Drug Action
Paclitaxel is a member of the taxane group of drugs.
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Individual generic drug information
Extracted information for Paclitaxel only.
Paclitaxel is a member of the taxane group of drugs.
Source page 998
Treatment of ovarian cancer (advanced or residual disease following laparotomy) in combination with cisplatin (conventional paclitaxel only) | Treatment of metastatic ovarian cancer where platinum-containing therapy has failed (conventional paclitaxel only) | Treatment of locally advanced or metastatic breast cancer (in combination with other cytotoxics or alone if other cytotoxics have failed or are inappropriate) (conventional paclitaxel only) | Adjuvant treatment of node-positive breast cancer following treatment with anthracycline and cyclophosphamide (conventional paclitaxel only) | Treatment of non-small cell lung cancer (in combination with cisplatin) when surgery or radiotherapy not appropriate (conventional paclitaxel only) | Treatment of advanced AIDS-related Kaposi’s sarcoma where liposomal anthracycline therapy has failed (conventional paclitaxel only) | Monotherapy of metastatic breast cancer when first-line treatment has failed and standard, anthracycline-containing therapy is not indicated (albumin-bound paclitaxel only) | In combination with gemcitabine for the first-line treatment of metastatic adenocarcinoma of the pancreas (albumin-bound paclitaxel only) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature or local protocols)
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Avoid in Acute porphyrias p. 1120. consult product literature. patients aged over 75 years with metastatic adenocarcinoma of the pancreas
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Paclitaxel is available as both conventional and albumin-bound formulations. The different formulations vary in their licensed indications, pharmacokinetics, dosage and administration, and are not interchangeable. Prescribers should specify the brand to be dispensed.
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NICE decisions ▶Guidance on the use of paclitaxel in the treatment of ovarian cancer (updated May 2005) NICE TA55 Either paclitaxel in combination with a platinum compound (cisplatin or carboplatin) or a platinum compound alone are alternatives for the first-line treatment of ovarian cancer (usually following surgery). www.nice.org.uk/guidance/ta55 ▶Bevacizumab in combination with paclitaxel and carboplatin for the first-line treatment of advanced ovarian cancer (May 2013) NICE TA284 Bevacizumab in combination with paclitaxel and carboplatin is not recommended for the first-line treatment of advanced ovarian cancer (including fallopian tube and primary peritoneal cancer). www.nice.org.uk/guidance/ta284 ▶Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer (April 2016) NICE TA389 Paclitaxel, in combination with platinum or as monotherapy, is recommended as an option for treating recurrent ovarian cancer. www.nice.org.uk/guidance/ta389 ▶Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer (September 2017) NICE TA476 Paclitaxel (Abraxane ®) as albumin-bound nanoparticles (nab-paclitaxel) with gemcitabine is recommended as an option for untreated metastatic adenocarcinoma of the pancreas in adults, only if: . other combination chemotherapies are unsuitable and they would otherwise have gemcitabine monotherapy, and . the manufacturer provides nab-paclitaxel with the discount agreed in the patient access scheme. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta476 Scottish Medicines Consortium (SMC) decisions SMC No. 556/09 The Scottish Medicines Consortium has advised (April 2010) that paclitaxel albumin (Abraxane ®) is accepted for restricted use within NHS Scotland for the treatment of metastatic breast cancer in patients who have failed first- line treatment for metastatic disease and for whom standard anthracycline containing therapy is not indicated; use is restricted to patients who would otherwise receive docetaxel or 3-weekly solvent-based paclitaxel as second-line treatment for metastatic breast cancer. SMC No. 968/14 The Scottish Medicines Consortium has advised (February 2015) that paclitaxel albumin (Abraxane ®) is accepted for use within NHS Scotland in combination with gemcitabine for the first-line treatment of adults with metastatic adenocarcinoma of the pancreas.
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Extracted information for Paclitaxel only.
→Appendix 1: taxanes
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▶Common or very common Alopecia. anaemia. anxiety. appetite decreased. arrhythmias. arthralgia. asthenia. bone marrow disorders. chest discomfort. chills. constipation. cough. decreased leucocytes. depression. diarrhoea. dizziness. drowsiness. dry eye. dyspnoea. electrolyte imbalance. excessive tearing. extravasation necrosis. eye inflammation. fever. fluid imbalance. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. headache. hyperpyrexia. hypertension. increased risk of infection. influenza like illness. insomnia . laryngeal pain. lymphoedema. malaise. movement disorders. mucositis. muscle complaints. nail discolouration. nail disorders. nasal complaints. nausea. nerve disorders. neutropenia. oedema. oral disorders. pain. respiratory disorders. sensation abnormal. skin reactions. taste altered. thrombocytopenia. vasodilation. vertigo. vision disorders. vomiting. weight changes ▶Uncommon Allergic rhinitis. breast pain. catheter related infection. dry mouth. dysphagia. ear pain. embolism and thrombosis. eye discomfort. facial swelling. gait abnormal . hepatomegaly. hoarseness. hyperglycaemia. hypoalbuminaemia. hypoglycaemia. hypotension. limb discomfort. muscle weakness. neoplasm complications. peripheral coldness. photosensitivity reaction. polydipsia . reflexes abnormal. sepsis. sweat changes. swelling. syncope. tinnitus. tremor. urinary disorders ▶Rare or very rare Atrioventricular block. cardiac arrest. congestive heart failure. left ventricular dysfunction. radiation injuries. severe cutaneous adverse reactions (SCARs) SIDE-EFFECTS, FURTHER INFORMATION Manufacturer advises routine premedication with a corticosteroid, an antihistamine and a histamine H2-receptor antagonist is recommended to prevent severe hypersensitivity reactions; hypersensitivity reactions may occur rarely despite premedication.
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Ensure effective contraception during and for at least 6 months after treatment in men or women.
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Avoid (toxicity in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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(Consult product literature)
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▶Cardiac monitoring should be undertaken, particularly if patients have underlying cardiac disease or previous exposure to anthracyclines. ▶Patients should be monitored for signs and symptoms of pneumonitis and sepsis.
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Extracted information for Paclitaxel only.
There can be variation in the licensing of Immune system and malignant disease different medicines containing the same drug. Solution for infusion EXCIPIENTS: May contain Polyoxyl castor oils ▶Paclitaxel (Non-proprietary) Paclitaxel 6 mg per 1 ml Paclitaxel 150mg/25ml concentrate for solution for infusion vials | 1 vial P £300.52–£561.00 (Hospital only) Paclitaxel 30mg/5ml concentrate for solution for infusion vials | 1 vial P £66.85–£120.03 (Hospital only) Paclitaxel 100mg/16.7ml concentrate for solution for infusion vials | 1 vial P £200.35–£374.00 (Hospital only) | 1 vial P £359.72 Paclitaxel 300mg/50ml concentrate for solution for infusion vials | 1 vial P £601.03–£1,122.00 (Hospital only) Powder for suspension for infusion ELECTROLYTES: May contain Sodium ▶Abraxane (Celgene Ltd) Paclitaxel albumin 100 mg Abraxane 100mg powder for suspension for infusion vials | 1 vial P £246.00 (Hospital only) ANTINEOPLASTIC DRUGS › TOPOISOMERASE I INHIBITORS
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Filter the extracted dose blocks for this individual drug.
First line only; read the complete Indications and dose section above.
(consult product literature or local protocols)
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 998