Precautions and warnings

Bone marrow suppression can happen during treatment. If there are heart rhythm problems, check heart function regularly. Before giving this medicine, doctors may give a steroid, an antihistamine, and an H2 blocker to lower the risk of allergic reactions. Stop treatment if serious side effects like low blood pressure, trouble breathing, swelling, or hives develop. Be careful in patients with moderate liver problems. Watch for reactions during administration. This medicine’s safety and effectiveness have not been proven in children. If used with platinum-type cancer drugs (like cisplatin or carboplatin), give this medicine first. This drug is hazardous, so handle and dispose of it safely.

Drug Interactions

Myelosuppression (lowered blood cell counts) is worse if paclitaxel is given after cisplatin, compared to giving paclitaxel before cisplatin.

Certain medicines that increase CYP2C8 activity—like carbamazepine, phenobarbital, phenytoin, rifampicin, rifapentine, and secobarbital—can lower paclitaxel levels or reduce its effects. On the other hand, drugs that block CYP2C8—such as gemfibrozil, ketoconazole, montelukast, and ritonavir—can increase paclitaxel levels or its effects.

Similarly, medications that increase CYP3A4 activity—such as aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins—may decrease paclitaxel levels or its effects. Conversely, drugs that block CYP3A4—like azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, telithromycin, and verapamil—may increase paclitaxel levels or its effects.

Paclitaxel can raise the levels or side effects of anthracyclines (such as doxorubicin or epirubicin); giving the anthracycline at least 24 hours before paclitaxel may help avoid this problem.

Paclitaxel may also lower the absorption of cardiac glycosides, especially digoxin tablets, so digoxin levels should be monitored.

Contraindications

History of allergic reactions (especially to macrogol glycerol ricinolate). Patients who already have low levels of neutrophils (a type of white blood cell).

Mode of actions

Paclitaxel helps microtubules form by making tubulin dimers work better. It also keeps microtubules stable and stops them from breaking down. Because of this, normal cell division is interrupted during the late G2 and mitosis phases of the cell cycle, which prevents cells from multiplying.

Dosage & Administration

Adult: IV Ovarian carcinoma Primary treatment: 135 mg/m2, followed by cisplatin. Repeat 3 wkly. Secondary treatment: As single agent: 135 or 175 mg/m2 3 wkly.

Breast cancer As adjunct therapy, 2nd line monotherapy or 1st line treatment w/ trastuzumab: 175 mg/m2 3 wkly for 4 courses. W/ trastuzumub, give dose one day after 1st dose of trastuzumab or immediately after subsequent doses if tolerated. 1st line treatment w/ doxorubicin: 220 mg/m2 3 wkly, give dose 24 hr after doxurubicin.

Advanced non-small cell lung cancer 135 mg/m2 over 24 hr, followed by cisplatin. Repeat 3 wkly. AIDS-related Kaposi's sarcoma 135 mg/m2 3 wkly.

Pregnancy & Lactation

This medicine is not allowed during pregnancy. Do not use it if you are pregnant. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict effective birth control during treatment and for six months after stopping this medicine. If you do become pregnant, stop taking this medicine and discuss your doctor right away.

There is no specific information on whether this medicine passes into breast milk or not. Considering the possible risks for the children, breastfeeding while using this medicine is not recommended and at least two weeks after the last dose. Consult your doctor before breastfeeding.

Pack Size & Price