Docetaxel


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Docetaxel
Docetaxel (Taxotere)
Docetaxel
(doh-seh- TAX-ell)
Pregnancy Category: D Taxotere (Rx)

Classification: Antineoplastic, miscellaneous

See Also: See also Antineoplastic Agents .

Action/Kinetics: Prepared with a precursor extracted from the yew plant. Effect is due to disruption of the microtubular network in cells that is required for mitotic and interphase cellular functions. t 1/2, 3 phases: 4 min, 36 min, and 11.1 hr. Metabolized in the liver, and metabolites and small amounts of unchanged drug are excreted through both the feces (75%) and urine (6%).

Uses: Locally advanced or metastatic breast cancer after failure of prior chemotherapy.

Contraindications: Severe hypersensitivity to docetaxel or to other drugs formulated with polysorbate 80. Use in those with neutrophil counts less than 1,500 cells/mm 3 , in those with bilirubin greater than the upper limit of normal (ULN), or in those with AST or ALT greater than 1.5 times the ULN. Lactation.

Special Concerns: The incidence of treatment-related mortality is increased in clients with abnormal liver function and in those receiving higher doses. Safety and efficacy have not been determined in children less than 16 years of age.

Side Effects: Hematologic: Neutropenia (virtually in 100% of clients given 100 mg/m 2). Leukopenia, thrombocytopenia, anemia, febrile neutropenia. GI: N&V, diarrhea, stomatitis, abdominal pain, constipation, ulcer, esophagitis, GI hemorrhage intestinal obstruction, ileus. CV: Fluid retention (even with premedication), hypotension, atrial fibrillation, DVT ECG abnormalities, thrombophlebitis, pulmonary embolism, heart failure syncope, tachycardia, sinus tachycardia, atrial flutter, dysrhythmia, unstable angina, pulmonary edema, hypertension (rare). Respiratory: Dyspnea, acute pulmonary edema, ARDS. Dermatologic: Reversible cutaneous reactions characterized by a rash, including localized eruptions on the hands, feet, arms, face, or thorax, and usually associated with pruritus. Nail changes, alopecia. Hypersensitivity: Flushing, localized skin reactions. Severe hypersensitivity reactions characterized by hypotension, bronchospasm, or generalized rash/erythema. Musculoskeletal: Myalgia, arthralgia. Neurologic: Paresthesia, dysesthesia, pain in those with anthracycline-resistant breast cancer. Distal extremity weakness. Reactions at infusion site: Hyperpigmentation, inflammation, redness or dryness of the skin, phlebitis, extravasation, mild swelling of the vein. Miscellaneous: Septic death, nonseptic death infections, fever in absence of infections, asthenia, diffuse pain, chest pain, renal insufficiency, confusion.

Laboratory Test Alterations: ALT, AST, alkaline phosphatase.

Drug Interactions: The metabolism of docetaxel may be modified by drugs that inhibit, induce, or are metabolized by the cytochrome P4503A4 system, including cyclosporine, erythromycin, ketoconazole, terfenidine, and troleandomycin.

How Supplied: Injection: 20 mg/0.5 mL, 80 mg/2 mL

Dosage
?IV Breast cancer.
60-100 mg/m 2 given IV over 1 hr q 3 weeks. Reduce the dose to 75 mg/m 2 or discontinue therapy in those who are dosed initially at 100 mg/m 2 and who experience febrile neutropenia, neutrophils less than 500/mm 3 for more than 1 week, severe or cumulative cutaneous reactions, or severe peripheral neuropathy. Those who are dosed at 60 mg/m 2 and do not experience these symptoms may tolerate higher doses.

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