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Taxane Chemotherapy 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 a taxane cytotoxic chemotherapy agent used in urological oncology, notably in metastatic and high-risk prostate cancer, usually combined with androgen deprivation therapy or corticosteroid.

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: Castration-resistant prostate cancer (CRPC): 75 mg/m2 with prednisone 5 mg orally twice a day continuously
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
Urology context - leading regimen shown is CRPC. 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). Other labelled indications: locally advanced/metastatic breast cancer 60-100 mg/m2 single agent; adjuvant breast cancer 75 mg/m2 with 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 with cisplatin 75 mg/m2; gastric and head/neck cancers 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 and arresting cells in mitosis, leading to apoptosis of dividing tumour cells.

Prescribing in practice

  • Severe neutropenia and neutropenic sepsis are the principal life-threatening risks, so febrile illness must be treated as a medical emergency.
  • Fluid retention and hypersensitivity reactions occur, and corticosteroid premedication is used to reduce these.
  • Peripheral neuropathy and nail changes are common cumulative toxicities.

Monitoring

Monitor full blood count before each cycle and review for neuropathy, fluid retention and hypersensitivity throughout treatment.

Counselling the patient

  • Seek urgent medical care for fever, rigors or feeling unwell, which may signal a serious infection.
  • Report swelling, breathlessness, numbness or tingling in the hands and feet.
  • Take any prescribed steroid premedication exactly as instructed.

Evidence & guidelines

Landmark trials including TAX 327 and the STAMPEDE/CHAARTED programmes established docetaxel's survival benefit in prostate cancer.

Reference: NICE NG131 (Prostate Cancer); STAMPEDE Trial; CHAARTED Trial; EAU Guidelines 2024; 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).

Related

Curated clinical cross-links plus same-class fallbacks.

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