BCG vaccine
• Bicalutamide
• boceprevir
• Bosentan
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Carbamazepine
• Carvedilol
• Celecoxib
• Cimetidine
• Clopidogrel
• Clozapine
• Cobicistat
• conivaptan
• corticosteroids (e.g., budesonide, Dexamethasone, Hydrocortisone, fluticasone, Prednisone)
• Cyclosporine
• Deferasirox
• Denosumab
• Desipramine
• dexamethasone
• Dipyridamole
• Dronedarone
• echinacea
• Eltrombopag
• Enzalutamide
• estrogens
• Gemfibrozil
• grapefruit juice
• Haloperidol
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Hydrocodone
• Hydroxyurea
• Infliximab
• Irbesartan
• Leflunomide
• Lomitapide
• Losartan
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Mefloquine
• Metronidazole
• mifepristone
• Montelukast
• Modafinil
• mycophenolate
• Natalizumab
• nefazodone
• Norfloxacin
• phenobarbital
• Phenytoin
• Pimecrolimus
• Prazosin
• primidone
• Progesterone
• quinidine
• quinine
• Rabeprazole
• retinoic acid
• rifabutin
• rifampin
• Rituximab
• Roflumilast
• St. John's wort
• Saxagliptin
• Sertraline
• simeprevir
• sitaxentan
• Stiripentol
• Tacrolimus
• Tamoxifen
• telaprevir
• tenofovir
• testosterone
• Tetracycline
• thiazolidinediones (e.g., Pioglitazone, Rosiglitazone)
• Tocilizumab
• Trastuzumab
• Trazodone
• Trimethoprim
• vaccines
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Paclitaxel.

Allergic reactions: Paclitaxel may cause an allergic reaction (flushing of the face, severe back pain, chest tightness, shortness of breath) within the first few minutes of receiving paclitaxel. You will be asked to take some medication prior to treatment with paclitaxel to reduce your chances of experiencing a reaction.

Arrhythmia: People with heart rhythm problems may experience a worsening of these problems due to this medication. If you have a heart problem, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Paclitaxel, and whether any special monitoring is needed.

Blood clotting: Paclitaxel can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly as usual. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that do not stop bleeding.

Drowsiness/reduced alertness: Paclitaxel may cause fatigue and weakness which may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Paclitaxel affects you.

Eye problems: Paclitaxel may cause a rare eye problem called cystoid macular edema, which reults in blurred vision due to swelling of the Retin A. If you notice blurred vision or any other vision changes, notify your doctor immediately.

Infection: As well as killing cancer cells, Paclitaxel can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who have a contagious infection and tell your doctor immediately if you begin to notice signs of an infection, such as fever or chills.

Liver function: Liver disease or reduced liver function may cause increased side effects with Paclitaxel. If you have liver problems, discuss with your doctor how Paclitaxel may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor will test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Nerve pain: Paclitaxel may cause a mild burning, tingling, or numbing sensation of the fingers and toes. This side effect is rarely severe and usually goes away once you finish treatment.

Pregnancy: There are no adequate studies of use of Paclitaxel by pregnant women, however paclitaxel may cause severe harm to a developing baby if it is used by the mother during pregnancy. Paclitaxel should not be used during pregnancy. If you become pregnant while taking Paclitaxel, contact your doctor immediately.

Breast-feeding: It is not known if paclitaxel passes into breast milk. If you are a breast-feeding mother and are taking Paclitaxel, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Paclitaxel have not been established for children.

Seniors: People over the age of 65 may be at increased risk of side effects from Paclitaxel.