Paclitaxel

Solid tumours in patients with baseline neutrophil counts <1500 cells/mm³. Kaposi sarcoma in patient with baseline neutrophil <1000 cells/mm³ and serious uncontrolled infection. Severe hepatic impairment (as conventional solution). Lactation.

Patient with pre-existing neuropathies, conduction abnormalities. Hepatic impairment. Elderly. Pregnancy. Premedication with corticosteroid, antihistamine and histamine H₂-receptor antagonist may be required to reduce risk of hypersensitivity reaction. Patient counselling This drug may cause mild tiredness and dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CBC with differential and platelet count; LFT, kidney function; vital signs (frequently during the 1st hour of infusion); cardiac function; infusion site during infusion.

Significant: Bone marrow suppression (e.g. neutropenia); hypotension, hypertension, bradycardia; extravasation, injection site reactions; sensory/peripheral neuropathy, sepsis, nausea, vomiting, diarrhoea. Rarely, conduction abnormalities, CHF, left ventricular dysfunction. Blood and lymphatic system disorders: Anaemia, leukopenia, thrombocytopenia, febrile neutropenia. Cardiac disorders: Tachycardia, arrhythmia, supraventricular tachycardia, chest pain, bradycardia, dyspnoea. Eye disorders: Increased lacrimation, blurred vision. Gastrointestinal disorders: Constipation, stomatitis, abdominal pain and distension. General disorders and administration site conditions: Fatigue, asthenia, pyrexia, malaise, ataxia. Infections and infestations: Candidiasis, conjunctivitis. Injury, poisoning and procedural complications: Injection site reactions (including pain, erythema, localised oedema, induration). Investigations: Increased AST, gamma-glutamyltransferase, blood alkaline phosphatase, serum creatinine; ECG abnormality. Metabolism and nutrition disorders: Anorexia, dehydration, oedema. Musculoskeletal and connective tissue disorders: Arthralgia, myalgia, back pain. Nervous system disorders: Paraesthesia, headache, dizziness, vertigo. Renal and urinary disorders: UTI. Respiratory, thoracic and mediastinal disorders: Upper respiratory tract infection, cough, pulmonary embolism. Skin and subcutaneous tissue disorders: Alopecia, rash, pruritus, erythema, nail discolouration, skin hyperpigmentation, nail changes. Vascular disorders: Flushing, hypertension, hypotension, venous thrombosis.
Potentially Fatal: Anaphylaxis and severe hypersensitivity reactions, pneumonitis.

Increased plasma concentration and toxicity with CYP2C8 and CYP3A4 inhibitors (e.g. ketoconazole, erythromycin, fluoxetine, clopidogrel, cimetidine, ritonavir). Decreased plasma concentration and efficacy with CYP2C8 and CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenytoin, efavirenz).

Cytotoxic Chemotherapy

L01CD01 - paclitaxel ; Belongs to the class of plant alkaloids and other natural products, taxanes. Used in the treatment of cancer.