Taxane Chemotherapy Pregnancy: Contraindicated in pregnancy — cytotoxic

Docetaxel

Brand names: Taxotere

Adult dose

Dose: 75 mg/m2 IV every 3 weeks (prostate cancer); 60-100 mg/m2 (other cancers)

Route: Intravenous infusion (over 1 hour)

Frequency: Every 3 weeks for up to 10 cycles (prostate cancer)

Max: 75 mg/m2 per cycle (prostate cancer)

Premedicate with dexamethasone 8 mg twice daily for 3 days starting day before (reduces fluid retention and hypersensitivity). G-CSF support may be needed

Paediatric dose

Dose: Seek specialist opinion N/A/kg

Route: IV

Frequency: Seek specialist opinion

Max: Seek specialist opinion

Seek specialist opinion

Dose adjustments

Renal

No dose adjustment required for renal impairment

Hepatic

Reduce dose or avoid in hepatic impairment — hepatically metabolised; elevated bilirubin or transaminases are relative contraindications

Paediatric weight-based calculator

Patient weight (kg)

Seek specialist opinion

Clinical pearls

STAMPEDE and CHAARTED trials: Early docetaxel addition to ADT in high-volume metastatic prostate cancer improves overall survival — now standard of care per NICE NG131
Fluid retention is managed with prophylactic dexamethasone premedication — mandatory; patients who skip dexamethasone are at risk of severe oedema
Febrile neutropenia is a medical emergency — teach patients to seek urgent assessment for fever above 37.5°C during neutrophil nadir (day 8-14)
Peripheral neuropathy can be cumulative and persistent — dose reduction or delay required if grade 2 or above neuropathy develops
G-CSF (filgrastim) reduces febrile neutropenia risk — consider in high-risk patients (age over 65, comorbidities, prior chemotherapy)

Contraindications

Severe hepatic impairment
Neutrophil count under 1.5 x 10^9/L
Hypersensitivity to docetaxel or polysorbate 80

Side effects

Neutropenia (dose-limiting, febrile neutropenia risk)
Alopecia (universal)
Peripheral neuropathy
Fluid retention and oedema (peripheral, pleural, ascites)
Nail changes
Mucositis
Fatigue
Hypersensitivity reactions (infusion)

Interactions

CYP3A4 inhibitors (ketoconazole, clarithromycin — increase docetaxel exposure)
CYP3A4 inducers (rifampicin — reduce efficacy)
Ciclosporin (increases exposure)

Monitoring

FBC before each cycle (delay if neutrophils under 1.5)
LFTs
Peripheral neuropathy assessment
Fluid balance and oedema
Cumulative neurotoxicity

Reference: BNFc; BNF 90; NICE NG131 (Prostate Cancer); STAMPEDE Trial; CHAARTED Trial; EAU Guidelines 2024. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Paclitaxel (Specialist drug) · Taxane chemotherapy

Pathways