DOCETAXEL (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
Category
Description
Docetaxel (doe-se-TAX-el) belongs to the group of medicines calledantineoplastics. It is used to treat breast cancer, non-small cell lung cancer,gastrointestinal (stomach), and prostate cancer. Docetaxel is sometimes usedin combination with other medicines for certain types of cancer.
Docetaxel interferes with the growth of cancer cells, which are eventuallydestroyed. Since the growth of normal body cells may also be affected by docetaxel,other effects will also occur. Some of these may be serious and must be reportedto your doctor. Other effects may not be serious but may cause concern. Someeffects may not occur for months or years after the medicine is used.
Docetaxel may also be used to treat other conditions as determined by yourdoctor.
Before you begin treatment with docetaxel, you and your doctor should talkabout the good this medicine will do as well as the risks of using it.
Docetaxel is to be administered only by or under the immediate supervisionof your doctor. It is available in the following dosage form:
Parenteral- Injection (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For docetaxel, the followingshould be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to docetaxel. Also tell your health care professional ifyou are allergic to any other substances such as polysorbate 80.
Pregnancy?Tell your doctor if you are pregnant or if you intendto become pregnant. Studies in rats and rabbits have shown that docetaxelcauses miscarriages and deaths of the fetus, as well as problems in the mother.
Be sure that you have discussed this with your doctor before taking thismedicine. It is best to use some kind of birth control while you are receivingdocetaxel. Tell your doctor right away if you think you have become pregnantwhile receiving docetaxel.
Breast-feeding?It is not known whether docetaxel passes into breastmilk. However, because this medicine may cause serious side effects, breast-feedingis generally not recommended while you are receiving it.
Children?Docetaxel has been studied in a limited number ofchildren. The study showed that children are especially sensitive to the effectsof docetaxel and cannot be given usual doses of the medicine.
Older adults?Elderly people are especially sensitive to the effectsof docetaxel. This may increase the chance of side effects during treatment.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are receivingdocetaxel, it is especially important that your health care professional knowif you are taking any of the following:
- Amphotericin B by injection (e.g., Fungizone) or
- Antithyroid agents (medicine for overactive thyroid) or
- Azathioprine (e.g., Imuran) or
- Chloramphenicol (e.g., Chloromycetin) or
- Colchicine or
- Flucytosine (e.g., Ancobon) or
- Ganciclovir (e.g., Cytovene) or
- Interferon (e.g., Intron A, Roferon-A) or
- Plicamycin (e.g., Mithracin) or
- Zidovudine (e.g., AZT, Retrovir) or
- If you have ever been treated with x-rays or cancer medicines?Docetaxelmay increase the effects of these medicines or radiation therapy on the blood.
- Erythromycins (medicine for infection) or
- Ketoconazole (e.g., Nizoral) or
- Midazolam (e.g., Versed) or
- Orphenadrine (e.g., Norflex) or
- Testosterone (male hormone) or
- Troleandomycin?Higher blood levels of docetaxel may occur,increasing the chance of serious side effects
Other medical problems?The presence of other medicalproblems may affect the use of docetaxel. Make sure you tell your doctor ifyou have any other medical problems, especially:
- Alcohol abuse or history of?The risk of some side effects affectingthe muscles and nerves may be increased.
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles)?Risk of severe disease affecting otherparts of the body
- Fluid in lungs?Docetaxel may make your condition worse
- Infection?Docetaxel may decrease your body's ability to fightinfection.
- Liver disease?The chance of serious side effects is greatlyincreased.
Proper Use of This Medicine
This medicineoften causes nausea and vomiting, which is usually mild. However, it is veryimportant that you continue to receive the medicine even if you begin to feelill. Ask your health care professional for ways to lessen these effects.
Your doctor may direct you to take a corticosteroid medicine such as dexamethasone(e.g., Decadron), starting the day before you receive an injection of docetaxeland may continue for a few days after a docetaxel treatment. This other medicinedecreases the chance of an allergic reaction to docetaxel and certain otherside effects. It is very important that you take eachdose of the corticosteroid medicine as directed.
Dosing?The dose of docetaxel will be different fordifferent patients. The dose that is used may depend on a number of things,including what the medicine is being used for, the patient's size, and whetheror not other medicines are also being taken. If you arereceiving docetaxel at home, follow your doctor's orders or the directionson the label. If you have any questions about the proper dose of docetaxel,ask your doctor.
Precautions While Using This Medicine
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check forunwanted effects.
While you are being treated with docetaxel, and after you stop treatmentwith it, do not have any immunizations (vaccinations)without your doctor's approval. Docetaxel may lower your body's resistanceand there is a chance you might get the infection the immunization is meantto prevent. In addition, other persons living in your household should nottake oral polio vaccine since there is a chance they could pass the poliovirus on to you. Also, avoid persons who have taken oral polio vaccine withinthe past several months. Do not get close to them and do not stay in the sameroom with them for very long. If you cannot take these precautions, you shouldconsider wearing a protective face mask that covers the nose and mouth.
Docetaxel can temporarily lower the number of white blood cells in yourblood, increasing the chance of getting an infection. It can also lower thenumber of platelets, which are necessary for proper blood clotting. If thisoccurs, there are certain precautions you can take, especially when your bloodcount is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Checkwith your doctor immediately if you think you are getting an infectionor if you get a fever or chills, cough or hoarseness, lower back or side pain,or painful or difficult urination.
- Check with your doctor immediately ifyou notice any unusual bleeding or bruising; black, tarry stools; blood inurine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick.Your medical doctor, dentist, or nurse may recommend other ways to clean yourteeth and gums. Check with your medical doctor before having any dental workdone.
- Do not touch your eyes or the inside of your nose unless you havejust washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects suchas a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injurycould occur.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects.Some side effects will have signs or symptoms that you can see or feel. Yourdoctor may watch for others by doing certain tests.
Also, because of the way these medicines act on the body, there is a chancethat they might cause other unwanted effects that may not occur until monthsor years after the medicine is used. These delayed effects may include certaintypes of cancer. Discuss these possible effects with your doctor.
Check with your doctorimmediately if any of the following side effects occur:
Less common
Black, tarry stools; blood in urineor stools; cough or hoarseness (accompanied by feveror chills); difficult or labored breathing; difficult or painful urination (accompanied by fever or chills); difficulty swallowing; dizziness; fast heartbeat; fever or chills; heart problems; hives; itching, puffiness or swelling of the eyelidsor around the eyes, face, lips, or tongue; lowerback or side pain (accompanied by fever or chills); noisy, rattling breathing; pinpoint red spots onskin; shortness of breath; skin rash; tightness in chest; troubled breathing while at rest; unusual bleedingor bruising; unusual tiredness or weakness; wheezing
Incidence not known
Abdominal pain, cramping, or tenderness; anxiety; bleeding episodes; blistering, peeling, loosening of skin; blistering,peeling, redness, and/or swelling of palms of hands or bottoms of feet; blue lips, fingernails or skin; blurredor loss of vision; changes in skin color; convulsions; coughing that sometimesproduces a pink frothy sputum; dark urine; decreased frequency/amount of urine; difficult, fast, noisy breathing, sometimes with wheezing; disturbed color perception; dizziness or lightheadedness; double vision; fainting; general tiredness or weakness; halos around lights; heartburn; increased sweating; increased thirst; itching; light-colored stools; loss of appetite and weight; loss ofbladder control; muscle pain; muscle spasm or jerking of all extremities; nightblindness; numbness, pain, tingling, or unusual sensationin palms of hands or bottoms of feet; overbrightappearance of lights; pain or burning in throat; pain or discomfort in arms, jaw, back, or neck; pain, redness, tenderness or swelling in arm, foot, or leg; pale skin; rectal bleeding; red, irritated eyes; red skin lesions,often with a purple center; severe constipation; severe pain in abdomen; severe vomiting; sores, ulcers, or white spots on lips or tongueor inside the mouth; stomach cramps, tenderness orpain; sudden loss of consciousness; sudden shortness of breath or troubled breathing; sweating; swelling in legs and ankles; swelling of face, fingers, lower legs; transient loss of consciousness; troubledor quick, shallow breathing; tunnel vision; upper right abdominal pain; vomitingof blood or material that looks like coffee grounds; watery or bloody diarrhea; yellow eyes and skin
Docetaxel sometimes causes allergic reactions, especiallyduring the first few treatments. Tell your doctor ornurse right away if you notice back pain or itching during an injection.Your doctor or nurse will be watching out for other signs of an allergic reactionwhile you are receiving this medicine, and will be ready to treat any seriouseffects right away.
A kind of leukemia called acute myeloid leukemia [AML] can occur if youare taking a combination of docetaxel and cyclophosphamide to treat your breastcancer. Tell your doctor right away if you develop a lot of infections, experiencebone or joint pain, or have a fever.
Other side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. Also, your health care professionalmay be able to tell you about ways to prevent or reduce some of these sideeffects. Check with your health care professional if any of the followingside effects continue or are bothersome or if you have any questions aboutthem:
More common
Burning, numbness, tingling, or pain in arms, hands, legs, orfeet; congestion; diarrhea; dryness or soreness of throat; nausea; skin rash or redness (mild); sores or ulcers on the lips or tongue or inside the mouth; weakness in arms, hands, legs, or feet
Less common
Bloody nose; body aches or pain; change in color of fingernails or toenails; congestion; dry, red, hot, or irritated skin at placeof injection; hoarseness; headache; loosening or loss of fingernails or toenails,sometimes painful; pain in joints or muscles; pain, swelling, or lump under the skin at place of injection; runny nose; tender, swollenglands in neck; trouble in swallowing; voice changes; vomiting
Incidence not known
Burning upper abdominal pain; burning,dry or itching eyes; confusion; difficulty having a bowel movement [stool]; dischargefrom eyes; excessive tearing; mood or mental changes; pain all over body; pain and redness of skin at place of earlier radiation treatment; rapid breathing; redness,pain, swelling of eye, eyelid, or inner lining of eyelid; stomach pain; sunken eyes; tearing of the eyes; wrinkled skin
This medicine usually causes a temporaryloss of hair. After treatment with docetaxel has ended, normal hair growthshould return.
Other side effects not listed above may also occur in some patients. Ifyou notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approved for marketingfor a certain use, experience may show that it is also useful for other medicalproblems. Although these uses are not included in the product labeling, docetaxelis used in certain patients with the following medical conditions:
- Bladder cancer
- Esophageal cancer
- Head and neck cancer
- Lung cancer, small cell
- Ovarian cancer
Other than the above information, there is no additionalinformation relating to proper use, precautions, or side effects for theseuses.
Developed: 09/17/1997
Revised: 04/28/2006
