II. Indications
- FDA Approved
- Off-Label
- Head and neck cancer (advanced)
- Gastrointestinal Tract Adenocarcinoma (gastric, esophageal, colon)
- Non-Hodgkin Lymphoma
- Pancreatic Cancer
- Polycystic Kidney Disease
- Prostate Cancer (Hormone refractory)
- Transitional Cell Carcinoma (urothelial cancer)
- Uterine Cancer
III. Contraindications
- Polyoxyethylated Castor Oil (Cremophor EL) allergy
IV. Mechanism
- See Mitotic Inhibitor Chemotherapy
- Paclitaxel is a taxane Antineoplastic Agent
- Derived from extract of the Pacific yew tree (Taxus brevifolia)
- Paclitaxel has antineoplastic activity as a an antitubulin agent
- Binds and stabilizes tubulin
- Inhibits microtubule disassembly
- Results in Cell Cycle arrest in G2/M phase
- Paclitaxel induces apoptosis
V. Medications
- Paclitaxel injection solution
- Doses available from 30 mg/5 ml to 300 mg/50 ml
VI. Dosing
- See other references for disease specific dosing protocols
VII. Adverse Effects
- Hypersensitivity Reaction (including Anaphylaxis)
- Myelosuppression (Bone Marrow suppression) with Neutropenia
- Peripheral Neuropathy
- Future impaired fertility
- Alopecia
- Nausea
- Myalgias
- Cardiac conduction abnormalities
VIII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
IX. Drug Interactions
- Agents that increase Paclitaxel levels
X. Resources
- Paclitaxel (DailyMed)
- Paclitaxel (StatPearls)