Paclitaxel

Indications & Dose:

Ovarian carcinoma, Breast carcinoma, NonSmall Cell Lung Carcinoma, Kaposi’s Sarcoma, Gastric Carcinoma.
DOSE
Adults

DOSAGE AND ADMINISTRATION: Carcinoma of the Ovary: Combination therapy: 175 mg/m2 I/V over 3 hours every 3 wks followed by cisplatin. Alternatively, 135 mg/m2 I/V over 24 hours followed by cisplatin, every 3 weeks. Single-agent therapy: 175 mg/m2 I/V over 3 hours every 3 wks, Carcinoma of the Breast: Adjuvant therapy: 175 mg/m2 I/V over 3 hours every 3 wks for 4 courses administered sequentially to doxorubicin-containing combination chemotherapy. Single-agent: 175 mg/m2 I/V over 3 hours every 3 wks. Non-Small Cell Lung Carcinoma: Combination therapy: 175 mg/m2 I/V over 3 hours followed by a platinum compound. Alternatively, 35mg/m2 I/V over 24 hours followed by a platinum compound, with a 3-wk interval between courses. Single-agent therapy: 175 to 225 mg/m2 I/V over 3 hours every 3 wks. AIDS-related Kaposi’s Sarcoma: 135 mg/m2 I/V over 3 hours every 3 wks or at a dose of 100 mg/m2 I/V over 3 hours every 2 weeks. Gastric Cancer: Adults- Once daily 210 mg/m2 (body surface area) by 3-hour I/V infusion with at least 3 weeks of dosing interval. Hepatic Impairment: Patients with hepatic impairment may be at increased risk of toxicity, particularly grade III-IV myelosuppression. Dose adjustment is recommended. Patients should be monitored closely for the development of profound myelosuppression.
Children: Not recommended. 

Contraindications:

Hypersensitivity to Paclitaxel or polyoxyethylated castor oil. Pregnancy & Lactation: Women of childbearing age should be advised to avoid becoming pregnant during TAXOL therapy. If TAXOL (paclitaxel) is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard. Breastfeeding should be discontinued for the duration of Taxol therapy. 

Side Effects:

Hypotension, bradycardia, GI disturbances, elevations in liver function tests, oedema. Bone marrow depression, hypersensitivity reactions, myalgia, chest pain, a stocking-glove sensory neuropathy, mucositis, alopecia. Altered liver function tests

Cautions:

Monitor cardiac conduction abnormalities, peripheral neuropathy, renal or hepatic failure. Ensure resuscitation equipment available. 

Precautions:

Safety and efficacy in children has not been established. Monitor haematological functions. The drug should be administered under supervision of a physician experienced in use of cancer chemotherapy.
Pregnancy: Use with caution.
Breast-feeding: Discontinue nursing.
Old age: Use with caution

Interaction:

Drugs
Cisplatin: Given after cisplatin leads to profound myelosupp-ression.
Ketoconazole: Inhibition of paclitaxel metabolism.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: