Trade/other name(s): Taxol, Onxol, PaxeneWhy would
this drug be used?
This drug is used to treat breast, lung, and ovarian cancers, as well
as Kaposi sarcoma. Your doctor may also use it to treat other types of
cancer.How does this drug work?
Paclitaxel is a type of chemotherapy drug known as a taxane.
It is thought to work by interfering with microtubules, which are
part of the internal scaffolding needed by cells when they are dividing
into 2 cells. Over time, this leads to cell death. Because cancer cells
divide more quickly than normal cells, they are more likely than normal
cells to be affected by this drug.Before taking this medicineTell
- If you are allergic to any medicines, dyes, additives,
- If you have any type of liver disease (including
hepatitis). This drug is cleared from the body mainly by the liver.
Reduced liver function might result in more drug staying in the body,
which could lead to worse side effects. Your doctor may need to adjust
- If you have any other medical conditions such as kidney
disease, heart disease, diabetes, gout, high blood pressure, or
infections. These conditions may require that your medicine dose,
regimen, or timing be changed.
- If you are pregnant, trying to get pregnant, or if there
is any chance of pregnancy. This drug may cause problems with the fetus
if taken at the time of conception or during pregnancy. Men and women
who are taking this drug should use some kind of birth control during
treatment. Check with your doctor about what kinds of birth control can
be used with this medicine. In pregnant women, treatment with this drug
should be used only if the potential benefit to the mother outweighs the
risk to the fetus.
- If you are breast-feeding. While no studies have been
done, this drug may pass into breast milk and affect the baby.
Breast-feeding is not recommended during treatment with this drug.
- If you think you might want to have children in the future.
This drug may affect fertility. Talk with your doctor about the
possible risk with this drug and the options that may preserve your
ability to have children.
- About any other prescription or over-the-counter medicines
you are taking, including vitamins and herbs. In fact, keeping a
written list of each of these medicines (including the doses of
each and when you take them) with you in case of emergency may help
prevent complications if you get sick.
Paclitaxel may interact with a number of drugs and supplements, which
may either raise or lower the level of paclitaxel in your blood. Tell
your doctor if you are taking any of the following:
- TB drugs rifampin or rifabutin
- anti-seizure drugs phenytoin, phenobarbital, carbamazepine
- cyclosporine (used to prevent organ rejection)
- anti-fungal drugs itraconazole or ketoconazole
- anti-depressants such as nefazodone, fluoxetine, and others
- antibiotics erythromycin, clarithromycin, ciprofloxacin
- anti-viral drugs for HIV, such as ritonavir, nelfinavir,
indinavir, efavirenz, nevirapine, and others
- St. John's wort (herbal supplement)
If you are taking the blood thinner warfarin (Coumadin),
paclitaxel may increase its effect. Your doctor may want to watch you
Research on interactions with other drugs is incomplete at this
time.. Check with your doctor, nurse, or pharmacist about your other
medicines, herbs, and supplements, and whether alcohol can cause
problems with this medicine. Interactions with foods
Grapefruit or grapefruit juice may change the level of paclitaxel in
your blood. Check with your doctor, nurse, or pharmacist about whether
these or other foods may be a problem.
Tell all the doctors, dentists, nurses, and pharmacists you visit
that you are taking this drug.How is this drug taken or
Paclitaxel is given by an injection in a vein, usually over a 3-hour
period, every 3 weeks. Sometimes, smaller doses are given weekly and
infused over a shorter time. Rarely, it is given by an infusion over 24
hours. The dose depends on your weight, how well your liver is working,
the side effects you are having, and how often the medicine is given.
You will likely get medicines to lessen the chance you will have an
allergic reaction to this drug. This will include a steroid medicine,
dexamethasone, to take the night before and on the morning of treatment.
The antihistamine medicines diphenhydramine (Benadryl) and either
cimetidine (Tagamet) or ranitidine (Zantac) are usually given about an
hour before the infusion. You will also likely get an anti-nausea
medicine before the paclitaxel, especially if the medicine is being
given every 3 weeks. Precautions
This drug can cause allergic reactions in some people when the
drug is given, especially with the first few treatments. While you will
be given medicine ahead of time to lower this risk, reactions are still
possible. Mild reactions may consist of fever, chills, skin itching, or
feeling flushed. More serious reactions happen rarely, but can be
dangerous. Symptoms can include feeling lightheaded or dizzy (due to low
blood pressure), chest tightness, shortness of breath, back pain, or
swelling of the face, tongue, or throat. Tell your doctor or nurse right
away if you notice any of these symptoms during or after being given
In rare cases during an intravenous (IV) infusion, the drug may leak
out of the vein and under the skin, where it may damage the tissue,
causing pain, open sores, and scarring. Tell the nurse right away if
you notice redness, pain, or swelling at or near the IV site.
You may have nausea and vomiting on the day you receive this
drug or in the first few days afterward. Your doctor may give you
medicine before your treatment to help prevent nausea and vomiting. You
will likely also get a prescription for an anti-nausea medicine that you
can take at home. It is important to have these medicines on hand and
to take them as prescribed by your doctor.
This drug may cause sores in the mouth or on the lips,
which often occur within the first few weeks after starting treatment.
This can cause mouth pain, bleeding, or even trouble eating. Your doctor
or nurse can suggest ways to reduce this, such as changing the way you
eat or how you brush your teeth. If needed, your doctor can prescribe
medicine to help with the pain.
This drug can cause diarrhea, which in some cases may
be severe. If left unchecked, this can lead to dehydration and chemical
imbalances in the body. Your doctor may prescribe medicine to help
prevent or control this side effect. Make sure you get the medicine
right away, so that you will have it at home when you need it. Take the
medicine as prescribed.
This drug may cause damage to certain nerves in the body,
which can lead to a condition called peripheral neuropathy. This
can cause numbness, weakness, pain, burning, or tingling, usually in the
hands or feet. These are sometimes related to being exposed to hot or
cold temperatures. These symptoms can get worse, so that you have
trouble walking or holding things in your hands. Let your doctor know
right away if you notice any of these symptoms. If your symptoms are
severe enough, this drug may need to be stopped or the dose reduced
until they get better.
This drug may increase liver enzyme levels in your blood. Your doctor
will likely check your liver function with blood tests on a
regular basis. The drug may need to be stopped if the changes are
severe. If you have liver metastasis or other liver problems before
starting treatment, the doctor may need to monitor you more carefully.
This drug can cause a condition known as hand-foot syndrome,
in which a person may experience pain, numbness, tingling, reddening,
or swelling in the hands or feet. Peeling, blistering, or sores on the
skin in these areas are also possible. Let your doctor know right away
if you notice any of these symptoms.
In rare cases, this drug can affect the heart rhythm,
which could be serious and might even require the placement of a
pacemaker. Tell your doctor or nurse right away if you feel your heart
may be beating abnormally or if you have chest pain or feel short of
breath, lightheaded, or dizzy.
Your doctor will likely test your blood frequently throughout
your treatment, looking for possible effects of the drug on blood counts
or on blood chemistry levels. Based on the test results, you may be
given medicines to help treat any effects. Your doctor may also need to
reduce or delay your next dose of this drug, or even stop it altogether.
This drug can lower your white blood cell count, especially in the
weeks after the drug is given. This can increase your chance of getting a
serious, or even life-threatening, infection. Be sure to let
your doctor or nurse know right away if you have any signs of infection,
such as fever (100.5° or higher), chills, pain when passing urine, a
new cough, or bringing up sputum.
This drug may lower your red blood cell count. If this
occurs, it is usually a few months after starting treatment. A low red
blood cell count (known as anemia) can cause shortness of breath,
or make you to feel weak or tired all the time. Your doctor may give
you medicines to help prevent or treat this condition, or you may need
to get blood transfusions.
In rare cases, this drug may lower your platelet count in the
weeks after it is given, which can increase your risk of bleeding.
Speak with your doctor before taking any drugs or supplements that
might affect your body’s ability to stop bleeding, such as aspirin or
aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell
your doctor right away if you have unusual bruising, or bleeding such as
nosebleeds, bleeding gums when you brush your teeth, or black, tarry
Do not get any immunizations(vaccines), either during
or after treatment with this drug, without your doctor's OK. This drug
may affect your immune system, which could make vaccinations
ineffective, or could even lead to serious infections. Try to avoid
contact with people who have recently received a live virus vaccine,
such as the oral polio vaccine or smallpox vaccine. Check with your
doctor about this.Possible side effects
You will probably not have most of the following side effects, but if
you have any talk to your doctor or nurse. They can help you understand
the side effects and cope with them. Common
- low white blood cell count with increased risk of serious
- mild allergic reaction (fever, flushing, itching, rapid heart
- numbness, tingling, or pain in the hands, feet, or elsewhere*
- nausea and/or vomiting*
- hair loss, including hair on the face and body
- lowered red blood cell count (anemia) *
- sores in the mouth or on the lips*
- muscle or joint pain
- pain, redness or swelling at the infusion site
- low blood pressure during infusion
- feeling weak
- feeling tired
- change in how things taste
- loss of appetite
- skin rash
- abnormal blood tests which suggest that the drug is affecting the
liver* (Your doctor will discuss the importance of this finding, if
- low blood platelet count with increased risk of bleeding*
- serious allergic reaction (might include shortness of breath,
chest pain, throat swelling, dizziness)*
- redness, pain, swelling, or blisters on hands or feet (hand-foot
- retaining fluid (may include swelling in hands or feet, weight
gain, less urine output)
- nails changing color or becoming brittle
- changes in heart rhythm*
- darkening of skin where prior radiation was given (radiation
- excess tears from the eyes
- death from allergic reactions, infections, liver damage, or other
*See the "Precautions" section for more detailed information.
There are some other side effects not listed above that can also
occur in some patients. Tell your doctor or nurse if you develop these
or any other problems.FDA approval
Yes – first approved in 1992.
Nutrition and Taxol: