TM Owner Bristol Myers Squibb
Taxol 100mg/16.7ml Vial
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Indications & Clinical Uses
- Taxol (paclitaxel) 100 mg/16.7 mL injection is a solvent-based (Cremophor EL-formulated) taxane chemotherapy given by intravenous infusion in a hospital or cancer clinic, never self-administered.
- It is approved for first-line and subsequent treatment of advanced ovarian carcinoma (combined with cisplatin as initial therapy), adjuvant treatment of node-positive breast cancer after doxorubicin-and-cyclophosphamide-based chemotherapy, metastatic breast cancer after failure of combination chemotherapy or relapse within six months of adjuvant treatment, first-line non-small cell lung cancer with cisplatin in patients unsuitable for surgery or radiotherapy, and second-line treatment of AIDS-related Kaposi's sarcoma.
- Because it also treats lung cancer and Kaposi's sarcoma, which occur in men as well as women, it is not exclusively a women's cancer medicine despite common use in breast and ovarian cancer.
- It must not be confused with nab-paclitaxel (Abraxane), a different, non-interchangeable albumin-bound formulation.
Side Effects
- Taxol carries a boxed warning for anaphylaxis and severe hypersensitivity reactions, occurring in 2 to 4% of patients and occasionally fatal despite premedication; all patients receive corticosteroids, diphenhydramine, and an H2 antagonist beforehand to reduce this risk.
- Bone marrow suppression is very common, with neutropenia affecting most patients and requiring frequent blood counts; treatment is delayed if neutrophils fall too low.
- Other very common effects include hair loss (about 87%), peripheral neuropathy - numbness or tingling (around 60%), joint and muscle pain, nausea and vomiting, and low red blood cell counts.
- Heart rhythm changes occur in under 1% of patients.
- Seek urgent help for difficulty breathing, facial swelling, chest pain, irregular heartbeat, fever with chills, or numbness severe enough to affect daily activities.
Precautions & Warnings
- Taxol must never be given to patients with a baseline neutrophil count below 1,500 cells/mm3 or a history of severe hypersensitivity to paclitaxel or other Cremophor EL-containing medicines.
- Cardiac monitoring is advised in patients with conduction abnormalities.
- Because paclitaxel can cause fetal harm, it is contraindicated in pregnancy, and effective contraception is required during and after treatment for both women and men.
- Liver function should be checked before each cycle, as impairment increases toxicity.
- Peripheral neuropathy should be assessed regularly and may require dose reduction.
- Taxol solutions must be prepared and administered using non-PVC (glass, polypropylene, or polyolefin) containers and tubing, since paclitaxel can leach plasticiser from PVC equipment.
- It is given only as a hospital-supervised intravenous infusion, never as a rapid injection.
Avoid Interactions
- Paclitaxel is metabolised by CYP2C8 and CYP3A4, so strong inhibitors of these enzymes, including ketoconazole and certain HIV protease inhibitors, can raise paclitaxel levels and toxicity, while inducers such as rifampin and carbamazepine can reduce its effectiveness; use with caution and close monitoring.
- Myelosuppression is more pronounced when paclitaxel is given after cisplatin rather than before it, so the recommended sequence must be followed.
- Plasma levels of doxorubicin may increase when the two are combined, raising the risk of heart toxicity.
- Live vaccines should generally be avoided during chemotherapy because of a weakened immune response.
- Always tell your oncology team about every prescription medicine, over-the-counter product, and herbal supplement you take, since many interact with chemotherapy drugs.
References
Frequently Asked Questions
Taxol (paclitaxel) treats advanced ovarian cancer, node-positive and metastatic breast cancer, non-small cell lung cancer, and AIDS-related Kaposi's sarcoma. It's a solvent-based taxane chemotherapy, different from albumin-bound nab-paclitaxel (Abraxane) - the two are not interchangeable and use different dosing schedules and premedication.
Taxol is given as an intravenous infusion by a cancer specialist in a hospital or clinic - it's never self-injected or taken at home. You'll receive corticosteroids, an antihistamine, and an acid-reducing medicine beforehand to lower the risk of allergic reaction.
Taxol carries a boxed warning for anaphylaxis and severe allergic reactions, which affect 2-4% of patients despite premedication and can be fatal. Very common effects include low blood counts, hair loss, numbness or tingling, joint pain, and nausea. Get emergency help for breathing difficulty or facial swelling during infusion.
Avoid grapefruit and CYP3A4/CYP2C8-interacting medicines during Taxol treatment; strong enzyme inhibitors like ketoconazole can raise paclitaxel levels, while inducers like rifampin can reduce its effect. Taxol is not safe in pregnancy. Tell your oncology team about every medicine you take.
You'll be premedicated, then Taxol is infused slowly over several hours while your care team watches for allergic reactions, especially during the first infusion. Blood counts are checked before each cycle, since low neutrophils can delay the next dose until they recover.
No. Taxol is solvent-based paclitaxel dissolved in Cremophor EL, while Abraxane is a different, albumin-bound (nab-paclitaxel) formulation. They have different dosing, infusion times, premedication needs, and side-effect profiles, and the label states they must not be substituted for one another under any circumstances.
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