Taxane (microtubule inhibitor, specialist) Pregnancy: Can cause fetal harm based on animal reproduction studies and mechanism of action; also contains alcohol which can interfere with neurobehavioral development. Advise pregnant women and females of reproductive potential of the potential risk to a fetus.

Docetaxel

Brand names: Taxotere

Docetaxel is an intravenous taxane cytotoxic chemotherapy agent used by oncology specialists to treat solid tumours including breast, non-small-cell lung, prostate, gastric and head-and-neck cancers.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 60 mg/m2 to 100 mg/m2 as a single agent (locally advanced or metastatic breast cancer after failure of prior chemotherapy)

Route: Intravenous infusion over 1 hour (PVC equipment not recommended)

Frequency: Every 3 weeks

Max: Dose is body-surface-area based (mg/m2); toxicities may warrant dosage reductions per label section 2.7

US FDA labelling (verify against UK SPC - no UK SPC posology available in bundle). Premedicate with oral corticosteroids and administer in a facility equipped to manage possible complications (e.g. anaphylaxis). Indication-specific regimens: breast cancer (adjuvant, node-positive) 75 mg/m2 given 1 hour after doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 every 3 weeks for 6 cycles; NSCLC after platinum failure 75 mg/m2 single agent; NSCLC chemotherapy-naive 75 mg/m2 followed by cisplatin 75 mg/m2; castration-resistant prostate cancer (CRPC) 75 mg/m2 with prednisone 5 mg twice daily continuously; gastric cancer 75 mg/m2 with cisplatin 75 mg/m2 (day 1) then fluorouracil 750 mg/m2/day 24-hour IV days 1-5; head and neck (SCCHN) 75 mg/m2 with cisplatin then fluorouracil per protocol. Reduce dose or avoid concomitant potent CYP3A4 inhibitors. Efficacy in paediatric patients has not been established.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known severe hypersensitivity to docetaxel or to other drugs formulated with polysorbate 80 (anaphylaxis has occurred)
Neutrophil counts of <1500 cells/mm3

Side effects

Neutropenia / febrile neutropenia; anaemia; thrombocytopenia; infections
Hypersensitivity reactions
Fluid retention
Peripheral neuropathy; asthenia
Nausea, vomiting, diarrhoea, mucositis; alopecia, nail disorders, skin reactions; myalgia

Interactions

Potent CYP3A4 inhibitors (e.g. ketoconazole) - increase docetaxel exposure; avoid concomitant use
Protease inhibitors, particularly ritonavir - may increase docetaxel exposure
CYP3A4 inducers, inhibitors or substrates - may alter docetaxel metabolism

Clinical monograph

How it works

It binds tubulin and stabilises microtubules, preventing their depolymerisation; this disrupts mitotic spindle function and arrests cells in mitosis, leading to apoptosis of dividing cells.

Prescribing in practice

Severe hypersensitivity reactions and fluid retention can occur, so corticosteroid premedication is mandatory and infusion should take place under close supervision with resuscitation facilities available.
Febrile neutropenia is a major dose-limiting toxicity; withhold treatment if the neutrophil count is inadequate and counsel on infection precautions.
Reduce or avoid dosing in significant hepatic impairment, which increases toxicity, and monitor for peripheral neuropathy and nail changes.

Monitoring

Monitor full blood count before each cycle, plus liver function, fluid status and for hypersensitivity, neuropathy and skin/nail toxicity throughout treatment.

Counselling the patient

Take the corticosteroid tablets exactly as directed before each infusion to reduce allergic and fluid-retention reactions.
Seek urgent help for any fever or signs of infection between cycles.
Report swelling, tingling or numbness in the hands and feet, or mouth ulcers.

Evidence & guidelines

Docetaxel is an established taxane chemotherapy with efficacy across multiple solid tumours demonstrated in randomised trials and incorporated into NICE technology appraisals and oncology protocols.

Reference: multiple NICE TAs; ESMO; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways