Health Centres - Taxol (paclitaxel)
How does it work?
Taxol infusion contains the active ingredient paclitaxel, which is a type of chemotherapy medicine for cancer known as a 'taxane'. (NB. Paclitaxel infusion is also available without a brand name, ie as the generic medicine.)
Cancers form when some cells within the body multiply uncontrollably and abnormally. These cells then spread and destroy nearby tissues. Paclitaxel works by stopping the cancer cells from dividing and multiplying. This kills the cancer cells and stops the cancer growing.
Unfortunately, paclitaxel also affects normal, healthy cells, particularly those that multiply quickly such as blood cells. The most important side effect is on the bone marrow where blood cells are made. Paclitaxel can decrease the production of blood cells, leaving people susceptible to infection. Regular blood tests are therefore needed to monitor levels of blood cells.
Paclitaxel is usually given in hospital as a three hour drip into a vein (intravenous infusion), with a two or three week interval between treatment courses. The aim of the treatment is to progressively shrink the cancer over several cycles of chemotherapy, allowing normal, healthy cells to recover in between. A corticosteroid, an antihistamine and an H2 antagonist such as cimetidine or ranitidine will also be prescribed before the infusion. This is to reduce the chance of experiencing allergic reactions to the medicine, or the severity of any reactions.
Paclitaxel is licensed to treat cancer of the ovaries, breast cancer, lung cancer and a form of skin cancer that is associated with AIDs, called Kaposi's sarcoma.
Other unlicensed uses of paclitaxel should be as part of a clinical trial.
What is it used for?
In ovarian cancer paclitaxel is licensed for cancers that are advanced and cancers that have first been treated with surgery. In these cases it is used as a first-line chemotherapy in combination with another chemotherapy medicine called cisplatin. Paclitaxel is also used to treat ovarian cancer that has spread to other areas of the body (metastasised) and which has been resistant to treatment with platinum-based chemotherapy medicines such as cisplatin.
In breast cancer, paclitaxel is licensed to treat early node-positive breast carcinoma, following anthracycline and cyclophosphamide (AC) therapy. It is also used for cancers that are advanced or have spread to other areas of the body. In these cases it is used as first-line treatment in combination with another anti-cancer medicine. This will be either a type of medicine called an anthracycline, eg doxorubicin, or a medicine called trastuzumab. Paclitaxel can also be used on its own to treat breast cancer that has spread and is resistant to anthracyclines, or for people unsuitable for anthracyclines.
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Advanced non-small cell lung cancer
Paclitaxel is licensed to treat advanced non-small cell lung cancer when surgery or radiotherapy is not suitable. In this case it is used in combination with another chemotherapy medicine called cisplatin.
- Advanced Kaposi's sarcoma (a form of skin cancer) in people with AIDS
Paclitaxel is used when this condition is not responding to treatment with liposomal anthracycline chemotherapy, for example liposomal doxorubicin (Caelyx).
Warning!
- Chemotherapy medicines can decrease the number of blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell.
- Your heart function should be monitored before and during treatment with this medicine.
- This medicine may be harmful to an unborn baby. For this reason, women receiving this medicine should use effective contraception to prevent pregnancy, and men receiving this medicine should use effective contraception to prevent fathering a child, both during treatment, and for at least a few months after treatment is finished. Women should consult their doctor immediately if they become pregnant.
- Your ability to become pregnant or father a child may be affected by treatment with this medicine. It is important to discuss fertility with your doctor before starting treatment.
Use with caution in
- Decreased liver function.
Not to be used in
- Severely decreased liver function
- Low levels of a type of white blood cell (neutrophils) in the blood (neutropenia)
- Kaposi's sarcoma patients with serious uncontrolled infections
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Pregnancy
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Breastfeeding.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least a few months after treatment is finished. Seek medical advice from your doctor.
- It is not known whether this medicine passes into breast milk. Mothers who need treatment with this medicine should not breastfeed. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Reactions such as pain, swelling, redness discolouration or hardening of skin at injection site
- Decreased production of blood cells by the bone marrow (bone marrow suppression)
- Low red blood cell count (anaemia)
- Decrease in the number of a type of white blood cell (neutrophil) in the blood (neutropenia)
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Increased susceptibility to infections
- Bleeding
- Disorder of the peripheral nerves causing weakness and numbness (peripheral neuropathy)
- Pain in the muscles and joints
- Nausea and vomiting
- Diarrhoea (tell your doctor if you get severe or persistant diarrhoea after treatment)
- Inflamed and sore mouth
- Hair loss (alopecia)
- Low blood pressure (hypotension)
- Pain, redness, swelling and hardening of skin at the site of injection
- Allergy to active ingredients (hypersensitivity) such as facial flushing, skin rash, itch, narrowing of airways (bronchospasm) or swelling of lips, tongue or throat (angioedema)
- Abnormal heat beats, heart rate or other problems with the heart
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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