II. Indications
- Breast Cancer (locally advanced or metastatic)
III. Contraindications
- Liver transaminases (AST, ALT) >2.5 times the upper limit of normal
- Serum Bilirubin > upper limit of normal
- Polyoxyethylated Castor Oil (Cremophor EL) allergy
IV. Mechanism
- See Mitotic Inhibitor Chemotherapy
- Ixabepilone is a semisynthetic analog of epothilone B with antineoplastic properties
- Used in Taxane-resistant neoplasms
- Available in an enteric coated oral formulation with good Bioavailability
- Ixabepilone is an anti-tubulin agent
- Ixabepilone binds to tubulin
- Ixabepilone promotes tubulin polymerization and microtubule stabilization
- Arrests Cell Cycle at G2/M phase
V. Medications
- Ixabepilone 15 and 45 mg powder for injection
VI. Dosing
- See other references for disease specific dosing protocols
- Pretreatment (given 1 hour before Ixabepilone )
- Anthistamine (H1 Blocker) AND
- H2 Blocker (e.g. Famotidine) AND
- If prior reaction, Corticosteroid
VII. Adverse Effects
VIII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
IX. Drug Interactions
- Agents that increase Ixabepilone levels
- CYP3A4 Inhibitors (e.g. Ketoconazole)
- Agents that decrease Ixabepilone levels
X. Resources
- Ixabepilone Injection Solution (DailyMed)