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Taxane chemotherapy

Paclitaxel (Specialist drug)

Brand names: Taxol, Abraxane (nab-paclitaxel)

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC
Route: IV
Frequency: per protocol

Clinical pearls

  • Breast, ovarian, NSCLC, pancreatic; nab-paclitaxel does not require routine steroid pre-medication

Contraindications

  • Severe myelosuppression
  • Severe hypersensitivity to castor oil (Taxol — Abraxane has different vehicle)
  • Pregnancy

Side effects

  • Hypersensitivity reactions (Taxol — pre-medicate with steroid + antihistamine)
  • Severe myelosuppression
  • Peripheral neuropathy
  • Alopecia
  • Cardiotoxicity (rare)

Interactions

  • Strong CYP3A4/2C8 modulators
  • Trastuzumab (cardiac additive)
  • Live vaccines

Monitoring

  • FBC
  • LFTs
  • Neurological exam
  • Cardiac function

Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/paclitaxel-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.