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Paclitaxel Injection 100mg/16.7mL Injection
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Indications & Clinical Uses
- Paclitaxel Injection 100 mg/16.7 mL is a conventional, solvent-based formulation of paclitaxel, a taxane chemotherapy medicine dissolved in polyoxyl 35 castor oil (Cremophor EL) and dehydrated alcohol, supplied as a multiple-dose vial at a concentration of 6 mg/mL.
- It is a hospital-administered intravenous chemotherapy only, never self-injected.
- Approved uses include first-line treatment of ovarian carcinoma in combination with cisplatin and as subsequent therapy, adjuvant treatment of node-positive breast cancer after doxorubicin-based chemotherapy, treatment of metastatic breast cancer after prior chemotherapy has failed, first-line treatment of non-small cell lung cancer with cisplatin in patients unsuitable for surgery or radiotherapy, and second-line treatment of AIDS-related Kaposi's sarcoma.
- This conventional formulation is a distinct product from albumin-bound paclitaxel (nab-paclitaxel, brand Abraxane); the two are not interchangeable and must never be substituted for one another.
Side Effects
- The most common side effects of Paclitaxel Injection are hair loss (up to 87% of patients), peripheral neuropathy such as numbness or tingling in the hands and feet (around 60%), joint and muscle pain, nausea, vomiting and diarrhoea.
- Neutropenia is the main dose-limiting toxicity, with severe neutrophil suppression seen in roughly half of patients, so regular blood counts are required before each cycle.
- Hypersensitivity reactions, including anaphylaxis, occur in 2-4% of patients even with premedication, and fatal reactions have occurred, usually within the first 10 minutes of an infusion.
- Tell your care team immediately about breathing difficulty, chest tightness, facial or throat swelling, severe flushing, fever or chills during or shortly after treatment.
- Corticosteroid, antihistamine and H2-blocker premedication is given before every infusion to reduce this risk.
Precautions & Warnings
- Paclitaxel Injection must be given only under the supervision of a physician experienced in cancer chemotherapy, following mandatory premedication to lower the risk of severe hypersensitivity reactions.
- It is contraindicated in patients with a history of severe hypersensitivity to paclitaxel or to polyoxyl 35 castor oil-based drugs, and in patients whose baseline neutrophil count is below 1,500 cells/mm3 for solid tumours (below 1,000 cells/mm3 for Kaposi's sarcoma).
- It can cause fetal harm and must not be used in pregnancy; effective contraception is required during treatment and breastfeeding should be stopped.
- Cardiac monitoring is advised when combined with doxorubicin.
- The prepared infusion must not contact PVC equipment - use glass or non-PVC containers, tubing and an in-line filter.
- Dose reduction is needed for severe peripheral neuropathy or significant liver impairment.
Avoid Interactions
- Paclitaxel is broken down mainly by the liver enzymes CYP2C8 and CYP3A4.
- Strong inhibitors of these enzymes - including ketoconazole, itraconazole, clarithromycin, ritonavir, verapamil and gemfibrozil - may raise paclitaxel levels and increase toxicity, while strong inducers such as rifampicin, carbamazepine and phenytoin may lower its effect.
- Giving paclitaxel after cisplatin rather than before reduces its clearance by about a third and worsens bone marrow suppression, so your oncology team controls the order and timing of infusions.
- Combining paclitaxel with doxorubicin can raise doxorubicin blood levels, increasing cardiac risk.
- Always tell your healthcare provider about every prescription medicine, herbal remedy and supplement you take.
- Paclitaxel Injection must never be mixed or administered using PVC bags or giving sets.
References
Frequently Asked Questions
Paclitaxel Injection is a chemotherapy medicine for ovarian cancer, breast cancer, non-small cell lung cancer and AIDS-related Kaposi's sarcoma. It stops cancer cells from dividing. This is the conventional, Cremophor-based form of paclitaxel given as a hospital infusion - not the albumin-bound (Abraxane) version.
A healthcare team gives Paclitaxel Injection as an intravenous infusion, typically over 3 or 24 hours depending on the cancer being treated. You receive a corticosteroid, antihistamine and H2-blocker beforehand to reduce the risk of an allergic reaction. It is never given at home.
Common side effects include hair loss, tingling or numbness in the hands and feet, joint and muscle aches, nausea and low blood counts. Severe allergic reactions can occur despite premedication, usually during the first infusion, so tell your team at once about breathing trouble or facial swelling.
No, and the two must never be substituted for each other. Paclitaxel Injection is the solvent-based (Cremophor EL) formulation, while Abraxane is albumin-bound paclitaxel with a different dose and infusion schedule. Your care team always confirms exactly which formulation and dose has been prescribed.
You will have a full blood count checked before each cycle of Paclitaxel Injection, because low neutrophil counts are the main dose-limiting side effect. Your oncologist may delay treatment or lower the dose if counts are too low or nerve symptoms become severe.
No. Paclitaxel can harm an unborn baby, so it must not be used during pregnancy, and effective contraception is needed during treatment. Breastfeeding should stop before starting Paclitaxel Injection. Tell your oncology team right away if you are or could be pregnant.
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