Docetaxel

Brand name: Taxotere®  

Generic name: Docetaxel  

Therapeutic Class: plant alkaloid, taxane and antimicrotubule agent 

Manufacturer / Distributor: Sanofi Aventis 

Availability: Docetaxel is available by prescription only  

FDA Approval: Docetaxel (Docetaxel injection) was approved by the US Food and Drug Administration (FDA) in October 2006 for the treatment of inoperable, locally advanced head and neck cancers (the drug is used for other conditions, see indication).  

Indication: Docetaxel is used alone or in combination with other chemotherapy drugs to treat the following cancers: 

• breast cancer (certain types)
• head and neck cancer 
• non-small cell lung cancer 
• advanced stomach cancer 
• metastatic prostate cancer 
• Ovarian cancer.  

Docetaxel may be used in the treatment of other medical conditions; ask your doctor or pharmacist for more information. 

Dosage form: Docetaxel is given by injection into a vein 

Dosage: to determine a dose capable of fighting your cancer, your oncologist will consider your age, health status, and body surface area (BSA). If you are undergoing radiation therapy or taking other medications, you will be prescribed a lower dosage of Docetaxel. Docetaxel is always associated with adverse reactions. Before receiving the injection, your physician may give you a drug (dexamethasone for instance) that will alleviate the symptoms of these adverse effects. Therefore, it is you experience any unexpected or adverse reactions during the therapy, see your doctor immediately.  Certain Docetaxel adverse reactions can be life threatening.  

The risk of complications is higher for patients who had liver disease or have been treated with cisplatin (Platinol) or carboplatin (Paraplatin).  

Usually, Docetaxel is injected into a vein from an injection site on the skin that has been prepared beforehand. The injection is given once every 3 weeks and lasts approximately 1 hour. Docetaxel should be given by an oncologist or health care professional that has experience in chemotherapy drugs. In addition, It is recommended that Docetaxel is administered in a hospital or a health center having sterilization material for its preparation. 

Overdose: Docetaxel is given in hospital by professionals; the risk of overdose is very difficult.  However, accidental overdose can happen. An overdose of Docetaxel can cause a decrease in the number of blood cells in the bone marrow, and lead to severe health problems or death.  Even in the absence of overdose, Docetaxel can cause severe allergic reactions and fluid retention. Before starting the treatment, tell your doctor all details about your medical history. During and after the treatment, compliance with all appointments with your doctor is necessary. Regular testing can help detect abnormalities in early stage before they become life threatening conditions.    

Missing dose - Docetaxel is administered in hospital; it is basically difficult for you to miss any dose if you keep all appointments of your doctor. If for some reasons you cannot go to the hospital for the treatment, contact your oncologist before the date scheduled for the injection. Any missing dose of Docetaxel can affect the entire therapy.  

Contraindication: Docetaxel is contraindicated or not recommended in these conditions: 

·         allergy to Docetaxel or to any of its components 

·         pregnancy  

·         breast-feeding 

·         fluid retention (oedema)

·         low number of white blood  

·         severe hepatic impairment.  

Mechanism of action (MOA): Docetaxel is a taxane; it stops the growth and spread of cancer cells by interfering with their DNA, a genetic material necessary for the growth and reproduction of living cells. 

Interactions:  if you are taking Docetaxel, it is not safe to take aspirin, vitamins, nutritional supplements or St. John's wort without first talking to your doctor. Certain substances can interact with Docetaxel, and cause health problems. Tell your doctor or pharmacist if you are taking any of these medications:   

• Doxorubicin
• Vaccines 
• Cyclosporine  
• Erythromycin  
• Terfenadine 
• Carboplatin 
• Cisplatin 
•  Ketoconazole.  

Side effects: In addition to attacking cancer cells, Docetaxel may interfere with healthy cells that multiply quickly, and cause a number of adverse reactions in most patients. Most common Docetaxel side effects include:

• weight loss 
• hair loss 
• tiredness
• weakness 
• diarrhea 
• dry mouth  
• constipation 
• nausea and vomiting 
• sores on your lips or mouth  
• dry mouth 
• change in taste 
• decreased appetite 
• darkening of skin 
• skin rash 
• muscle or limb pain
• redness or swelling at the injection site
• White horizontal discoloration of the nail plate.

If the side effects above persist for weeks, contact your oncologist. Also, contact your doctor if you experience any of these symptoms: 

• nosebleeds 
• blistering skin 
• weakness in the hands and feet 
• unusual bleeding or bruising 
• numbness, tingling, or burning sensation in the hands or feet  
• fast or irregular heart beat 
• black or tarry stools 
•  blood in urine 
• severe shortness of breath  
• severe pain in the lower back or along the side accompanied with fever or chills 
• chest pain  
• rash occurring during or shortly after your treatment 
•  difficulty breathing at rest 
• Cough or hoarseness accompanied with fever and/or chills.