Paclitaxel

• Brand name- Taxol

• Generic name- Paclitaxel
• Drug class- Antineoplastics, Antimicrotubular
• Chemical formula- C47H51NO14

INTRODUCTION
Paclitaxel is an anti-cancer ("antineoplastic" or "cytotoxic")
chemotherapy drug. Paclitaxel is classified as a "plant alkaloid," a
"taxane" and an "antimicrotubule agent. Treatment of breast, ovarian,
lung, bladder, prostate, melanoma, esophageal, as well as other types of
solid tumor cancers. It has also been used in Kaposi's sarcoma.

MODE OF ACTION:
It works by slowing or stopping cancer cell growth by interfering with the normal
function of microtubule growth. Anti-microtubule agent that interferes with
microtubule network essential for interphase and mitosis. Induces abnormal
spindle formation and multiple asters during mitosis. In addition, normal
functioning microtubules are essential for cell shape and organelles present within
cells.
Pharmacokinetics

Absorption: proximal part of small intestine.

Onset: 0.5-1 hour
Metabolism: metabolized by liver ( CYP2C8 and CYP3A4)
Elimination: Faces (20%); urine (4%)

Dose
Available form

Route of administration: Intravenous, Intraperitoneal route

Injectable solution:- 6mg/ml

• Paclitaxel Injection administered intravenously over 3 hours at a dose

of 175 mg/m² followed by cisplatin at a dose of 75 mg/m².
• Paclitaxel Injection administered intravenously over 24 hours at a
dose of 135 mg/m² followed by cisplatin at a dose of 75 mg/m².
 . Children;- 350—420 mg/m2 IV over 3 hours

DRUG INTERACTIONS
Amlodipine; Celecoxib: (Major) Due to the thrombocytopenic effects of
paclitaxel, an additive risk of bleeding may be seen in patients receiving
concomitant anticoagulants, NSAIDs, platelet inhibitors, including aspirin,
strontium-89 chloride, and thrombolytic agents. In addition, large doses of
salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional
risk factor for bleeding.

Amoxicillin; Clarithromycin; Lansoprazole: (Minor) Paclitaxel is partially

metabolized by CYP3A4. The systemic clearance of paclitaxel may be
decreased if coadministered with clarithromycin, an inhibitor of CYP3A4.

Amoxicillin; Clarithromycin; Omeprazole: (Minor) Paclitaxel is partially

metabolized by CYP3A4. The systemic clearance of paclitaxel may be
decreased if coadministered with clarithromycin, an inhibitor of CYP3A4.

Amprenavir: (Minor) Amprenavir may inhibit the metabolism of other

medications that are metabolized via cytochrome P450 3A4 including
paclitaxel. The serum concentration of paclitaxel may be increased with
concomitant administration of amprenavir.

Contraindication
Lactation and pregnancy
Angina, bradycardia, AV block cardiac arrhythmias,
Hepatic disease
Peripheral neuropathy
Radiation therapy
Patients who have received prior radiation therapy are at risk for radiation recall
reactions when receiving paclitaxel. These patients should be monitored closely. In
addition, paclitaxel may increase the efficacy and/or the adverse reactions of
radiation therapy.
Intramuscular injections
Intramuscular injections should be avoided in patients with platelet counts <
50,000/mm3 who are receiving paclitaxel. IM injections can cause bleeding,
bruising, or hematomas in patients with paclitaxel-induced thrombocytopenia

• Clinical Uses:
Advanced ovarian cancer
Breast cancer
Non-small cell lung cancer

Side effect:
Bone marrow depression
hair loss
nausea and vomiting,
hypotension
 allergic reactions,
slow heart reaction
muscle
joint pain
mouth sore
diarrhea
low blood count
Hypersensitivity reaction

Nursing consideration
1. Monitor for hypersensitivity reactions, especially during first and second
administrations of the paclitaxel.
2. Monitor hematologic status throughout course of treatment.
3. Monitor for peripheral neuropathy, the severity of which is dose dependent.
4. Do not breastfeed during taking this drug.
5. Immediately report to physician S&S of paclitaxel hypersensitivity.
6. Avoid aspirin, NSAIDs, and alcohol to minimize GI distress.

Reference
https://go.drugbank.com/drugs/DB01229

https://www.rxlist.com/taxol-drug.htm
https://www.pdr.net/drug-summary/Paclitaxel-paclitaxel-1299
eference.medscape.com/drug/taxol-paclitaxel-34218
(Retrieved on October 3)
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